2022-10-30-世界卫生组织-Antimicrobial_resistance_TrACSS_Central_African_Republic_2022_country_profile_10页_283kb

报告摘要

Central African Republic TrACSS 2022 Country Report Summary

Core Content

The Tracking AMR Country Self-Assessment Survey (TrACSS) 2022 report provides an overview of the Central African Republic's progress in addressing Antimicrobial Resistance (AMR) across various sectors. The country is classified as low income by the World Bank and has a population of 4,919,987. AMR is a major global health threat, with nearly 5 million deaths linked to it in 2019, including 1.27 million directly caused by AMR.

TrACSS evaluates the implementation of National Action Plans (NAPs) on AMR and uses a five-point scale (A to E) to rate national capacity and progress. The goal is for countries to reach levels C-E on all indicators. The 2022 survey had an 86% participation rate, with 166 of 194 countries responding.

The report highlights the need for multisectoral coordination, political commitment, technical capacity, and data-driven interventions to combat AMR effectively. It also emphasizes the importance of One Health approaches and the integration of environmental considerations in AMR management.

Main Points by Sector

Human Health

Training and Education: AMR training for healthcare workers is limited (B in 2022), with improvement noted from 2018 to 2022.
Monitoring and Surveillance: There is limited progress on monitoring antimicrobial consumption (B in 2022), and no national surveillance system for AMR in humans.
Infection Prevention and Control (IPC): IPC is limited (B in 2022), but some progress has been made.
Antimicrobial Stewardship: The AWaRe classification is not adopted (0 in 2022), but some progress has been made in optimizing antimicrobial use.
Lab Capacity: The country has reference labs performing AST for 11 key bacteria, but no standardized guidelines or external quality assurance (EQA) systems are in place.

Animal Health

Training and Education: AMR training in the veterinary sector is limited (B in 2022), but some progress has been made in aquatic animal health.
Surveillance Systems: There is no national surveillance system for AMR in terrestrial or aquatic animals.
Lab Integration: Only some labs are integrated into the AMR surveillance system, and no centralized coordination exists.
Biosecurity Practices: There is limited progress on implementing biosecurity and good animal husbandry practices to reduce antimicrobial use.

Food and Agriculture

Training and Education: AMR training in agriculture, food production, and environment sectors is limited (B in 2022).
Surveillance Systems: No national surveillance system for AMR in food systems.
Lab Integration: No standardized procedures or harmonization among labs.
Good Practices: There is limited progress on implementing biosecurity and hygiene practices to reduce AMR development and transmission.

Environment

Risk Assessment: No national assessment of AMR residues and resistant pathogens in the environment.
Legislation: No laws or regulations to prevent antimicrobial contamination of the environment.
Water Monitoring: No system for regular monitoring of antimicrobial compounds and resistant bacteria in water quality.

Key Messages

Human Health

AMR awareness campaigns should be nationwide, with a focus on gender, equity, and vulnerable populations.
Systematic training of healthcare workers is essential for AMR awareness and stewardship.
National antimicrobial consumption monitoring systems are needed to enforce legislation and guide stewardship.
Lab capacity should be strengthened, including quality assurance and continuous supply of diagnostic consumables.
IPC programs should be implemented nationwide, with a focus on WASH and routine immunization.

Animal Health

AMR training should be formally integrated into veterinary and aquatic animal health curricula.
Standardized AMR surveillance systems are required in both terrestrial and aquatic animal sectors.
Lab integration needs to be coordinated by a National Reference Laboratory.
Biosecurity and good husbandry practices are important to reduce antimicrobial use and AMR transmission.

Food and Agriculture

Training and education in food production and safety should be increased.
AMR surveillance systems in food systems need to be developed.
Standardized lab procedures and data management systems are required for effective surveillance.
Good manufacturing and hygiene practices are needed to reduce AMR development in food processing.

Environment

Environmental risk assessments should be conducted to inform legislation and policy.
Monitoring of antimicrobial residues and resistant genes in water bodies is necessary to prevent AMR spread.
Legislation is needed to control antimicrobial contamination in the environment.

Challenges and Recommendations

Limited financial and human resources hinder AMR NAP implementation.
Inconsistent political commitment and lack of programmatic approaches lead to uneven progress.
Only 54% of countries use TrACSS to monitor their AMR NAPs.
AMR awareness campaigns and youth education are underdeveloped, with less than 20% of countries implementing youth-focused interventions.
Data quality and use are critical, with 60% using antimicrobial consumption data and 65% using AMR surveillance data.