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Published on: August 30, 2018
Technology, Training, and Task Shifting at the World's Largest Mass Gathering in 2025: An Opportunity for Antibiotic
Isaac H Y Chan1, Miriam Gofine2,3, Shitij Arora4
1Lakshmi Mittal and Family South Asia Institute, Harvard University, Cambridge, MA, United States.
Abstract:
The role of antibiotic overuse in intensifying selection pressures and contributing to the emergence of antimicrobial resistance is well established. The Kumbh Mela, a religious festival that occurs in 4 Indian cities of spiritual significance, is the world's largest mass gathering, attracting over 80 million pilgrims in 2013. Digital syndromic surveillance from the 2013 and 2015 Melas demonstrated a consistent pattern of antibiotic overuse, with an antibiotic prescribing rate of up to 31% for all patient encounters. As preparations for the 2025 Kumbh Mela begin, task shifting, point-of-care diagnostic and digital tools, robust clinician training, and community awareness can promote the restrained and evidence-based use of antibiotics, minimizing the potential for the emergence of antimicrobial resistance at the world's largest mass gathering.
Insights
Antibiotic overuse is a significant problem, especially during large events like the Kumbh Mela. Strategies can reduce antimicrobial resistance risks at future gatherings.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Antimicrobial Stewardship
Background:
- Antibiotic overuse accelerates antimicrobial resistance (AMR) globally.
- The Kumbh Mela, the world's largest religious gathering, presents unique public health challenges.
- Previous surveillance indicated high antibiotic prescribing rates (up to 31%) at the Kumbh Mela.
Purpose of the Study:
- To highlight the risk of AMR emergence due to antibiotic overuse at mass gatherings.
- To propose interventions for promoting judicious antibiotic use at the Kumbh Mela.
Main Methods:
- Digital syndromic surveillance was employed during the 2013 and 2015 Kumbh Melas.
- Analysis focused on antibiotic prescribing rates during patient encounters.
Main Results:
- Consistent patterns of antibiotic overuse were observed.
- Antibiotic prescribing rates reached up to 31% of all patient encounters.
Conclusions:
- The Kumbh Mela's scale amplifies AMR emergence risks.
- Implementing task shifting, diagnostics, digital tools, training, and awareness can mitigate these risks for the 2025 Mela.
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