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Mahmoud Eltholth

Department of Economicsnull

E: Mahmoud.Eltholth@city.ac.uk

PhD Title: Assessing the economic impact of antimicrobial resistance: model calibration and evaluation of policy interventions

Supervisor: Professor Mireia Jofre-Bonet

Brief description of research topic

Antimicrobials have been considered as an essential tool not only for combatting infectious diseases and saving human and animal lives but also for improving animal health and productivity. They are powerful drugs that prevent many deaths each year without which many invasive medical procedures would be much more life threatening. Many life aspects such as global trade, travel and security would be endangered by the emerging of resistant strains of microorganisms. Unfortunately, the abuse of antimicrobials have resulted in the development of antimicrobials resistance (AMR). Therefore, there is a growing concern about the efficacy of antimicrobials use in humans and livestock due to the emerging resistant strains of microorganism and consequently increasing costs of treatments and mortality rates in humans. The estimates for economic burdens of AMR are underestimated because are based roughly only on the incremental cost associated to the additional treatment of resistant over susceptible primary infection and other costs are ignored. The objective of this proposal is to model the channels and main contributors to AMR using models of contagion, network and propagation. We will use the constructed model to estimate the economic impact of AMR and eventually identify the most effective policy interventions to alleviate the negative consequences of AMR. To do so, we first will review current approaches/methods to model contagion, propagation and networks, and also methods used to assess economic impact in similar contexts. Secondly, we will construct a stylized model of AMR progression. We will then calibrate the model and examine the cost implications using the AMR model. Finally, we will simulate how different interventions would affect AMR and its economic impact.

Research Interests

  • Health Economics
  • Economic Evaluation in Healthcare
  • Epidemiology and Public Health


  • MSc in Economic Evaluation in Healthcare, City University London, UK, 2015
  • PhD in Epidemiology and Veterinary Public Health, University of London, the Royal Veterinary College, London, UK, 2011
  • MVSc in Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Tanta University, Egypt, 2002
  • BVSc Bachelor of Veterinary Sciences, Tanta University, Egypt, 1998

Public Presentations and Conference Papers Given

  • Barbara Häsler, George Msalya, Maria Garza, Kimberly Fornace, Mahmoud Eltholth, Anna Sikira, Lusato Kurwijila, Jonathan Rushton, Delia Grace 2015 Integration of food safety and nutrition research to promote food security: A case study from Tanzania. 14th International Symposium on Veterinary Epidemiology and Economics, Merida, Yucatan, Mexico, 3-7 November 2015
  • W Beauvais, N Moyen, Y Hegazy, M Eltholth, H Holt, W El-Tras, J Guitian 2014 Estimation of individual seroprevalence of brucellosis in large ruminants from bulk-milk-tank ELISA results. Brucellosis 2014, International Research Conference Berlin, 9–12 September 2014
  •  M Eltholth, Y Hegazy, W EL-Tras, M Bruce, J Rushton 2014 Temporal analysis and costs of ruminant brucellosis eradication program in Egypt between 1999 and 2011. Brucellosis 2014, International Research Conference Berlin, 9–12 September 2014
  •  Eltholth MM, Holt H, Hegazy Y, Eltras W, Guitian J. 2011 Knowledge, attitudes and practices of livestock owners of the Nile Delta region with regard to brucellosis. Brucellosis 2011 International Research Conference Puerto Madero, Buenos Aires, Argentina; September 21-23, 2011