Weekly Digest: Europe declared free of malaria; Drug-resistant gonorrhea spreads in England

Reproductive, Maternal, Newborn and Child Health, volume 2 in the Disease Control Priorities, 3rd edition, was released on April 9 in San Francisco. CDDEP researchers Ashvin Ashok, Arindam Nandi and Ramanan Laxminarayan authored a chapter on “The Benefits of a Universal Home-Based Neonatal Care Package in Rural India: An Extended Cost-Effectiveness Analysis.” The volume provides a basis for low- and middle-income countries (LMICs) to develop national plans based on cost-effective, affordable and scalable interventions. Key messages from the volume were published in The Lancet on April 9. [DCP-3 Volume, Chapter 18, The Lancet]

“Good morning, my name is Staphylococcus aureus.” Winning essays from a contest held during Nepal’s 2015 World Antibiotic Awareness week, written by Nepali medical school students, are now available on the CDDEP blog. The theme was “A World Without Antibiotics.” Pranjal Rokaya took first place at Patan Academy of Health Sciences with “A Staph’s Diary,” written from the point of view of a bacterium living in an antibiotic-free world. Said Rokaya, “I didn’t want to write a sad story—I wanted to write something happy and satirical, while still getting a strong message across. So I decided to be a happy Staphylococcus bacterium who is overjoyed by the results of irresponsible antibiotic use.” [CDDEP]

The World Health Organization has declared Europe the first region to be free of malaria. Europe was first declared free of malaria in 1975, but the disease re-emerged in Central Asia, Turkey and the Russian Federation. The last cases of malaria (not locally acquired) in Europe were reported in Tajikistan in 2014. Elsewhere in the world in 2015, there were 214 million cases of malaria, and 438,000 malaria deaths. [Reuters]

A strain of gonorrhea that is highly resistant to azithromycin is spreading across England, according to Public Health England (PHE), an agency of the UK Department of Health. PHE has reported 34 confirmed cases since November 2014, first seen in northern England but now spreading to the south-east and West Midlands. The strain can currently be treated with ceftriaxone—but beyond that, there are no available treatments. [The Guardian]

Rates of appropriate use of antibiotic prophylaxis before pediatric surgeries varies widely among hospitals across the United States, according to research published in JAMA Pediatrics. The study included data from 31 U.S. children’s hospitals between 2010 and 2013, involving 670,000 procedures.  Use of antibiotic prophylaxis in the 45 most commonly performed operations was compared with clinical guidelines and consensus statements. Overall, antibiotic prophylaxis was considered appropriate in 64 percent of cases. When antibiotics were indicated, hospitals performed well, with appropriate use in 94 percent of cases, but when prophylaxis was not recommended, only 52 percent were treated appropriately, resulting in widespread overuse. Analyzed by hospital, appropriate use ranged from 47 to 84 percent, with significant variability within hospitals by procedure. The researchers also found that children who received prophylaxis (appropriately or inappropriately) were three times more likely to contract Clostridium difficile after treatment and twice as likely to suffer an allergic reaction. [Infection Control Today, JAMA Pediatrics]

Survivors of the April 16 7.8 magnitude earthquake in Ecuador face an “immediate threat” from mosquito-borne diseases, including Zika virus infection, according to CARE International. Heavy rain and stagnant water following property destruction create breeding sites for mosquitoes, which congregate around water sources. Citizens are also in need of clean drinking water to prevent water-borne diseases. Ecuadorian President Rafael Correa declared a state of emergency in the country following the earthquake, which killed at least 580 people and injured more than 8,000. [Reuters]

Telling high-prescribing clinicians how they compare to their peers can lower their antibiotic prescribing rates. A study reported in The Lancet used behavioral science techniques to influence antibiotic prescribing by primary-care practitioners in the UK. The intervention was a letter signed by England’s Chief Medical Officer informing a practice that it prescribed antibiotics at a higher rate than 80 percent of other local practices. The targeted practices reduced antibiotic prescriptions by 4 per 1000  people compared to a control group—or 73,000 fewer prescriptions in six months. The article was originally published online February 18. [Lancet article, Lancet commentary]

Taco Bell is the latest fast food chain to pledge elimination of antibiotics important for human medicine in chicken products. The company announced that it will phase out use of such antibiotics from chicken by April 2017. Yum! Brands, the company that owns Taco Bell, along with fast food chains KFC and Pizza Hut, has bowed to pressure from more than 80 consumer and environmental groups, including the National Resources Defense Council (NRDC) to make the change. [Taco Bell, Fierce Pharma, NRDC]