Cropping Up Crisis at the Nexus Between COVID-19 and Antimicrobial Resistance (AMR) in Africa: A Scoping Review and Synthesis of Early Evidence

Abstract

In this study, we aim to synthesize some evidence on the impacts that coronavirus disease 2019 (COVID-19) is having on the epidemiology of antimicrobial resistance (AMR) in Africa since it was declared a global pandemic by the WHO in March 2020. A scoping review was undertaken by collecting and curating relevant resources from peer-reviewed articles and also from the gray literature. Mixed approaches of extracting data (qualitative and quantitative) were employed in synthesizing evidence, as suggested by the Health Evidence Network. A model constructed based on the synthesis of early evidence available on the effects of factors linked to COVID-19 in impacting the evolution of AMR in Africa predicted that, in cumulative terms, those factors favoring the evolution of AMR outpace those disfavoring it by no less than three folds. COVID-19 is likely fueling the evolution of AMR almost unhindered in Africa. Due to the recognition of this crisis, concerted efforts for resource mobilization and global cooperation are needed to tackle it.

Keywords: africa; antimicrobial resistance; covid-19; health policy; impacts.

Figure 1. PRISMA-ScR flow diagram of literature selection.

PRISMA-ScR, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.

Figure 2. Model constructed based on the opposing interactions that specific factors driven by COVID-19 pandemic (shown here by areas of the geometric figures on the positive side of Y-axis) and those factors driven by the public health responses to COVID-19 pandemic (shown by the area of the geometric figures on the negative side of Y-axis) are having with the three determinants of AMR evolution.

Assumptions and designations about the effects of the specific factors on the determinants in constructing the model are: (a) no effect = 0; (b) positive effect (moderate) = 1; (c) positive effect (strong) = 2; (d) negative effect (moderate) = −1; and (e) negative effect (strong) = −2.