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. 2022 Dec 23;78(1):31-51.
doi: 10.1093/jac/dkac342.

Systematic review of surveillance systems for AMR in Africa

Obiageli Jovita Okolie  1 , Uzoma Igwe  1 , Sanda Umar Ismail  2 , Uzairue Leonard Ighodalo  3 , Emmanuel C Adukwu  1
Affiliations

Systematic review of surveillance systems for AMR in Africa

Obiageli Jovita Okolie et al. J Antimicrob Chemother. .

Abstract

Aims: Surveillance is a useful tool for tracking antimicrobial resistance (AMR) trends, patterns, therapeutic and policy interventions. Proper correlation of surveillance data gives meaningful insight into the underlying epidemiology and facilitates development of rational interventions. This comprehensive review aims to identify, classify and assess gaps in Global Antimicrobial Resistance and Use Surveillance System (GLASS) reporting and national action plan (NAP) implementation in Africa.

Methods: Articles published in English were searched across five electronic databases (PubMed, Scopus, Embase, AJOL and Cochrane) and grey literature. Articles were screened against inclusion/exclusion criteria and data from eligible studies were retrieved and analysed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 31 July 2020 under protocol CRD42020192165.

Results: Of the 4304 records found, only 32 met the initial inclusion criteria (4 peer reviews and 28 were grey literature). From these records, 41 surveillance systems were identified (30 national and 11 transnational). After final review of reported outcomes, only 23 national surveillance systems met the inclusion criteria. Indicators recorded from these systems shows lack of external quality assessment (EQA) in some systems and limited reporting of parameters such as infection origin, patient population and pathogen types.

Conclusions: The outcome of the review shows that although AMR surveillance has been implemented in 23 out of the 47 countries in the region, a number of limitations exist in the surveillance methods and reporting protocols that can impair the usefulness, validity and trustworthiness of data generated from these surveillance systems.

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Figures

Figure 1.
Figure 1.
PRISMA flow chart showing screening steps of articles retrieved from database and grey literature search.
Figure 2.
Figure 2.
Trends in development and implementation of NAPs in the region for the period reviewed. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.
Figure 3.
Figure 3.
Percentage of countries enrolled to GLASS and countries reporting surveillance data to GLASS for the period reviewed. The percentage of the respective parameters (enrolled and reporting) were calculated for each year using 47 as the denominator. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.
Figure 4.
Figure 4.
Trends in the increase of the number of surveillance sites reporting data to GLASS for the period reviewed.
Figure 5.
Figure 5.
Percentage of systems reporting important surveillance indicators. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.
See this image and copyright information in PMC

References

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