Category: MIL-OSI

Source: The Conversation – Africa – By Thulani P. Makhalanyane, Professor of Microbiology, Stellenbosch University

Antimicrobial resistance (AMR) is defined as the ability of disease-causing microorganisms to withstand treatments like antibiotics.

Often described as a silent pandemic, it is already responsible for an estimated 1.27 million deaths each year, with the highest burden in Africa.

Efforts to tackle antibiotic resistance have largely focused on hospitals and clinics, where antibiotic use is highest and resistant infections often emerge. But the problem is not confined to healthcare settings. Resistant bacteria can reproduce and pass on their resistance, or transfer resistance genes to other bacteria. These can spread beyond hospitals via wastewater or human carriers. Scientists increasingly recognise that the environment also plays a role. Rivers, lakes and wastewater systems are places where bacteria, antibiotic residues and other pollutants mix and interact.

Wastewater treatment plants bring all of this together. They take in what we flush away from homes, hospitals and industry and clean it before releasing it back into rivers or reusing it. These systems have significantly reduced the burden of infectious disease.

But there is a blind spot.

As part of the African Microbiome Project, we investigate the occurrence of antibiotic-resistant bacteria and resistance genes in wastewater discharges and receiving environments. We’ve found that resistant bacteria can still be found downstream, even after treatment has reduced overall bacterial loads. So, we set out to examine how this happens.

We pursued this line of inquiry because earlier research showed that when bacteria are killed during treatment, their cells break apart, releasing DNA into the water. This genetic material, known as extracellular DNA, or DNA that exists outside the cell, can carry antibiotic resistance genes and persist in treated water released into the environment. Some microorganisms in the environment are then able to incorporate this genetic material into their own.

In effect, resistance can spread without the original bacteria being present. Our research in South Africa suggests that there is indeed an overlooked pathway to the spread of antibiotic resistance.

Our findings also suggest that current measures of treatment success may be incomplete. Reducing living bacteria is important, but it may not capture the full risk if the genetic basis for resistance remains. Therefore, advanced treatment technologies, such as ultraviolet treatment, enzymatic degradation and advanced oxidation, should be considered for use. These technologies have been shown to degrade extracellular DNA in wastewater, reducing its ability to transfer resistance genes.

The evidence

We analysed wastewater from several treatment plants in the city of Tshwane. We found that even after standard treatment, extracellular DNA carrying antimicrobial resistance genes remained in the water released into the environment.

Some of these genes are linked to resistance against antibiotics of last resort. These are medications used to treat serious infections in humans and animals.

This does not mean treated wastewater is directly causing disease. But it points to a way for resistance to survive treatment and potentially re-enter communities, through drinking water, food production or recreational exposure.

Similar findings have been reported in other parts of the world. Some countries are beginning to use advanced treatment technologies designed to remove or degrade extracellular DNA.

What’s called for

Developing countries face bigger challenges than developed countries for a number of reasons.

Treated wastewater is routinely discharged into rivers, reused in agriculture, or fed back into domestic water supplies. Limited access to safe water and sanitation may create more opportunities for antibiotic resistance genes to circulate from these environmental reservoirs to communities.

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Read more: Resistance to antibiotics in northern Nigeria: what bacteria are prevalent, and which drugs work against them

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On top of this, water scarcity is hitting developing countries harder.

In water-scarce regions such as South Africa, where infrastructure challenges persist, communities may be more directly exposed to these contaminated water sources and opportunities for resistance genes to spread.

These risks point to the need for a shift in how antibiotic resistance is understood. It is not only a medical issue, but also an environmental one. It will require changes across both domains.

First, monitoring systems need to evolve. Globally, water quality assessments rarely include genetic material – detecting it requires specialised molecular methods.

Although these techniques require specialised equipment and expertise, they are already available in many laboratories and could be integrated into monitoring programmes as costs decline and testing capacity expands.

Second, wastewater treatment technologies may need to adapt. Advanced processes, like ozonation (which uses ozone to break down contaminants), ultrafiltration membranes that physically remove particles and genetic material, and DNA-degrading enzymes, are being explored but they aren’t widely used.

The rollout of these technologies has mostly occurred in parts of Europe, North America and Asia. In South Africa, there are encouraging signs of adoption. For example, current upgrades to wastewater treatment plants in Cape Town include UV treatment.

Third, stronger collaboration across sectors is essential. Antibiotic resistance is not solely a health issue, and water management is not only an engineering challenge. Policymakers, engineers, microbiologists and public health practitioners must work together on this interconnected challenge.

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Read more: South Africa’s sewage crisis: official reports don’t include millions of litres of leaking wastewater

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Finally, public awareness matters. Most people don’t know that antibiotic resistance can spread through water. Communicating this risk clearly can help build support for the changes needed. While individuals cannot always control the quality of the water available to them, understanding the risks can encourage simple protective measures, such as boiling water and disposing of medicines responsibly.

Antibiotic resistance and water insecurity are linked through the systems that sustain everyday life. As pressure on global water systems grows, understanding and managing the links will become increasingly important.

