More than 250 000 newborn babies in sub-Saharan Africa die every year from severe bacterial infections, with antibiotic-resistant bacteria responsible for at least half of these deaths.
Newborns are particularly vulnerable to infections as their immune systems are not yet fully developed, Professor Angela Dramowski, a paediatrician at Stellenbosch University and Head of the Clinical Unit: General Paediatrics at Tygerberg Hospital.
Preterm babies are even more affected. “They spend weeks to months in hospital and rely on medical devices such as ventilators and intravenous drips to keep them alive," says Dramowski. “Their immunity, skin, and gut infection barriers are less developed than those of full-term babies, allowing bacteria to more easily invade the bloodstream," she explains.
Rising rates of antimicrobial resistance (AMR), coupled with population growth, overcrowded maternal and neonatal units, and inadequate infection prevention and control practices, mean that the disease burden in Africa is growing.
Without major interventions to tackle these challenges, Africa is far off track to achieve the Sustainable Development Goal (SDG) of less than 12 deaths per 1000 live births. The current rate in Africa is 27 per 1000 live births.
In light of these alarming figures, NeoNET AFRICA, a collaborative multidisciplinary network of specialists from across Africa and the United Kingdom focusing on neonatal health in Africa, will hold an awareness webinar on 22 November about the plight of AMR neonatal infections. The webinar will coincide with World Antibiotic Awareness Week, which runs from November 18 to 22.
Dramowski, a paediatric infectious disease specialist in SU's Department of Paediatrics and Child Health, said the issue of AMR neonatal infections is “under-recognised, under the radar and under-funded."
“All bacteria are programmed to survive, so as soon as a new antibiotic is invented, they try to develop resistance to it. Unfortunately, this will be an endless cycle," she explained. “The general public may be unaware that we have limited treatment options available. In the 15 years since I qualified as an infectious disease specialist, I've seen several antibiotics become ineffective due to rising AMR rates, forcing us to rely on 'antibiotics of last resort' for many patients."
Dramowski said a major problem in Africa is the inadequate implementation of infection control measures. “The suboptimal delivery of infection prevention in many African settings leads to the spread of AMR bacteria, causing difficult-to-treat hospital-acquired infections. This becomes a vicious cycle as we need more antibiotics to treat the infections, and the more we expose bacteria to antibiotics, the more we drive the development of resistance."
The NeoNET AFRICA webinar – aimed at anybody who works with hospitalised newborns in African countries – will, besides raising awareness of the rate of infections, also shed light on the work that many “silent warriors" have been doing in both the clinical and the research spaces, Dramowski said.
“Our usual target audience is the full range of clinicians, doctors, nurses and pharmacists working with neonates. But, more importantly, we hope, through this webinar, to attract the attention of hospital managers, public health specialists, and ministries of health to advocate for more resources to improve hospital care for small and sick newborns. It's only through large-scale change that we can improve and make a difference to the plight of the babies who die from AMR infections across Africa every day," she said.
Dramowski said NeoNET AFRICA was founded in November 2023 through a networking grant from the UK Academy of Sciences.
“The motivation for bringing this network together was that we needed to expand beyond the silo of doctors and nurses looking after newborns to collaboratively work on potential solutions to neonatal infections with multi-disciplinary colleagues such as data scientists, microbiologists, public health specialists, obstetricians and genomics researchers.
“Through this diversity of expertise, we hope to solve some of the challenges across African neonatal units that worsen the situation for newborns with sepsis."