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Drug resistance has increased in the recent years. This is because of the poor use of drug and drug products. Because of drug resistance, human populations are faced with the danger of disease out breaks and emergence of new diseases from resistant strains. This paper is going to look into some of the factors that contribute to the increase of these risks and measures that can be taken to avoid the situation.
Human population is faced with a danger of being infected with emerging diseases. Emerging diseases are those diseases whose occurrence in humans has been on the rise in the recent past and still threatens to continue increasing. These diseases can also be occurring for the first time and are spreading to different areas. They can be transmitted through different means such as person to person transmission, transmission by insects/animals or through water contamination. There are many factors that have been found to enhance development of new infections which include human, biological and environmental (Bowen et al, 2007).
In biological causes, the major contributing factors are: mutations and drug resistance. New infectious strains can be as a result of unregulated use of drugs together with misuse, mutation of disease causing organisms or it can be as a result of drug abuse. Because of this, new strains of more infectious organisms are likely to develop and there will be an increase in antimicrobial resistance which will be resistant to the current available drugs leading to new infections that are drug resistant. This will affect the way in which drugs used in treatment of common diseases work (Brower & Chalk, 2003).
Microorganisms undergo mutations that help them survive in increasingly hostile conditions in the hosts. An example is the HIV/AIDS which was not know until, the early 1980s but it has spread and infected about 24 million people world wide. Its origin is not exactly known but it’s suspected to have originated from monkeys which had viruses that caused Aids-like illness. New types of hemorrhagic fever have emerged with Ebola being the most notorious of all. The first case of Ebola was first discovered in Zaire and Sudan in the year 1976. It has since spread to countries like Cote d’lvoire, Liberia and other countries. Animals are presumed to be the carriers of this virus but no exact animal has been identified (Outbreaks of Animal-Related Illnesses, 2003).
Hantavirus syndrome in the USA has also emerged with characteristics of respiratory failure and a fatality rate of more than 50 % of its victims. Since its detection in 1993, it has continued to spread to different states and countries like Argentina together with Brazil. Rodents are the primary carriers of this virus in particular the deer mice. Other discoveries of Hantaviruses have been found in Asia for a long period of time in which they cause hemorrhagic fever in man (New WHO Office, 2001).
A worldwide influenza pandemic threat is continually increasing. It has been noted that in every 20 years there occurs a major shift in the genetic composition of influenza virus triggering epidemics in most parts of the world. Another shift is expected to happen in the near future. The origin of influenza virus is thought to be China. Ducks, pigs and chicken act as reservoir hosts to the virus. When they are raised together in farms, exchange of genetic materials between the viruses occurs which bring about new strains of the virus. This results in an epidemic of human influenza with each epidemic resulting from a different strain of virus.
Strains such as cholera strains together with influenza no longer follow the previous pattern where they used to infect children but instead they infect all age groups. This is because of the new strains that adults have also not acquired immunity against them which comes about after an infection.
According to Huhn et al, 2005, development of different kinds of strains is brought about by treatments that do not bring about cure. An increase in the use of antimicrobials which are usually in form of sub-therapeutic doses and counterfeit is an indication in more problems that are likely to emerge in the near future.
Modern medicine practices have also contributed to the spread of new diseases. Spread of diseases found in blood such as hepatitis and others like syphilis HIV and malaria have been on the rise. Medical procedures like kidney dialysis, multiple blood transfusions together with the different forms of transfusions have contributed greatly to the outbreaks. Other practices in immunization such as Relaxation quickly result to reoccurrence of some diseases. An example is the latest spread of diphtheria in Russia together with former USSR republics (Loppacher, Kerr & Barichello, 2008).
New diseases in animals like bovine spongiform encephalopathy are exposing a great health risk to human beings. This disease causes “madness” in cows and there are fears that the organisms responsible may be passed on from cows to humans causing a variant incurable Creutzfeldt-Jakob disease that affects the brain. Because of this threat, the beef market in Britain has largely been affected with strict measures being introduced to safeguard the health of the British population (Bowen et al, 2007).
This has become a major public problem through out the world. It occurs when organisms that bring about diseases become resistant to antimicrobial drugs together with other agents used in treatment. Resistance occurs in the following ways: through evolution of the molecule in the target molecule/organism of a particular drug making it impossible for the drug to bind with the molecule, the target cell or organism may produce better enzymes that corrupt the drug or the organisms can come up with a way of eliminating the drug from their system (Drake, 2005).