– Antibiotic resistance is spreading through South Africa’s water systems: study explains how
– https://theconversation.com/antibiotic-resistance-is-spreading-through-south-africas-water-systems-study-explains-how-283907

Source: The Conversation – Africa – By Mary Asirifi, Assistant Professor, Department of Nursing Foundations, MacEwan University

About 8% of Ghana’s population is disabled. A high percentage are adolescents, which could be linked to the country’s dominant population of young people (15 to 35 years).

The perspectives of adolescents with disabilities in Ghana are often overlooked, as most of the time, society views the cause of the disability as related to parental sins against the gods, being a descendant of river gods, and bewitchment or curses by family members. Consequently, the adolescents experience pejorative labelling, ableism and social exclusion, resulting in depression, low self-esteem, a lack of confidence and suicidal thoughts.

I was part of an interdisciplinary research team with diverse expertise on stigma, nursing, public health and social work. We engaged adolescents in Ghana with disabilities in a recent study that focused on their lived experiences. This research involved working with 54 adolescents aged 10-19 years with hearing, visual and physical disabilities. We explored their lived experiences using photos that participants captured. Participants used a range of visual images to represent their challenges.

We also found that adolescents with disabilities often face hostile experiences that contribute to negative self-perceptions. These include feelings of hopelessness about their future. This calls for urgent attention to addressing the needs of this vulnerable population.

Finding the challenges

We provided participants with a range of visual images to represent their challenges. These included images symbolising darkness, a stick lying on the floor, a coconut tree, heaps of sand, and stacks of wood logs. These images from the participants were used in the study as they captured the perspectives and the meaning of their experiences with disability.

Of the 54 adolescents we interviewed, 22 were hearing impaired, 23 were visually impaired and 9 struggled with physical disability. Of these, 34 were females and 20 were males. The majority of the participants had been born with their disabilities. Only four participants with visual impairments had been disabled later in life. The visually impaired participants informed the researchers to take pictures of images that the participants preferred to depict their experience of disability. The researchers informed the participants of the content and the features of the images captured in the photos.

We then used photo voice data analysis. This is a process where participants’ stories related to the photos were interpreted into meaningful clusters of ideas known as themes. Three overarching themes emerged from the data:

• adversity

• resilience

• social support.

Adversity

Some of the adolescents characterised the adversity experience of disabilities as difficult, burdensome, and full of rejection. Participants presented images symbolising darkness, a stick lying on bare floor, a coconut tree, heaps of sand, and stacks of wood logs as challenges they face.

The photographs of wood logs and darkness were used to explain participants’ lived experiences. According to the adolescents with disabilities, the images of wood logs and darkness meant that life was a burden. Those who used darkness compared their lived experiences to an unforeseen, blurred future because they were physically challenged, lacking strength, and appeared unfit for any productive job.

A 19-year-old adolescent with physical impairment compared her life journey to a stick lying on the ground, indicating “everyone can walk on her life”.

According to her, a stick on the ground could be easily picked up, used, and then dumped at any time. She said several men had showed interest in her but abandoned her after a sexual encounter. She had a child with a partner who did not provide paternal support, and she found it difficult to get any employment, which made her vulnerable to similar exploitative advances.

A visually impaired participant related her experience with a coconut tree.

I could see with my eyes before this sickness happened to me. When I was having sight, people saw me as someone who would be a great person in the future, but now that I am blind, they believe that it is the end of my life. Some still consider me beautiful in my current state because I have not given birth yet. However, I know if I allow myself to become pregnant, I will become a wretched thing after giving birth, which can be related to the coconut tree: once the fruit has been harvested and the leaves have been removed, it will lose its attraction.

A 17-year-old who was visually challenged used a heap of sand at the side of the road to explain his predicament.

According to him, life was a burden because it required him to bear more weight, and occasionally he thought about ending his life.

A female physically challenged adolescent compared her life to a footpath that anyone could walk on. She indicated that the disability had devalued her personality and she’d lost her identity. She felt bullied by her peers, and excluded, which had affected her academic and sporting life and mental health.

Resilience and social support

Some adolescents were hopeful and resilient about their life experiences. They used a photograph of a chapel representing a place where their experiences, struggles and identity were most visible and meaningful.

One of the participants indicated that the church was a place where he felt accepted beyond his disability.

The photo of a group of people meeting and holding hands together signified a space to share their experiences and their sense of safety as well as expressing feelings such as anger, frustration and hope. According to the participants, such meetings fostered a sense of community and offered practical coping strategies for navigating school activities and life in general.

What needs to happen

The findings show that there’s a need for culturally appropriate interventions to support and empower adolescents with disabilities in Ghana.

An example is the Obuntu Bulamu peer-to-peer support intervention in Uganda. The concept underlying the this intervention is fostering behaviour that reflects a shared set of values promoting well-being, togetherness and unity. The intervention, which was co-created by a team of children, parents, teachers, disability rehabilitation workers and academics in Uganda, consists of training sessions, peer support meetings, and activities for children, parents and teachers around the themes of peer support, disability and belonging.

Finally, the findings also provide a basis for programmes and policies to incorporate their voices into decision-making that affects their well-being.

– How do teens living with disabilities in Ghana view their future? We asked them to show us
– https://theconversation.com/how-do-teens-living-with-disabilities-in-ghana-view-their-future-we-asked-them-to-show-us-287727