Search Results (63)

Background: Antibiotic resistance (AMR) is a critical global and national health challenge, largely driven by the misuse and overuse of antibiotics. Understanding the public′s knowledge and practices regarding antibiotic use is essential for informing effective interventions. This study aimed to assess the levels of knowledge, attitude, and practice (KAP) related to antibiotic use among adults in Saudi Arabia’s Western Region and to identify the demographic and behavioral determinants of these outcomes. Methods: A regional cross-sectional survey was conducted from March to June 2025 using a 40-item self-administered online questionnaire. Adults aged ≥ 18 years residing in the Western Region of Saudi Arabia were recruited via social media using snowball sampling. Descriptive statistics and Chi-square tests were used to examine associations, while multivariate logistic regression was employed to identify determinants of high knowledge and good practices, presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: A total of 891 participants were included; most were female (63.6%) and aged 18–30 years (56.2%). Moderate knowledge of antibiotic use was observed in 54.0% of participants, while 30.8% had high knowledge. In terms of attitude and practice, 55.6% demonstrated good performance and 42.8% average performance. High knowledge was significantly associated with the female gender (aOR = 1.90; 95% CI: 1.34–2.70), age of 41–50 years (aOR = 2.22; 95% CI: 1.42–3.48), and a postgraduate education (aOR = 15.37; 95% CI: 1.84–128.13). Good practices were associated with the female gender (aOR = 2.32; 95% CI: 1.66–3.24) and being married (aOR = 1.99; 95% CI: 1.43–2.77). A moderate positive correlation was found between knowledge and practice scores (r = 0.406, p < 0.001). Conclusions: Significant variability in public KAP regarding antibiotic use was identified. Female gender, older age, and higher education were key determinants of better KAP. These findings emphasize the need for targeted educational strategies focusing on high-risk groups to support rational antibiotic use and mitigate antimicrobial resistance. Full article

Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities. Full article

The opioid drug overdose death rate remains a significant public health crisis in the U.S., where an opioid epidemic has led to a dramatic rise in overdose deaths over the past two decades. Since 1999, opioids have been implicated in approximately 75% of the nearly one million drug-related deaths. Research indicates that the epidemic is caused by both over-prescribing and social and psychological determinants such as economic stability, hopelessness, and social isolation. Impeding this research is the lack of measurements of these social and psychological constructs at fine-grained spatial and temporal resolution. To address this issue, we sourced data from Reddit, where people share self-reported experiences with opioid substances, specifically using opioid drugs through different routes of administration. To achieve this objective, an opioid overdose dataset is created and manually annotated in binary and multi-classification, along with detailed annotation guidelines. In traditional manual investigations, the route of administration is determined solely through biological laboratory testing. This study investigates the efficacy of an automated tool leveraging natural language processing and transformer model, such as RoBERTa, to analyze patterns of substance use. By systematically examining these patterns, the model contributes to public health surveillance efforts, facilitating the identification of at-risk populations and informing the development of targeted interventions. This approach ultimately aims to enhance prevention and treatment strategies for opioid misuse through data-driven insights. The findings show that our proposed methodology achieved the highest cross-validation score of 93% for binary classification and 91% for multi-class classification, demonstrating performance improvements of 9.41% and 10.98%, respectively, over the baseline model (XGB, 85% in binary class and 81% in multi-class). Full article

Background: Antibiotic resistance (AR) is a global public health crisis, largely driven by the misuse and overuse of antibiotics. This study aimed to assess the level of knowledge, attitude, and practice (KAP) toward AR among non-medical university students in Riyadh, Saudi Arabia and identify factors that influence antibiotic use. Methods: A cross-sectional survey was conducted with 672 students from both public and private universities in Riyadh. Data were collected using a self-administered questionnaire covering sociodemographic characteristics and KAP regarding antibiotics. Results: The findings indicated that 59.1% of students had sufficient knowledge of antibiotics, while 60% had positive attitudes, and 60.6% exhibited responsible practices. However, 40.9% of students demonstrated insufficient knowledge, and factors such as age, gender, and field of study significantly impacted KAP outcomes. Females had 65.8% higher odds of demonstrating a positive attitude toward AR prevention, compared to males, and 52% higher odds of adopting appropriate practices than males. The primary source of information on antibiotics was healthcare professionals, particularly doctors. Conclusions: These findings underscore the need for targeted educational interventions to enhance awareness and promote the responsible use of antibiotics among university students, helping to mitigate the threat of antibiotic resistance. Full article

Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed to explore the perceived barriers and enablers of community pharmacists’ participation in AMS. One-on-one semi-structured telephone interviews were conducted with a sample of community pharmacists from across Australia. Interviews were transcribed verbatim and analysed using the Framework Analysis method. Twenty community pharmacists (70% female), representing urban, regional, and remote areas of Australia participated in the study. Pharmacists identified a discord between clinical needs of patients and practice policies as the primary source of excessive prescribing and dispensing of antibiotics. The fragmented nature of the primary healthcare system in Australia was seen as limiting information exchange between community pharmacists and general practitioners about antibiotic use, that was encouraging inappropriate and, at times, unsupervised use of antibiotics. The existing community pharmacy funding model in Australia, where individual pharmacists do not benefit from any financial incentives associated with clinical interventions, was also discouraging their participation in AMS. Pharmacists suggested restricting default antibiotic repeat supplies, reducing legal validity of antibiotic prescriptions to less than the current 12 months, and adopting a treatment duration-based approach to antibiotic prescribing instead of the ‘quantity-based’ approach, where the quantity prescribed is linked to the available pack size of the antibiotic. Structural changes in the way antibiotics are prescribed, dispensed, and funded in the Australian primary care setting are urgently needed to discourage their misuse by the public. Modifications to the current funding model for pharmacist-led cognitive services are needed to motivate pharmacists to participate in AMS initiatives. Full article

Antimicrobial resistance (AMR) poses a significant threat to human, animal, and public health, particularly in Sub-Saharan Africa (SSA), where the beef sector is vital to food security and livelihoods. We conducted a scoping review to explore the determinants and impacts of AMR within the beef value chain in SSA, highlighting the challenges and progress in mitigating AMR risks in livestock production. This review identifies key factors contributing to AMR, including the overuse and misuse of antimicrobials, inadequate veterinary oversight, and weak regulatory frameworks. These practices are prevalent across various stages of the beef value chain, from farm to slaughterhouse, and are exacerbated by informal markets and insufficient infrastructure. Our findings also highlight the role of environmental factors, such as contamination of feed, water, and manure, in the spread of resistant pathogens. Additionally, gaps in AMR surveillance, education, and enforcement limit effective control measures in the region. While efforts to combat AMR have gained momentum in some countries, including the development of national action plans and surveillance systems, substantial challenges remain. These include poor adherence to antimicrobial guidelines, insufficient veterinary training, and the lack of integration between sectors. There is a need for targeted research to better understand antimicrobial misuse, socio-economic drivers, and the environmental pathways of AMR, as well as the need for stronger regulatory frameworks and cross-border cooperation. Addressing these challenges will be essential to safeguarding food safety, public health, and the sustainability of the beef industry in SSA. Full article

Background/Objectives: The misuse of veterinary drugs is a growing concern, with increasing evidence of their presence in illicit drug markets and their use as alternatives to traditional substances. Methods: This study explores Reddit discussions on the misuse of veterinary drugs on Reddit, focusing on xylazine, carfentanil, medetomidine, pentobarbital, phenylbutazone, and acepromazine. Reddit was utilised for its abundant real-time data on users’ thoughts and experiences with substance misuse. Through a combination of manual and Artificial Intelligence (AI)-driven thematic analysis, we examined posts and comments to explore patterns of misuse. Results: The themes analysed included adverse effects, polysubstance misuse, routes of administration, motivations for misuse, and methods of obtaining these drugs. Our findings revealed that xylazine, medetomidine, carfentanil, and pentobarbital exhibit significant potential for misuse, while phenylbutazone and acepromazine are not widely misused. Despite this, phenylbutazone and acepromazine have been identified as adulterants in the illicit drug supply in the United States. The most discussed themes included motivations for misuse, followed by public experiences and perceptions, as well as adverse effects. Conclusions: The dual-method approach of combining manual interpretation with AI analysis allowed for a comprehensive understanding of social media discussions. This research highlights the importance of monitoring online platforms for early indicators of emerging drug trends, offering valuable insights to inform public health policies and intervention strategies. Impact Statement: This research highlights the growing public health risk posed by veterinary drug misuse, underscoring the need for enhanced monitoring, regulatory frameworks, and education to address their diversion into illicit markets. By leveraging social media as an early detection tool for emerging drug trends, our findings can inform targeted interventions. Full article

With the development of genome sequencing technologies, the amount of data produced has greatly increased in the last two decades. The abundance of digital sequence information (DSI) has provided research opportunities, improved our understanding of the genome, and led to the discovery of new solutions in industry and medicine. It has also posed certain challenges, i.e., how to store and handle such amounts of data. This, coupled with the need for convenience, international cooperation, and the possibility of independent validation, has led to the establishment of numerous databases. Spearheaded with the idea that data obtained with public funds should be available to the public, open access has become the predominant mode of accession. However, the increasing popularity of commercial genetic tests brings back the topic of data misuse, and patient’s privacy. At the previous United Nations Biodiversity Conference (COP15, 2022), an issue of the least-developed countries exploiting their natural resources while providing DSI and the most-developed countries benefitting from this was raised. It has been proposed that financial renumeration for the data could help protect biodiversity. With the goal of introducing the topic to those interested in utilizing biological databases, in this publication, we present the history behind the biological databases, their necessity in today’s scientific world, and the issues that concern them and their content, while providing scientific and policy context in relation to United Nations Biodiversity Conference (COP16, 21.10—1.11.24). Full article

