2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Sierra_Leone_2022_country_profile_10页_277kb

报告摘要

Summary of Sierra Leone's 2022 TrACSS Country Report

Core Content

The Tracking AMR Country Self-Assessment Survey (TrACSS) is a global initiative aimed at monitoring the implementation of National Action Plans on Antimicrobial Resistance (NAPs). In 2022, Sierra Leone participated in the survey, which evaluates progress across key sectors: Human Health, Animal Health, Food and Agriculture, and Environment. The survey uses a five-point rating scale (A to E), with A-B indicating limited capacity and C-E representing nationwide implementation.

Sierra Leone is classified as a low-income country by the World Bank, with a population of approximately 8.14 million. The report highlights the country's challenges in addressing Antimicrobial Resistance (AMR), which is a critical global health threat, contributing to nearly 5 million deaths globally in 2019, with 1.27 million directly linked to AMR.

Key Indicators and Country Status

Human Health

Training and Education on AMR: Limited progress (rating B).
Monitoring Antimicrobial Consumption: Mixed progress (rating C-B-A-A-B).
National Surveillance System for AMR: Developed (rating A).
Infection Prevention and Control (IPC): Limited progress (rating B).
Optimizing Antimicrobial Use: Developed (rating C).
Adoption of AWaRe Classification: Not yet implemented.
Lab and Diagnostics Capacity:
- AST for 11 critical bacteria: Yes, with at least one reference lab.
- Continuity of services for clinical labs: Yes, with stockout reporting.
- Standardized AST guidelines: Partially used.
- External Quality Assurance (EQA) Programme: Not implemented.

Animal Health

Training and Professional Education on AMR: Limited (rating A-B-B).
National Surveillance System for AMR in Live Animals: Not yet established (rating B).
Effective Integration of Laboratories in AMR Surveillance: Limited (rating B).
Biosecurity and Good Animal Husbandry Practices: Limited progress.

Food and Agriculture

Training and Education on AMR: Limited (rating B).
National Surveillance System for AMR in Food Systems: Not yet established.
Integration of Laboratories in AMR Surveillance: Limited (rating B).
Good Manufacturing and Hygiene Practices: Limited progress.
Optimizing Antimicrobial Pesticide Use: Limited progress.

Environment

National Risk Assessment for AMR Residues: Not yet implemented.
Legislation to Prevent Environmental Contamination: Not yet implemented.
System for Monitoring AMR in Water Quality: Not yet established.

Global Comparison

Sierra Leone's responses are generally below the global average across most indicators, highlighting the need for significant improvements in capacity building, policy development, surveillance systems, and data utilization.

Key Messages

Human Health

Ensure AMR NAPs are inclusive, addressing gender, equity, and vulnerable populations.
Systematic training of healthcare workers on AMR and antimicrobial stewardship is crucial.
Develop national antimicrobial consumption monitoring systems to support legislative enforcement and data-driven decision-making.
Strengthen infection prevention and control (IPC) and laboratory capacity for AMR surveillance.

Animal Health

Formalize AMR education in veterinary and aquatic animal health curricula.
Establish national AMR surveillance systems for both terrestrial and aquatic animals.
Promote biosecurity and good husbandry practices to reduce antimicrobial use.
Ensure laboratory integration in AMR surveillance, coordinated by a National Reference Laboratory.

Food and Agriculture

Enhance AMR training and education across all sectors (agriculture, food production, environment).
Implement national AMR surveillance systems for food and agricultural systems.
Promote prudent use of antimicrobials through good manufacturing and hygiene practices.
Support the FAO's InFARM platform for data collection and analysis.
Encourage public-private partnerships and innovative technologies to reduce antimicrobial use.

Environment

Include environmental concerns in One Health strategies.
Conduct risk assessments to inform legislation and policy on AMR.
Monitor water quality for antimicrobial residues and resistant genes (ARGs).
Address pollution sources such as wastewater, solid waste, and agricultural runoff.

Challenges and Recommendations

Limited financial and human resources, technical capacity, and inconsistent political commitment are major barriers to AMR NAP implementation.
Programmatic approach is needed for effective NAP implementation, moving away from ad-hoc interventions.
Integration of AMR planning into existing national strategies and budgets is essential for sustainability.
Formalized multisector coordination with dedicated leadership and funding is required.
Nationwide awareness campaigns and youth education on AMR should be prioritized.
Data quality and use should be enhanced, with 60% of countries using antimicrobial consumption data and 65% using AMR data for decision-making.