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Infant Deaths Fall Sharply in Africa with Routine Antibiotics
- neonate 8y agohttp://archive.is/aQ2x3 http://archive.is/aQ2x3
- 13of40 8y agoI don't have a subscription so I'm not going to read the article, but maybe someone can tell me how this is different, in a "creating superbugs" sense, from giving antibiotics to livestock when they're not sick.
- Robotbeat 8y agoBecause human infants are not livestock, and this is a huge win for humanity instead of just slightly cheaper beef.
- lainga 8y agoThat is true, but has no bearing on the "creating superbugs" sense.
- 13of40 8y agoExactly. The resulting pandemic could cause much more suffering.
- zuminator 8y agoThe resulting entirely speculative pandemic could have a speculative outcome. Versus actually saving lives now in reality.
- ars 8y agoYou should maybe actually read the article before commenting. A huge part of it addressed your exact question. And saying you have no subscription is no excuse - someone posting a link to it at least an hour before you commented.
- RcouF1uZ4gsC 8y agoThe article says that these antibiotics are given as single does months apart for a few years. Any resistance that develops quickly reverts. Livestock on the other hand, get much more regular antibiotics.
- 13of40 8y agoIf I had to guess, I'd say the mechanism behind that is it's expensive to be antibiotic resistant, and when you revert to normal times the mutation becomes a burden. That's serendipitous, but if it turned out the mutation was OK in either case we would be screwed.
- crygin 8y agoThis is not really the best way to cognate about mutation at the bacterial scale. A better way of putting it is that every possible simple mutation is happening right now. If a mutation were truly neutral, it would already be fairly present in the population. It is possible that a complex mutation could emerge with these properties, but the likelihood is much less that the likelihood of many other things that would screw us more. All that aside, these antibiotic regimes have been carefully designed by people who have already thought very hard about these problems. The single-dose model is designed to produce a significant response with a non-durable mutative result in the population. There's an awful lot of literature about the design process for third-world medication (see e.g. tuberculosis treatment) if you're curious.
- quasimodem 8y agoI learned in Headlines 101 not to use "Infant", "Fall", and "Sharply" together in a headline. But what does college matter once you're in the real world?
- jadedhacker 8y agoI don't think I get it. I didn't have the wrong impression from reading that headline in the sense of thinking that infants were falling on sharp objects. Can you elaborate on the lesson they were trying to teach you? Is for optimizing for people that don't even fully read the headline?
- tim333 8y agoAntibiotics can be handy things. It's easy to forget in the modern west how common it was for bacteria to do people in in the past, though I was reminded this morning by the HN stuff on Feynman and his watching his wife slowly die from Mycobacterium tuberculosis. I hope with antibiotic resistance they don't come back too much.
- mylons 8y agomy girlfriend is the Program Manager of the Mordor study. when i told her this was here, the first thing she said was, "everyone's going to freak out about resistance. just tell them they've been using these antibiotics in the region for decades and have been measuring and monitoring resistance levels."
- craftyguy 8y ago> measuring and monitoring resistance levels Ok, but what does that have to do with preventing bacteria from gaining resistance to antibiotics?
- deleted 8y ago[deleted]
- mylons 8y agothey stop using the drug at a certain threshold? first result from a google search. https://www.cell.com/trends/microbiology/abstract/S0966-842X(00)01873-4 https://www.cell.com/trends/microbiology/abstract/S0966-842X...
- hacknpol 8y agoWhile this is prima facie good news, it is worth mentioning that Africa’s population growth doesn’t appear to be slowing down http://www.worldometers.info/world-population/africa-population/ http://www.worldometers.info/world-population/africa-populat... The decline in mortality is not followed by a decline in fertility for Africans.
- jake-low 8y agoIt absolutely is. See this animated chart of birth rate vs child mortality rate since 1960 (press the play button in the lower right). https://www.gapminder.org/tools/#_state_time_delay:172;&marker_axis/_x_which=child/_mortality/_0/_5/_year/_olds/_dying/_per/_1000/_born&domainMin:null&domainMax:null&zoomedMin:1.95&zoomedMax:756.29&scaleType=linear;&axis/_y_which=children/_per/_woman/_total/_fertility&domainMin:null&domainMax:null&zoomedMin:1.12&zoomedMax:8.87;;;&data_/_lastModified:1524803248601&lastModified:1524803248601;&chart-type=bubbles https://www.gapminder.org/tools/#_state_time_delay:172;&mark... African nations (blue bubbles) are lagging behind the rest of the world, but the trend is clear: declining infant mortality results in declining birth rate, often with a delay of just a single generation.
