Exploring the Nexus of Antimicrobial Resistance and Natural Hazards and Associated Disasters: A Scoping Approach

Sammanfattning

Antimicrobial resistance (AMR) and natural hazards and associated disasters both pose significant global threats, with potential for exacerbating intersections. Despite AMR’s growing international priority, the nexus of AMR and hazards/disasters remains underexplored. This thesis aims to provide a comprehensive overview of the nexus to inform future perspectives and highlight further investigation areas. A scoping literature study across Scopus and PubMed was conducted, complemented by semi-structured interviews. Out of 1,234 unique references, 90 were analysed. Most literature focused on human health (60%), followed by environmental (35.6%), but limited animal perspectives. Earthquakes (32.2%), floods (24.4%), and hurricanes (14.4%) were most frequently studied. Mapping revealed diverse AMR occurrence perspectives, relating primarily to infections among disaster-affected patients (36.7%), environmental occurrence and spread (32.2%), gastrointestinal infections (11.1%), and malaria infections (5.6%). Central pathways included infection risks, baseline AMR conditions, and disaster-exacerbated circumstances. Management approaches reflected these pathways, including contextualised infection control and prevention, water, sanitation and hygiene (WASH), and surveillance. Concrete impact evidence remained limited. Interviews with 12 stakeholders largely confirmed the scoping results. While the nexus was perceived as relevant and indirectly addressed through infection prevention and control and WASH, AMR is not prioritised during acute disaster situations and lacks direct integration. Findings emphasise the relevance of a progressive dual-layered perspective, reinforcing long-term besides short-term approaches, alongside foundational measures like infection prevention and control or WASH. Greater interdisciplinary exchange is warranted. Research should deepen analysis across hazards/disasters and One Health sectors and enhance understanding of concrete impacts.