ORIGINAL RESEARCH article
Front. Public Health
Sec. Disaster and Emergency Medicine
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1589290
This article is part of the Research TopicUnderstanding the Nexus of Conflict, Disaster, and Infectious Disease in Vulnerable PopulationsView all 4 articles
Antibiotic Stewardship and Antimicrobial Resistance in Conflict-Affected Sudan: A Situational Analysis
Provisionally accepted
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, England, United Kingdom
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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 broadspectrum 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.
Keywords: antimicrobial resistance1, Antimicrobial Stewardship2, Healthcare professional3, conflict4, Sudan5
Received: 07 Mar 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Fletcher, Trueba and Al-Hassan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Leena Al-Hassan, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, England, United Kingdom
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