Antimicrobial stewardship in the era of the COVID-19 pandemic: A systematic review protocol on the opportunities and challenges for Sub-Saharan Africa

John Njuma Libwea^{1

2

3

4}, Che Henry Ngwa^{3

5

6}, Armelle Viviane Ngomba¹, Frankline Sevidzem Wirsiy^{6

7}, Limkile Mpofu⁸, Chanceline Bilounga Ndongo¹, Sinata Koulla-Shiro^{9

10}, Stephen Graham¹¹, Lionelle Patricia Tchokokam Djieuya⁹, Nadia Mandeng^{1

4}, Georges Alain Etoundi Mballa^{1

4}, Eman Sobh^{3

12

13}, Bright I Nwaru^{3

14}, Paul Koki Ndombo^{9

15}, Emilienne Epee^{1

4}

Affiliations

¹ Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon.
² Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
³ African Science Frontiers Initiatives [ASFI], Lagos, Nigeria.
⁴ Public Health Emergency Operation Center, Yaoundé, Cameroon.
⁵ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁶ Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
⁷ Emerging Threats Epidemiology Group (ETEG); Department of Epidemiology| College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, Nebraska, USA.
⁸ Health Economics, HIV/AIDS, Research Division (HEARD), University of Kwazulu Natal, Durban, South Africa.
⁹ Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon.
¹⁰ Centre Pasteur du Cameroun, Yaounde, Cameroon.
¹¹ Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
¹² Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
¹³ Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia.
¹⁴ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
¹⁵ Mother and child Hospital, Chantal Biya Foundation, Yaoundé, Cameroon.

PMID: 37171319
PMCID: PMC10173944
DOI: 10.1097/MD.0000000000033697

Antimicrobial stewardship in the era of the COVID-19 pandemic: A systematic review protocol on the opportunities and challenges for Sub-Saharan Africa

John Njuma Libwea et al. Medicine (Baltimore). 2023.

. 2023 May 12;102(19):e33697.

doi: 10.1097/MD.0000000000033697.

Authors

Affiliations

¹ Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon.
² Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
³ African Science Frontiers Initiatives [ASFI], Lagos, Nigeria.
⁴ Public Health Emergency Operation Center, Yaoundé, Cameroon.
⁵ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁶ Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
⁷ Emerging Threats Epidemiology Group (ETEG); Department of Epidemiology| College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, Nebraska, USA.
⁸ Health Economics, HIV/AIDS, Research Division (HEARD), University of Kwazulu Natal, Durban, South Africa.
⁹ Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon.
¹⁰ Centre Pasteur du Cameroun, Yaounde, Cameroon.
¹¹ Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
¹² Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
¹³ Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia.
¹⁴ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
¹⁵ Mother and child Hospital, Chantal Biya Foundation, Yaoundé, Cameroon.

PMID: 37171319
PMCID: PMC10173944
DOI: 10.1097/MD.0000000000033697

Abstract

Background: Antimicrobial resistance (AMR) remains one of the leading threats to global public health and this may increase following COVID-19 pandemic. This is particularly the case in Africa where regulations on antimicrobial usage are weak. This protocol outlines the steps to undertake a systematic review to synthesize evidence on drivers of AMR and evaluate existing approaches to strengthening antimicrobial stewardship (AMS) programs in Sub-Saharan Africa (SSA). On the basis of the evidence generated from the evidence synthesis, the overarching goal of this work is to provide recommendations to support best practices in AMS implementation in SSA.

Methods: A systematic search will be conducted using the following databases: Global Health Library, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, Global Health, Embase, African Journals Online Library, Web of Science, antimicrobial databases (WHO COVID-19, TrACSS, NDARO, and JPIAMR), and the Cochrane databases for systematic reviews. Studies will be included if they assess AMR and AMS in SSA from January 2000 to January 31, 2023.

Results: The primary outcomes will include the drivers of AMR and approaches to AMS implementation in SSA. The Preferred Reporting Items for Systematic Reviews and Meta-analyses will guide the reporting of this systematic review.

Conclusions: The findings are expected to provide evidence on best practices and resource sharing for policy consideration to healthcare providers and other stakeholders both at the local and international levels. Additionally, the study seeks to establish drivers specific to AMR during the COVID-19 era in the SSA, for example, with the observed increasing trend of antimicrobial misuse during the first or second year of the pandemic may provide valuable insights for policy recommendation in preparedness and response measures to future pandemics.

Prospero registration number: CRD42022368853.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

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Antimicrobial stewardship in the era of the COVID-19 pandemic: A systematic review protocol on the opportunities and challenges for Sub-Saharan Africa

Affiliations

Antimicrobial stewardship in the era of the COVID-19 pandemic: A systematic review protocol on the opportunities and challenges for Sub-Saharan Africa

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials