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Women From The Aga Khan University Combat Multidrug-Resistant Typhoid

Longtime partners and colleagues of HSP, Dr. Rumina Hasan and Dr. Sadia Shakoor from the Aga Khan University (AKU) in Pakistan continue to make impactful strides in the field of global infectious disease control. These exceptional women have been working with HSP towards improving detection of antimicrobial resistance, and were recently featured in the New York Times, The Economist and The Telegraph to discuss the pressing concern of a multi-drug resistant typhoid outbreak in their country.

A highly drug-resistant strain of typhoid has been spreading in Pakistan since 2016, infecting more than 850 people across 14 of Pakistan’s 156 districts. This strain is resistant to five different types of antibiotics, leaving only one oral antibiotic left to treat patients. One more genetic mutation to this strain could render it near impossible to treat. Dr. Rumina Hasan, Professor of Pathology at AKU explains the magnitude of this situation, “Antibiotic resistance is a threat to all of modern medicine – and the scary part is, we’re out of options.”

Dr. Hasan’s colleagues were the first to discover this super bug in November 2016. The AKU team visited the city of Hyderabad for early case mapping, and discovered large clusters of cases around sewage lines in the city. Dr. Sadia Shakoor, Assistant Professor of Pathology and Laboratory Medicine was  part of the investigation team, and ultimately helped to realize that the outbreak was sparked by raw sewage leaking from a faulty pipe into the drinking water supply. Typhoid is highly infectious and spreads quickly via contaminated food and water, especially in regions with poor sanitation. Dr. Shakoor explained further, “We’ve learned from history that once the typhoid bug acquires a resistance gene it holds on to it and just spreads within geographical regions where sanitation measures are poor.” She also emphasized the vitality of infrastructure improvements to prevent future outbreaks.

As antibiotic resistance continues to grow at an alarming rate, it is imperative that interventions take place. In response to the findings from AKU, and through collaborations between researchers and public health officials in Pakistan, a large-scale vaccination campaign has been launched to inoculate 250,000 children with a new typhoid vaccine. Dr. Shakoor believes that the only way to eradicate infectious diseases is through vaccination, and is hopeful that this campaign will be effective.

HSP has supported AKU’s efforts to improve local laboratory capacity for antimicrobial susceptibility testing, procedure standardization and improved quality control. We look forward to continued collaborations in the future, while working toward the common goal of improved global health security.  

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