Moving from assessments to implementation: promising practices for strengthening multisectoral antimicrobial resistance containment capacity.

BACKGROUND: Antimicrobial resistance (AMR) poses a global threat to human, animal, and environmental health. AMR is a technical area in the Global Health Security Agenda initiative which uses the Joint External Evaluation tool to evaluate national AMR containment capacity. This paper describes four promising practices for strengthening national antimicrobial resistance containment capacity based on the experiences of the US Agency for International Development's Medicines, Technologies, and Pharmaceutical Services Program work with 13 countries to implement their national action plans on AMR in the areas of multisectoral coordination, infection prevention and control, and antimicrobial stewardship. METHODS: We use the World Health Organization (WHO) Benchmarks on International Health Regulations Capacities (2019) to guide national, subnational, and facility actions that advance Joint External Evaluation capacity levels from 1 (no capacity) to 5 (sustainable capacity). Our technical approach is based on scoping visits, baseline Joint External Evaluation scores, benchmarks tool guidance, and country resources and priorities. RESULTS: We gleaned four promising practices to achieve AMR containment objectives: (1) implement appropriate actions using the WHO benchmarks tool, which prioritizes actions, making it easier for countries to incrementally increase their Joint External Evaluation capacity from level 1 to 5; (2) integrate AMR into national and global agendas. Ongoing agendas and programs at international, regional, and national levels provide opportunities to mainstream and interlink AMR containment efforts; (3) improve governance through multisectoral coordination on AMR. Strengthening multisectoral bodies' and their technical working groups' governance improved functioning, which led to better engagement with animal/agricultural sectors and a more coordinated COVID-19 pandemic response; and (4) mobilize and diversify funding for AMR containment. Long-term funding from diversified funding streams is vital for advancing and sustaining countries' Joint External Evaluation capacities. CONCLUSIONS: The Global Health Security Agenda work has provided practical support to countries to frame and conduct AMR containment actions in terms of pandemic preparedness and health security. The WHO benchmarks tool that Global Health Security Agenda uses serves as a standardized organizing framework to prioritize capacity-appropriate AMR containment actions and transfer skills to help operationalize national action plans on AMR.

Allelic frequencies of mutants of the Plasmodium falciparum, quinoline and folate metabolizing genes in the west region of Cameroon.

The emergence and spread of Plasmodium falciparum (P.f) drug resistance is still a major concern in Sub-Saharan Africa and warrants that its evolution be monitored continuously. The present study aimed at determining the distribution of key P.f drug resistance-mediating alleles in circulating malaria parasites in the West region of Cameroon. A cross sectional hospital-based study was conducted in Dschang and Ngounso in the West region of Cameroon. The Pfcrt, Pfmdr1, and the Pfdhps genes were amplified through nested PCR in 208 malaria-infected samples of the 301 febrile outpatients enrolled. The presence or absence of mutations in the K76T, N86Y, A437G and A581G codons of these P.f. genes respectively were determined through restriction digestion analysis. The proportion of different alleles were estimated as percentages and compared between two study sites using the Chi square test. A p value <0.05 was considered significant. A high prevalence (75.6%) of the 437G allele was observed. It was significantly different between Dschang and Ngounso (62% vs. 89.2%, X2 = 19.6, P = 0.00005). Equally observed was a 19.2% (95%CI: 13.3-25.6) of the dhps-581G mutant allele. Furthermore, we observed the Pfcrt-76T, Pfmdr1-N86 mutations in 73.0% (67.5-79.7) and 87.2% (83.2-91.9), and 3.0% (0.0-9.6) and 12.8% was observed for the Pfcrt-K76T and Pfmdr1-N86Y respectively. When biallelic haplotypes were constructed from alleles of the three genes, same pattern was seen. Overall, 73% and 87% of circulating P. falciparum isolates carried wild type alleles at Pfmdr1-N86Y and Pfcrt-K76T. On the other hand, we found more parasites with mutant alleles at dhps (437G and 581G) loci which may reflect possible drug-related selection of this mutant in the parasite population. Continuous monitoring of these mutations is recommended to pre-empt a loss in sulphadoxine-pyrimethamine efficacy in malaria chemoprevention programs.

Computational design and molecular modeling of the interaction of nicotinic acid hydrazide nickel-based complexes with H2S gas.

The application of nickel complexes of nicotinic acid hydrazide ligand as a potential gas-sensor and adsorbent material for H2S gas was examined using appropriate density functional theory (DFT) calculations with the ωB97XD/Gen/6-311++G(d,p)/LanL2DZ method. The FT-IR spectrum of the synthesized ligand exhibited a medium band at 3178 cm-1 attributed to ν(NH) stretching vibrations and strong bands at 1657 and 1600 cm-1 corresponding to the presence of ν(C[double bond, length as m-dash]O) and ν(C[double bond, length as m-dash]N) vibration modes. In the spectrum of the nickel(ii) complex, the ν(C[double bond, length as m-dash]O) and ν(C[double bond, length as m-dash]N) vibration bands experience negative shifts to 1605 cm-1 and 1580 cm-1, respectively, compared to the ligand. This indicates the coordination of the carbonyl oxygen and the azomethine nitrogen atoms to the Ni2+ ion. Thus, the sensing mechanism of the complexes indicated a short recovery time and that the work function value increases for all complexes, necessitating an excellent H2S gas sensor material. Thus, a profound assertion was given that the complex sensor surfaces exhibited very dense stability with regards to their relevant binding energies corresponding to various existing studies.