In recent years, the off-label use of medications in sports has increased significantly, primarily driven by psychological and social factors. Athletes frequently misuse drugs without adequate medical supervision, relying on unreliable sources of information, which leads to improper usage and serious health risks. This narrative review analyzes literature from PubMed^® (Medline), Scopus^®, and Web of Science^® databases, focusing on studies up to December 2023, to examine the safety concerns related to off-label drug use in sports. The review presents an overview of the off-label use of pharmacological substances by athletes, focusing on both hormonal and non-hormonal drugs. Hormonal substances such as anabolic steroids and growth hormones, and non-hormonal agents like diuretics and β2-agonists, are frequently abused. These practices are associated with severe side effects, including infections, cardiovascular complications, hormonal imbalances, psychological disorders, dependence, and even cases of death. The study emphasizes the need for stronger regulation, public awareness initiatives, and preventive strategies to mitigate the health risks associated with this growing trend. Full article

Background/Objectives: The emergence of antimicrobial resistance (AMR) due to the misuse and overuse of antibiotics has become a critical threat to global public health. There is a dire need to forecast AMR to understand the underlying mechanisms of resistance for the development of effective interventions. This paper explores the capability of machine learning (ML) methods, particularly unsupervised learning methods, to enhance the understanding and prediction of AMR. It aims to determine the patterns from AMR gene data that are clinically relevant and, in public health, capable of informing strategies. Methods: We analyzed AMR gene data in the PanRes dataset by applying unsupervised learning techniques, namely K-means clustering and Principal Component Analysis (PCA). These techniques were applied to identify clusters based on gene length and distribution according to resistance class, offering insights into the resistance genes’ structural and functional properties. Data preprocessing, such as filtering and normalization, was conducted prior to applying machine learning methods to ensure consistency and accuracy. Our methodology included the preprocessing of data and reduction of dimensionality to ensure that our models were both accurate and interpretable. Results: The unsupervised learning models highlighted distinct clusters of AMR genes, with significant patterns in gene length, including their associated resistance classes. Further dimensionality reduction by PCA allows for clearer visualizations of relationships among gene groupings. These patterns provide novel insights into the potential mechanisms of resistance, particularly the role of gene length in different resistance pathways. Conclusions: This study demonstrates the potential of ML, specifically unsupervised approaches, to enhance the understanding of AMR. The identified patterns in resistance genes could support clinical decision-making and inform public health interventions. However, challenges remain, particularly in integrating genomic data and ensuring model interpretability. Further research is needed to advance ML applications in AMR prediction and management. Full article

Foodborne pathogens cause around 47.8 million illnesses in the U.S. annually, with antimicrobial misuse in food production, particularly in poultry processing, contributing significantly to this public health challenge. Misuse of antimicrobials can contribute to antimicrobial resistance (AMR) and make the treatment of pathogens increasingly difficult. This emphasizes the need to investigate antimicrobial resistance in U.S. poultry. This study analyzes data from the NCBI Pathogen Isolates Browser (2015–2023) to explore the relationships between antimicrobial-resistant pathogens, AMR genes, and antimicrobials detected with resistance in pathogens isolated from chicken and turkey. Using principal component analysis and hierarchical clustering, we mapped and profiled regional and temporal patterns of antimicrobial resistance. Salmonella enterica was the most prevalent antimicrobial-resistant pathogen across both chicken and turkey, with notable outbreaks, particularly in the Northeast. Antimicrobial-resistant Campylobacter jejuni was more prevalent in chicken, particularly in California and Georgia, while Escherichia coli and Shigella were more prominent in turkey, with concentrated antimicrobial resistance in Texas for pathogen samples isolated from chicken. Resistance to tetracycline and streptomycin was widespread, with distinct regional clusters: antimicrobial resistance was concentrated in states like Minnesota for pathogens isolated from chicken, while AMR found in pathogens isolated from turkey was more evenly distributed across the Midwest. Key AMR genes, such as tet(A), mdsA, and mdsB, also followed similar patterns, peaking in 2019 and significantly declining by 2022. The observed decline in AMR cases may be linked to improved biosecurity measures and disruptions in detection due to the COVID-19 pandemic. This comprehensive study of antimicrobial resistance in U.S. poultry provides valuable insights into resistance trends, which provide useful information to inform targeted interventions and policies to mitigate AMR threats in the poultry production industry. For consumers, these findings emphasize the importance of proper food handling and cooking practices to reduce the risk of exposure to resistant pathogens. Regulatory authorities should focus on enforcing stricter antimicrobial usage policies and enhancing surveillance systems to sustain the reduction in AMR cases. Full article

