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Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission

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dc.contributor.author Nadimpalli, Maya L.
dc.contributor.author Marks, Sara J.
dc.contributor.author Montealegre, Maria Camila
dc.contributor.author Gilman, Robert H.
dc.contributor.author Pajuelo, Monica J.
dc.contributor.author Saito, Mayuko
dc.contributor.author Tsukayama, Pablo
dc.contributor.author Njenga, Sammy M.
dc.contributor.author Kiiru, John
dc.contributor.author Swarthout, Jenna
dc.contributor.author Islam, Mohammad Aminul
dc.contributor.author Julian, Timothy R.
dc.contributor.author Pickering, Amy J.
dc.date.accessioned 2020-07-14T00:02:35Z
dc.date.available 2020-07-14T00:02:35Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/8348
dc.description.abstract Antimicrobial resistance (AMR) is a growing public health challenge that is expected to disproportionately burden lower- and middle-income countries (LMICs) in the coming decades. Although the contributions of human and veterinary antibiotic misuse to this crisis are well-recognized, environmental transmission (via water, soil or food contaminated with human and animal faeces) has been given less attention as a global driver of AMR, especially in urban informal settlements in LMICs—commonly known as ‘shanty towns’ or ‘slums’. These settlements may be unique hotspots for environmental AMR transmission given: (1) the high density of humans, livestock and vermin living in close proximity; (2) frequent antibiotic misuse; and (3) insufficient drinking water, drainage and sanitation infrastructure. Here, we highlight the need for strategies to disrupt environmental AMR transmission in urban informal settlements. We propose that water and waste infrastructure improvements tailored to these settings should be evaluated for their effectiveness in limiting environmental AMR dissemination, lowering the community-level burden of antimicrobial-resistant infections and preventing antibiotic misuse. We also suggest that additional research is directed towards developing economic and legal incentives for evaluating and implementing water and waste infrastructure in these settings. Given that almost 90% of urban population growth will occur in regions predicted to be most burdened by the AMR crisis, there is an urgent need to build effective, evidence-based policies that could influence massive investments in the built urban environment in LMICs over the next few decades. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof urn:issn:2058-5276
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Antimicrobial resistance en_US
dc.subject Environmental microbiology en_US
dc.subject Infectious diseases en_US
dc.subject Policy and public health in microbiology en_US
dc.subject Risk factors en_US
dc.title Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1038/s41564-020-0722-0
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.01


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