ABU DHABI // Easy access to antibiotics is being cited as an important cause behind the rising resistance of pneumonia cases to treatment.
The increased tenacity of what experts call "the forgotten killer" is attributed to self-medication and the over-prescription of antibiotics such as penicillin and amoxicillin.
"Many clinics and medical centres are using antibiotics freely and this has increased resistance over the years," said Dr Anwar Sallam, a consultant paediatric pulmonologist and deputy chief medical officer at Mafraq Hospital. "Almost anyone who walks into these centres can almost always walk out with antibiotics."
Dr Sallam was speaking ahead of World Pneumonia Day, which is today.
Dr Ghada Yahya, senior regional officer of communicable diseases at the Health Authority-Abu Dhabi (HAAD), said that only invasive forms of pneumococcal infection have been officially reported since last year, but the authority has put in a formal request to make sure that all incidents and forms of the infection are directly reported.
"A number of studies have shown the massive impact of over-prescribing antibiotics to patients," she said. "And HAAD is developing strict regulations to combat this."
Last month, HAAD said it has begun work on the first antibiotic resistance surveillance system.
HAAD's antibiotic resistance surveillance system aims to protect the populace from developing immunity to the drugs. The system is supposed to be fully functional by 2012.
Pneumonia mostly affects children under 5 and adults over 65. Figures from the World Health Organization show that 5 per cent of deaths among children under age 5 in the UAE are caused by pneumonia.
A study by Sheikh Khalifa Medical City (SKMC) and Mafraq Hospital published in July showed that the incidence of pneumococcal disease among the country's children was far higher than in the West before the introduction in the UAE four years ago of a vaccine against seven strains of the bacteria that can lead to pneumonia.
The rate in Abu Dhabi alone stood at 185 cases per 100,000 children, compared with 72 per 100,000 in the US and 42 per 100,000 in Great Britain.
Dr Mohamed Al Howidi, a paediatric consultant at Mafraq Hospital, said a new study is under way to measure progress since the vaccine was introduced.
"Preliminary research shows that the number has dropped drastically," he said.
However antibiotic resistance continues to be a significant problem.
"The use of antibiotics without good reason definitely has an impact," he said. "You find physicians prescribing medication right and left. And while we have put regulations in place, it is still out of control."
Most pneumonia cases are viral and do not respond to antibiotics, Dr Sallam said, adding that bacterial infections tend to increase as the winter season kicks in. The most common type of viral infection that can result in pneumonia is influenza. Docotrs recommend that the influenza vaccine be given to children each year until they are 12.
"If there is no undue deficiency in the individual's immune system, the body can fight it off naturally," he said. "However, a viral infection can develop into a bacterial infection if the immune system is not strong enough to combat the virus."
If the illness is only at a viral stage, patients should not be using antibiotics, Dr Sallam said. Other methods could be used to boost the immune system.
"The individual may need supplemental oxygen or IV fluids," he said. "But no specific antiviral medication would be administered to the patient."
At that point it is the doctor's responsibility to monitor the case. If it progresses into a bacterial infection, then antibiotics are prescribed accordingly.
Legally, antibiotics should be available only with a doctor's prescription. However, many patients self-medicate from pharmacists who are willing to break the law.
A study carried out last year by Haad found 68 per cent of 510 antibiotic sales in Abu Dhabi pharmacies were done without prescriptions.
An infectious disease usually starts with the colonisation of the pneumococcal bacteria in the respiratory tract, said Dr Nawal Al Kaabi, a consultant in paediatric infectious diseases at SKMC. The same bacteria can cause meningitis and sepsis, but nearly half of all cases result in pneumonia.
In advanced stages of the illness, fluid can collect in the respiratory tract, requiring a surgical procedure to drain the lungs. Antibiotic resistance coupled with highly prevalent risk factors among the UAE population, such as diabetes and heart disease, increase the chance of adults developing the disease, Dr Al Kaabi said.
mismail@thenational.ae
Guide to intelligent investing
Investing success often hinges on discipline and perspective. As markets fluctuate, remember these guiding principles:
- Stay invested: Time in the market, not timing the market, is critical to long-term gains.
- Rational thinking: Breathe and avoid emotional decision-making; let logic and planning guide your actions.
- Strategic patience: Understand why you’re investing and allow time for your strategies to unfold.
