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Review
. 2022 Jun:119:120-129.
doi: 10.1016/j.ijid.2022.03.041. Epub 2022 Mar 28.

Antimicrobial Resistance Through the Lens of One Health in Ethiopia: A Review of the Literature Among Humans, Animals, and the Environment

Ayako Wendy Fujita  1 , Kaitlyn Werner  2 , Jesse T Jacob  3 , Rea Tschopp  4 , Gezahegne Mamo  5 , Adane Mihret  6 , Alemseged Abdissa  6 , Russell Kempker  3 , Paulina A Rebolledo  3
Affiliations
Review

Antimicrobial Resistance Through the Lens of One Health in Ethiopia: A Review of the Literature Among Humans, Animals, and the Environment

Ayako Wendy Fujita et al. Int J Infect Dis. 2022 Jun.

Abstract

Objectives: We aimed to review and describe antimicrobial resistance (AMR) prevalence in humans, animals, and the environment in Ethiopia.

Methods: We conducted a structured review of literature on AMR in humans, animals, and the environment in Ethiopia from 2016-2020. We reported the pooled prevalence of AMR of bacterial pathogens in all 3 sectors.

Results: We included 43 articles in our review. Only 5 studies evaluated AMR across multiple sectors. The most common bacteria in humans were Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. High prevalence of resistance to third-generation cephalosporins, fluoroquinolones, and sulfamethoxazole-trimethoprim were seen in gram-negative organisms, often with >50% prevalence of resistance. Highest resistance rates were seen in humans, followed by environmental isolates. Salmonella spp. exhibited higher rates of resistance than previously reported in the literature. We found methicillin-resistant S. aureus (MRSA) in approximately half of S. aureus from the environment and a third from human isolates. Few studies evaluated AMR across all 3 sectors.

Conclusion: Our review demonstrated high prevalence of AMR among bacteria in humans, animals, and the environment in Ethiopia. Integrating a One Health approach into AMR surveillance as part of Ethiopia's national surveillance program will inform future implementation of One Health interventions.

Keywords: Ethiopia; One Health; antimicrobial resistance.

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Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Study selection process for literature review of AMR in humans, animals, and the environment in Ethiopia
Figure 2.
Figure 2.
Geographical locations of AMR studies conducted in Ethiopia between January 2016 and October 2020
Figure 3.
Figure 3.
Pooled prevalence of AMR for select gram-negative pathogens from studies of human, animal, and environmental samples. Escherichia coli (A), Klebsiella spp. (B), and Salmonella spp. (C) are included in the graphs. Klebsiella spp. were not isolated from animal studies. Salmonella spp. were isolated from all 3 sectors; however, the sample size in environmental samples (n=15) was too small to calculate pooled prevalence of resistance.
See this image and copyright information in PMC

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