Background: The opioid crisis remains a significant public health challenge in North America, highlighted by the substantial need for tools to analyze and understand opioid potency and prescription patterns. Methods: The OralOpioids package automates the retrieval, processing, and analysis of opioid data from Health Canada’s Drug Product Database (DPD) and the U.S. Food and Drug Administration’s (FDA) National Drug Code (NDC) database. It includes functions such as load_Opioid_Table, which integrates country-specific data processing and Morphine Equivalent Dose (MED) calculations, providing a comprehensive dataset for analysis. The package facilitates a comprehensive examination of opioid prescriptions, allowing researchers to identify high-risk opioids and patterns that could inform policy and healthcare practices. Results: The integration of MED calculations with Canadian and U.S. data provides a robust tool for assessing opioid potency and prescribing practices. The OralOpioids R package is an essential tool for public health researchers, enabling a detailed analysis of North American opioid prescriptions. Conclusions: By providing easy access to opioid potency data and supporting cross-national studies, the package plays a critical role in addressing the opioid crisis. It suggests a model for similar tools that could be adapted for global use, enhancing our capacity to manage and mitigate opioid misuse effectively. Full article

DNA-based biosensors have emerged as cutting-edge tools with significant potential to revolutionize medical diagnostics and environmental monitoring. These biosensors leverage the specificity and sensitivity of DNA interactions to detect a wide range of biomolecular targets, making them ideal for early disease detection, genetic analysis, and real-time environmental assessment. Despite their promising applications, several challenges impede their widespread adoption. Key issues include the stability of DNA molecules, which are prone to degradation under environmental conditions, and the need for enhanced specificity and sensitivity to accurately detect target molecules in complex samples. Technological hurdles in miniaturizing and integrating these sensors into portable, user-friendly devices, along with ethical concerns regarding data privacy and the misuse of genetic information, also pose significant barriers. This systematic review examines the current state of DNA-based biosensor technology, highlights the main challenges, and discusses potential strategies to overcome these obstacles. By addressing these multifaceted issues through ongoing research and innovation, DNA-based biosensors can be developed into robust tools for various applications, contributing to improved public health outcomes and environmental sustainability. Full article

Antimicrobial resistance (AMR) is a public health problem exacerbated by the overuse and misuse of antibiotics and the inadequate capacity of laboratories to conduct AMR surveillance. This study assessed the capacity of laboratories in seven faith-based hospitals to conduct AMR testing and surveillance in Zambia. This multi-facility, cross-sectional exploratory study was conducted from February 2024 to April 2024. We collected and analysed data using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. This study found an average score of 39%, indicating a low capacity of laboratories to conduct AMR surveillance. The highest capacity score was 47%, while the lowest was 25%. Only one hospital had a full capacity (100%) to utilise a laboratory information system (LIS). Three hospitals had a satisfactory capacity to perform data management with scores of 83%, 85%, and 95%. Only one hospital had a full capacity (100%) to process specimens, and only one hospital had good safety requirements for a microbiology laboratory, with a score of 89%. This study demonstrates that all the assessed hospitals had a low capacity to conduct AMR surveillance, which could affect diagnostic stewardship. Therefore, there is an urgent need to strengthen the microbiology capacity of laboratories to enhance AMR surveillance in Zambia. Full article

The use, misuse, and overuse of antimicrobials is one of the main public health threats of the 21st century. We investigated the risk factor of the presence of extended-spectrum, cephalosporin-resistant Enterobacterales in feces of non-domestic and domestic birds and other domestic animals in Piauí State, northeast Brazil. We collected a total of 387 cloacal and rectal swab samples of free-living birds, domestic birds, and domestic mammals in five municipalities: Amarante, Água Branca, Lagoa Alegre, Parnaíba, and Teresina. A total of 59/387 (15.2%) of these samples harbored extended spectrum beta-lactamase (ESBL)-producing Enterobacterales. Using the MALDI-TOF technique, we identified fifty-seven samples as Escherichia coli and two samples as Klebsiella pneumoniae. Teresina and Parnaíba had the highest prevalence of animals with resistant bacteria (32.1% and 27.1%, respectively) and highest exposure risk factor (OR of 16.06 and 8.58, respectively, and p < 0.001 for all). Multidrug-resistant, ESBL-producing Enterobacterales were observed in 72.8% of the samples (43/59). For the free-living birds, the positive samples belonged to a great kiskadee (Pitangus sulphuratus) and a semipalmated sandpiper (Calidris pusilla) in migratory and resident species, respectively. For domestic animals, the swine samples showed the highest prevalence of antimicrobial resistance. The lack of access to veterinary care and information regarding antimicrobial therapy, along with the easy access to antimicrobials without medical prescription, favors the inadequate use of antimicrobials in Piauí. Full article