- ohkaiby 8y agoI'm reminded of a similar notion that Bill & Melinda Gates wrote in their 2018 letter[0]: "When more children live past the age of 5, and when mothers can decide if and when to have children, population sizes don’t go up. They go down. Parents have fewer children when they’re confident those children will survive into adulthood. Big families are in some ways an insurance policy against the tragic likelihood of losing a son or a daughter. We see this pattern throughout history. All over the world, when death rates among children go down, so do birth rates. It happened in France in the late 1700s. It happened in Germany in the late 1800s. Argentina in the 1910s, Brazil in the 1960s, Bangladesh in the 1980s." [0] https://www.gatesnotes.com/2018-Annual-Letter https://www.gatesnotes.com/2018-Annual-Letter (#5)
- Alterlife 8y agoThis is such a great visualization. You can click on the dot you are interested in to draw a line that tracks it's movement through the years. The journey of Niger is especially interesting. Between 1947 and 1983, the birth rate actually increased despite infant mortality declining. Do you happen to know why that is? https://imgur.com/a/qnnHYbQ https://imgur.com/a/qnnHYbQ
- adrianN 8y agoLet's see how long they last before resistances develop.
- cm2012 8y agoConsidering in the developing world babies are not dying of infections, its safe to assume that it can last a long time.
- sadgit 8y agoHow does a lower infant mortality rate indicate lower antibiotic misuse? Antibiotic misuse could be constant as a % of overall antibiotic use.
- JBReefer 8y agoA lot of negativity in this thread is probably because they're saving the "wrong kind" of infants
- deleted 8y ago[deleted]
- adrianN 8y agoWell, yet. Resistances are on the rise. It will probably get a lot worse before we start using antibiotics more responsibly.
- PeterStuer 8y agoThat is not how it work. Resistant strains, once evolved, do not need to 'start from scratch'.
- travisp 8y agoIt's much more complicated than you seem to think, otherwise there would be almost no non-resistant strains left. For example, there typically seems to be a cost associated with maintaining resistance, and particularly maintaining multiple forms of resistance, and strains will often drop resistance absent constant selection pressure.
- _ph_ 8y agoMy first reaction when reading this of course was: what about resistance? But then I thought: as long as it is standard practise to heavily use antibiotics in meat farming, we shouldn't point at any good usage to save human life. And it indeed seems to be a faszinating and very beneficial usage of antibiotics. Beyond its obvious humanitarian benefit, lowering child mortality seems to be the working method to limit population growth.
- enriquto 8y agoThere is a somewhat unhealthy obsession with antibiotic resistance. The problem is not as scary as it may sound. It turns out that antibiotic-resistant strains are much weaker than normal strains in the absence of antibiotics (because they use a great deal of resources to be antibiotic resistant), and they tend to disappear quickly.
- Retric 8y agoIt's not a big deal for healthy people and non fatal diseases. It's however a big deal when you need antibiotics the most. So, the choice is to reserve them to the most extreme cases which will save the most human lives possible. Or, use them all over the place improving the average quality of life at the expense of significantly more people dying. I think it's reasonable for humanity to pick either option, but pretending it's not an important choice is over simplified.
- frockington 8y agoThank you for saying this. I have been looking for the correct verbage to say this for a while.
- _ph_ 8y agoThere are deaths from resistant strains. Because people got an infection, and there was no medicine to treat it. Untreated infections are like russian roulette - many survive them, but not all. After centuries where people would just die of infections, we had a few good decades. Where we had many viruses covered by vacinations and bacterial infections by antibiotics. But vaccination rates are not as good as they could be, and we are putting the antibiotics at risk. That is a step back.
- z3t4 8y agoThis seems to be sponsored by the drug manufacturers, which makes me wary. Don't forget about for example Nestle giving doctors money to tell new parents to use Nestle products instead of mothers milk. Mothers milk is the best for children and is very important for their immune system. I'm all for saving lives, but there are some very greedy people in the world, and to some account Hanlon's razor. Antibiotics has side effects, such as killing all bacteria. Our life depends on many of the bacterias living in our body, especially in the digestive system.
- baxtr 8y agoHow did you come up with this conclusion?
- deleted 8y ago[deleted]
- z3t4 8y agoI re-read the article and it seems to have charitable incentives. So my concern hopefully not warranted.
- giarc 8y agoIt's like the 4 paragraph.... please RTA. "The Bill and Melinda Gates Foundation, which paid for the study..."
- millermp12 8y agoIf only there were similarly breathless articles about the effective use of prophylactics. Otherwise, they're just going from the frying pan into the Malthusian fire.
- InclinedPlane 8y agoGreat to see most of the HN comments here wasting their time freaking out about too many brown babies living in the world. (Filter it through whatever level of indirection you like, that's fundamentally the core of these freakouts.) Anyway, it'll be interesting to see if these results hold up, because these are very outsized effects at very low cost compared to many other disease interventions. Also, it'll be interesting to see how much this is due to body weight versus other effects. Antibiotics are routinely used in livestock for weight gain not for disease control, it may be that weight gain gives a significant survival advantage for other conditions, such as enteric diseases, independent of their antibacterial effects. In any event, this has the promise to become an important tool in reduction of child mortality in developing countries and that will have a tremendous number of positive follow-on results (in addition to the lives saved, of course).