Dataset Information

The First Eastern Mediterranean Region/Arab Countries Meeting of Pharmacovigilance.

ABSTRACT: With many drugs coming to market and post-marketing surveillance limited to industry, there is a need for an integrated common approach to pharmacovigilance (PV) in the Eastern Mediterranean Region (EMR)/Arab region. The first meeting of the EMR/Arab countries for PV involved ten of the 22 states and revealed how these countries are learning from and working with each other in order to achieve this common approach. The aims of the meeting included highlighting challenges that could be overcome only by working as a team and setting the foundations for future PV centre work in the EMR/Arab region. The outcomes from the meeting showed that there is a need for a collaborative effort to provide a common structure, system and framework in order to establish an integrated PV system across the EMR/Arab world.

SUBMITTER: Bham B

PROVIDER: S-EPMC4883202 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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The First Eastern Mediterranean Region/Arab Countries Meeting of Pharmacovigilance.

Bham Bilal B

Drugs - real world outcomes 20150301 1

With many drugs coming to market and post-marketing surveillance limited to industry, there is a need for an integrated common approach to pharmacovigilance (PV) in the Eastern Mediterranean Region (EMR)/Arab region. The first meeting of the EMR/Arab countries for PV involved ten of the 22 states and revealed how these countries are learning from and working with each other in order to achieve this common approach. The aims of the meeting included highlighting challenges that could be overcome o ...[more]

PMID: 27747620

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Project description:BackgroundThe COVID-19 pandemic has escalated the use of telemedicine in both high and low resource settings however its use has preceded this, particularly in conflict-affected settings. Several countries in the WHO Eastern Mediterranean (EMR) region are affected by complex, protracted crises. Though telemedicine has been used in such settings, there has been no comprehensive assessment of what interventions are used, their efficacy, barriers, or current research gaps.Main bodyA systematic search of ten academic databases and 3 grey literature sources from January 1st 2000 to December 31st 2020 was completed, identifying telemedicine interventions in select EMR conflict-affected settings and relevant enablers and barriers to their implementation. Included articles reported on telemedicine use in six conflict-affected EMR countries (or territories) graded as WHO Health Emergencies: Afghanistan, Gaza, Iraq, Libya, Syria and Yemen. Data were extracted and narratively synthesised due to heterogeneity in study design and outcomes. Of 3419 articles identified, twenty-one peer-reviewed and three grey literature sources met the inclusion criteria. We analysed these by context, intervention, and evaluation.Contexteight related to Afghanistan, eight to Syria and seven to Iraq with one each in Yemen and Gaza. Most were implemented by humanitarian or academic organisations with projects mostly initiated in the United States or Europe and mostly by physicians. The in-country links were mostly health professionals rather than patients seeking specialist inputs for specialities not locally available.Interventionsthese included both SAF (store and forward) and RT (real-time) with a range of specialities represented including radiology, histopathology, dermatology, mental health, and intensive care.Evaluationmost papers were observational or descriptive with few describing quality measures of interventions.ConclusionsTelemedicine interventions are feasible in conflict-affected settings in EMR using low-cost, accessible technologies. However, few implemented interventions reported on evaluation strategies or had these built in. The ad hoc nature of some of the interventions, which relied on volunteers without sustained financial or academic investment, could pose challenges to quality and sustainability. There was little exploration of confidentiality, ethical standards, data storage or local healthcare worker and patient acceptability.

Project description:BackgroundThe WHO Eastern Mediterranean Region (EMR) faces major social, economic, and demographic challenges, with nearly half of its countries affected by conflicts that severely disrupt health systems. This study compared antimicrobial resistance (AMR) rates and surveillance efforts in conflict-affected, fragile, and non-conflict countries, further subdivided by income.MethodsData on bacteriologically confirmed bloodstream infections (BC-BSIs) from 2017 to 2021 were extracted from the WHO GLASS database. Countries were classified as conflict-affected, fragile, or non-conflict (subdivided by income) using World Bank criteria. Descriptive statistics (mean ± SD) were calculated, and group comparisons were performed using unpaired t-tests with Welch's correction. Mean differences (MD) and 95% confidence intervals (CI) were reported.ResultsConflict-affected countries reported significantly fewer surveillance sites than non-conflict countries (MD: 0.60, 95% CI: 0.361 to 0.836, P < 0.001) and fewer BC-BSIs per million population (MD: 31.00, 95% CI: 17.210 to 44.790, P < 0.001). In conflict zones, Acinetobacter spp. and S. aureus represented a higher proportion of BSIs compared to non-conflict countries (Acinetobacter spp. MD: -11.86, 95% CI: - 27.130 to 3.399, P = 0.099; S. aureus MD: - 10.68, 95% CI: - 30.030 to 8.680, P = 0.203). Carbapenem resistance in Acinetobacter spp. exceeded 65% across the groups, peaking in fragile zones (83.38%). Third-generation cephalosporin-resistant E. coli (3GCREC) prevalence ranged from 47.99% to 76.34%, peaking in conflict zones (76.34%). Carbapenem-resistant E. coli (CREC) prevalence ranged from 2.31% to 15.95%, highest in non-conflict low-middle income countries (15.95%). Third-generation cephalosporin-resistant K. pneumoniae (3GCRKP) exceeded 50% in all groups, peaking in conflict zones (80.42%). The prevalence of carbapenem-resistant K. pneumoniae (CRKP) ranged from 14.49% to 45.70%, peaking in conflict zones and non-conflict low-middle income countries (45.70%). Methicillin-resistant S. aureus (MRSA) exceeded 30%, peaking in conflict zones (70.09%).ConclusionsConflict-affected countries have weaker AMR surveillance and lower BC-BSI detection but a higher burden of resistant pathogens, notably carbapenem-resistant Acinetobacter spp. and MRSA. Tailored strategies are essential to restore infrastructure, strengthen surveillance, and mitigate the long-term impact of AMR in these zones.

Dataset Information

The First Eastern Mediterranean Region/Arab Countries Meeting of Pharmacovigilance.

Publications

The First Eastern Mediterranean Region/Arab Countries Meeting of Pharmacovigilance.

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