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Antibiotic stewardship and antimicrobial resistance in conflict-affected Sudan

A situational analysis

Bibliographic Data

ID22068893
AuthorsMegan Fletcher (Brighton and Sussex Medical School), Mei L Trueba (0000-0002-3468-9411, Brighton and Sussex Medical School), Mei Trueba, Leena Al-Hassan (0000-0002-0506-050X, Biology of Infection, corresponding author)
Year2025
Volume13
Pages1589290-1589290
Publication date2025-08-07
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1589290
PMID40852663
OpenAlexW4413035017
LanguageEN
References cited21

Introduction: Antimicrobial resistance (AMR) is a global concern, the drivers and consequences of which are exacerbated by poverty and inequality, with Low- and Middle-Income Countries (LMICs) bearing the highest rates, particularly Sub-Saharan Africa. Armed conflict further exasperates problem, by damaging healthcare systems, limiting access to essential medicines, and increasing the use of antibiotics in uncertain environments. This study sought to explore healthcare professionals' views on AMR and antimicrobial stewardship challenges before and during the conflict to investigate the impact of armed conflict on antimicrobial stewardship (ASP) in Sudan, a low-income country facing a humanitarian crisis exacerbated by ongoing violence. Methods: Data was collected via an anonymous qualitative online survey completed by healthcare workers with experience before and during the conflict and was analysed via thematic analysis. Results: Sudan is experiencing significant challenges due to its fragile healthcare system, poverty, and inequality. The results identify barriers to ASPs before and during the conflict, including lack of laboratory facilities, inadequate training, and the indiscriminate use of antibiotics. The findings reveal that the conflict has intensified the risk of AMR, with disrupted healthcare services leading to increased self-medication and reliance on broad-spectrum antibiotics. Discussion: The study underscores the urgent need for multi-faceted interventions that address immediate healthcare needs while implementing long-term strategies to control AMR in conflict-affected regions. Recommendations include enhancing healthcare infrastructure, improving diagnostic capabilities, and fostering collaborations among various stakeholders to ensure sustainable AMR prevention strategies

Antibiotic resistance · Antibiotics · Antimicrobial stewardship · Business · Economic growth · Focus group · Health care · Political science · Poverty · Psychological intervention · Qualitative research · Sociology · Thematic analysis · Antibiotic Use and Resistance · Disaster Response and Management · Global Maternal and Child Health · Medicine · Nursing

  • Global burden of bacterial antimicrobial resistance in 2019

    Open Access•Christopher J L Murray, Kevin S Ikuta et al.•The Lancet•2022

  • ‘My appetite and mind would go’

    Open Access•Sonja Ayeb-Karlsson, Anna Hoad et al.•Humanities and Social Sciences…•2024

  • Sudan

    Open Access•Amal Elamin, Sara Abdullah et al.•BMJ Global Health•2024

  • Antimicrobial resistance and the Iraq wars

    Open Access•Antoine Abou Fayad, Anthony Rizk et al.•BMJ Global Health•2023

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    Open Access•Roswell Quinn•American Journal of Public Health•2013

Highly citedNo

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