AWARDS
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German intelligence warnings
- 2002: "Hezbollah supporters feared becoming a target of security services because of the effects of [9/11] ... discussions on Hezbollah policy moved from mosques into smaller circles in private homes." Supporters in Germany: 800
- 2013: "Financial and logistical support from Germany for Hezbollah in Lebanon supports the armed struggle against Israel ... Hezbollah supporters in Germany hold back from actions that would gain publicity." Supporters in Germany: 950
- 2023: "It must be reckoned with that Hezbollah will continue to plan terrorist actions outside the Middle East against Israel or Israeli interests." Supporters in Germany: 1,250
Source: Federal Office for the Protection of the Constitution
COMPANY%20PROFILE
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COMPANY PROFILE
Name: Almnssa
Started: August 2020
Founder: Areej Selmi
Based: Gaza
Sectors: Internet, e-commerce
Investments: Grants/private funding
BMW%20M4%20Competition
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COMPANY PROFILE
Name: HyperSpace
Started: 2020
Founders: Alexander Heller, Rama Allen and Desi Gonzalez
Based: Dubai, UAE
Sector: Entertainment
Number of staff: 210
Investment raised: $75 million from investors including Galaxy Interactive, Riyadh Season, Sega Ventures and Apis Venture Partners
COMPANY%20PROFILE%20
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Persuasion
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Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
The%20specs
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The%20specs
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Dubai Bling season three
Cast: Loujain Adada, Zeina Khoury, Farhana Bodi, Ebraheem Al Samadi, Mona Kattan, and couples Safa & Fahad Siddiqui and DJ Bliss & Danya Mohammed
Rating: 1/5
Tales of Yusuf Tadros
Adel Esmat (translated by Mandy McClure)
Hoopoe
How to help
Send “thenational” to the following numbers or call the hotline on: 0502955999
2289 – Dh10
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'Lost in Space'
Creators: Matt Sazama, Burk Sharpless, Irwin Allen
Stars: Molly Parker, Toby Stephens, Maxwell Jenkins
Rating: 4/5
The Sand Castle
Director: Matty Brown
Stars: Nadine Labaki, Ziad Bakri, Zain Al Rafeea, Riman Al Rafeea
Rating: 2.5/5
Surianah's top five jazz artists
Billie Holliday: for the burn and also the way she told stories.
Thelonius Monk: for his earnestness.
Duke Ellington: for his edge and spirituality.
Louis Armstrong: his legacy is undeniable. He is considered as one of the most revolutionary and influential musicians.
Terence Blanchard: very political - a lot of jazz musicians are making protest music right now.
How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
FIXTURES
December 28
Stan Wawrinka v Pablo Carreno Busta, 5pm
Milos Raonic v Dominic Thiem, no earlier then 7pm
December 29 - semi-finals
Rafael Nadal v Stan Wawrinka / Pablo Carreno Busta, 5pm
Novak Djokovic v Milos Raonic / Dominic Thiem, no earlier then 7pm
December 30
3rd/4th place play-off, 5pm
Final, 7pm
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Other workplace saving schemes
- The UAE government announced a retirement savings plan for private and free zone sector employees in 2023.
- Dubai’s savings retirement scheme for foreign employees working in the emirate’s government and public sector came into effect in 2022.
- National Bonds unveiled a Golden Pension Scheme in 2022 to help private-sector foreign employees with their financial planning.
- In April 2021, Hayah Insurance unveiled a workplace savings plan to help UAE employees save for their retirement.
- Lunate, an Abu Dhabi-based investment manager, has launched a fund that will allow UAE private companies to offer employees investment returns on end-of-service benefits.
How to get exposure to gold
Although you can buy gold easily on the Dubai markets, the problem with buying physical bars, coins or jewellery is that you then have storage, security and insurance issues.
A far easier option is to invest in a low-cost exchange traded fund (ETF) that invests in the precious metal instead, for example, ETFS Physical Gold (PHAU) and iShares Physical Gold (SGLN) both track physical gold. The VanEck Vectors Gold Miners ETF invests directly in mining companies.
Alternatively, BlackRock Gold & General seeks to achieve long-term capital growth primarily through an actively managed portfolio of gold mining, commodity and precious-metal related shares. Its largest portfolio holdings include gold miners Newcrest Mining, Barrick Gold Corp, Agnico Eagle Mines and the NewMont Goldcorp.
Brave investors could take on the added risk of buying individual gold mining stocks, many of which have performed wonderfully well lately.
London-listed Centamin is up more than 70 per cent in just three months, although in a sign of its volatility, it is down 5 per cent on two years ago. Trans-Siberian Gold, listed on London's alternative investment market (AIM) for small stocks, has seen its share price almost quadruple from 34p to 124p over the same period, but do not assume this kind of runaway growth can continue for long
However, buying individual equities like these is highly risky, as their share prices can crash just as quickly, which isn't what what you want from a supposedly safe haven.
The specs
Engine: Direct injection 4-cylinder 1.4-litre
Power: 150hp
Torque: 250Nm
Price: From Dh139,000
On sale: Now
COMPANY%20PROFILE
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Vidaamuyarchi
Director: Magizh Thirumeni
Stars: Ajith Kumar, Arjun Sarja, Trisha Krishnan, Regina Cassandra
Rating: 4/5
ICC T20 Team of 2021
Jos Buttler, Mohammad Rizwan, Babar Azam, Aiden Markram, Mitchell Marsh, David Miller, Tabraiz Shamsi, Josh Hazlewood, Wanindu Hasaranga, Mustafizur Rahman, Shaheen Afridi