Because of resistance, there has been an increase in the number of infections that can not be treated using the normal treatment. This has had a negative impact on treatment of diseases like T.B, cholera, pneumonia, malaria and dysentery. These are not the first cases of drug resistance because the problem has existed for almost a decade. This period saw a decline in new antimicrobial development with an increase in resistance to existing antimicrobials. This has left doctors together with parents in a helpless situation. Each and every individual regardless of their age group is affected. The Elderly, young, chronically ill, people with compromised immunity together with patients undergoing surgery are at risk of developing resistance to existing medication (Loppacher, Kerr & Barichello, 2008).
According to Caballero-Anthony (2006), drug resistance increases the probability of an individual dying, elongation of an epidemic and also longer periods of illness. Bacteria have an inherent ability to evolve genes which help them become resistant to any antimicrobial. When an antimicrobial agent kills susceptible bacteria, it gives selective pressures that encourage bacteria with resistant gene to overgrow. When antimicrobial agents are continuously used, resistant strains multiply and spread.
A good example is the current crisis of antimicrobial resistance which is a result of unregulated together with inappropriate use of antibiotics. Some people use antibiotics in treatment of wrong infections, they also don’t take the required doses or they prolong or shorten the period that they are supposed to be using the drug. This has brought about numerous implications in the medical world. Drugs that cost a lot to produce can only be used for treatment within a short period of time after which they become ineffective. As resistance continues to mount, the gap between infection and control widens reducing the lifep of drugs and people.
Examples of bacterial resistance
Enterococci bacterial that is a common infection in hospitals has developed resistance to the first line drugs of treatment like beta-lactams and aminoglycosides. This has caused patients to suffer for a long period of time with only one option of treatment by vancomycin which is administered intravenously. Although Vancomycin has been the treatment of choice for long, it has gradually started developing resistance over the past 10 years.
Staphylococcus that causes food poisoning, skin infections, osteomyelitis, endocarditis together with other disorders, has also become resistant to all antibiotics apart from vancomycin. In case a strain that is resistant to vancomycin emerges, most hospital-acquired infections will be impossible to treat.
Streptococci which is the commonest cause of bacterial diseases, has slowly become resistant to a number of antibiotics for the last quarter of a century. It causes infections in the middle ear, wounds, throat and skin.
Pneumococcus which is responsible for respiratory infections among children is also becoming resistant to drugs. Its strains that could previously be treated using penicillin are becoming resistant with 18 % of the cases being reported in American and 40% in South Africa.
Malaria resistance comes with a double resistance. This includes: plasmodium parasites resistance to anti-malarial medications and resistance of the anopheles mosquitoes to insecticides hence limiting the action of anti-malarial drugs. Anti-malarial drugs act by killing malarial parasite when multiplying in the blood. Unfortunately because of the poor supply and use of drugs, rapid resistance to the drug in majority of places world over has arose (Infectious Diseases, 2004).
Drug resistance in TB has also become wide spread in the recent past although a lot of attention has been turned to the alarming occurrences of multi-drug resistance strains common in the states. Drug resistance is a result poor prescription of drugs or lack of compliance with prescription. It becomes dangerous when it has become incurable leaving doctors with a situation similar to that that existed prior to discovery of antibiotics (Edison, Sewell, Graves & Olson, 2000).
Drug resistance brings about problems in metabolism. It also leaves doctors wondering on other means available that they can use in controlling the spread of the resistant strain to the rest of the population. Resistance to first line drugs for HIV/AIDS, T.B, respiratory infections, malaria and also diarrhea has made the diseases to be among the leading killers in the world. It has also led to doctors turning to the second or third line drugs of treatment that have proved to be expensive. If this alternative treatment (second and third line of treatment drugs) also becomes in effective because of resistance then doctors will run out of treatment options unless new discoveries are made (Drake, 2005).
In order to avoid the risk of out break of new diseases, we need to be cautious in the way we use drugs. Drugs should be used according to instructions that are given and within the specified period. It is through that, that we can avoid emergence of new diseases that are resistant to medication. Vectors through which new infections can be acquired should be given proper attention and necessary steps taken to ensure they do not infect people.
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