A homochiral coordination polymer of cobalt(II) and L-serine.

A one-dimensional chiral cobalt(II) coordination polymer, namely, catena-poly[[[(S)-2-amino-3-hydroxypropanoato-κ2N,O1]cobalt(II)]-µ-(S)-2-amino-3-hydroxypropanoato-κ4O1,O3:N,O1'], [Co(C3H6NO3)2]n or Δ-[Co(L-Ser-κ2N,O)2]n (L-Ser = L-serine) (1), has been synthesized and characterized using elemental and thermal analyses, IR spectroscopy and single-crystal and powder X-ray diffraction techniques. The asymmetric unit of 1 consists of two serine anions which are coordinated to a Co2+ ion to give three chelate rings. These extend the structure into a helical chain with pendant chelate rings which participate in interchain hydrogen bonding. The ability of 1 to undergo transmetallation was evaluated. Among a range of divalent metal ions, only copper(II) partially replaced cobalt(II).

Success or Failure of Chiral Crystallization of Similar Heterocyclic Compounds.

Single crystals of two achiral and planar heterocyclic compounds, C9H8H3O(CA1) and C8H5NO2 (CA4), recrystallized from ethanol, were characterized by single crystal X-ray analysis, respectively, and chiral crystallization was observed only for CA1 as P212121 (# 19), whereas it was not observed for CA4P21/c (# 14). In CA1, as a monohydrate, the hydrogen bonds were pronounced around the water of crystallization (O4), and the planar cyclic sites were arranged in parallel to slightly tilted positions. On the other hand, an anhydride CA4 formed a dimer by hydrogen bonds between adjacent molecules in the crystal, which were aggregated by van der Waals forces and placed in parallel planar cyclic sites.

Integrating pharmaceutical systems strengthening in the current global health scenario: three 'uncomfortable truths'.

The response to emergency public health challenges such as HIV, TB, and malaria has been successful in mobilising resources and scaling up treatment for communicable diseases. However, many of the remaining challenges in improving access to and appropriate use of medicines and services require pharmaceutical systems strengthening. Incorporating pharmaceutical systems strengthening into global health programmes requires recognition of a few 'truths'. Systems strengthening is a lengthy and resource-intensive process that requires sustained engagement, which may not align with the short time frame for achieving targets in vertical-oriented programmes. Further, there is a lack of clarity on what key metrics associated with population and patient level outcomes should be tracked for systems strengthening interventions. This can hinder advocacy and communication with decision makers regarding health systems investments. Moving forward, it is important to find ways to balance the inherent tensions between the short-term focus on the efficiency of vertical programmes and broader, longer-term health and development objectives. Global health programme design should also shift away from a narrow view of medicines primarily as an input commodity to a more comprehensive view that recognizes the various structures and processes and their interactions within the broader health system that help ensure access to and appropriate use of medicines and related services.

Two 1D homochiral heterometallic chains: crystal structures, spectra, ferroelectricity and ferromagnetic properties.

Two new homo chiral Cu-Ln (Ln = Gd and Ho) compounds bearing a chiral Schiff base ligand (1R,3S)-N',N''-bis[3-methoxysalicylidene]-1,3-diamino-1,2,2-trimethylcyclopentane (H2L) have been synthesized and characterized by elemental analysis, IR spectroscopic and single-crystal X-ray diffraction techniques. The compounds were found to exhibit 1D zig-zag skeletons with double µ-1,5 bridging dicyanamide anions. Circular dichroism (CD) spectra have been used to verify their chiroptical activities. Magnetic studies suggest that 1 and 2 hold the same magnetic behavior with the dinuclear compounds presenting ferromagnetic interaction. Furthermore, both compounds show ferroelectricity with the remnant polarization (P r) value of 0.23 and 0.18 µC cm-2 at room temperature, respectively.

Synthesis, mol-ecular and crystal structure of 1-(1,2-di-hydro-phthalazin-1-yl-idene)-2-[1-(thio-phen-2-yl)ethyl-idene]hydrazine.

The title compound, C14H12N4S, was synthesized by the condensation reaction of hydralazine and 2-acetyl-thio-phene and during the reaction, a proton transfer from the imino nitro-gen atom to one of the endocylic nitro-gen atoms occurred. The compound crystallizes in the monoclinic crystal system with two independent mol-ecules (mol-ecules 1 and 2) in the asymmetric unit. In each mol-ecule, there is a slight difference in the orientation of the thio-phene ring with respect to phthalazine ring system, mol-ecule 1 showing a dihedral angle of 42.51 (1)° compared to 8.48 (1)° in mol-ecule 2. This implies an r.m.s deviation of 0.428 (1) Šbetween the two mol-ecules for the 19 non-H atoms. The two independent mol-ecules are connected via two N-H⋯N hydrogen bonds, forming dimers which inter-act by two bifurcated π-π stacking inter-actions to build tetra-meric motifs. The latter are packed in the ac plane via weak C-H⋯π inter-actions and along the b axis via C-H ⋯N and C-H⋯π inter-actions. This results a three-dimensional architecture with a tilted herringbone packing mode.

Di-mu-acetato-bis[(2-acetylpyridine thiosemicarbazonato)zinc(II)].

The title compound, [Zn2(C2H3O2)2(C8H9N4S)2], is a centrosymmetric dinuclear molecule with two acetate bridging ligands in a syn-syn arrangement. The Zn(II) atom is five-coordinated in a trigonal-bipyramidal configuration by three thiosemicarbazone atoms (two N and one S) and by an O atom from each of the two acetate groups.