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Meta-Analysis
. 2024 Jun 2;14(1):12652.
doi: 10.1038/s41598-024-62651-6.

Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis

Minyahil Tadesse Boltena  1   2 , Mirkuzie Wolde  3   4 , Belachew Hailu  5 , Ziad El-Khatib  6 , Veronika Steck  7 , Selam Woldegerima  8 , Yibeltal Siraneh  3 , Sudhakar Morankar  3
Affiliations
Meta-Analysis

Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis

Minyahil Tadesse Boltena et al. Sci Rep. .

Abstract

Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship.

Keywords: Antibiotic prescribing; Antimicrobial use; Evidence-based healthcare; Hospitalized patients; Point prevalence survey; Sub-Saharan Africa.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of included studies: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. 10.1136/bmj.n71.
Figure 2
Figure 2
The pooled point prevalence of evidence-based use of antibiotics among hospitalized patients in sub-Saharan Africa.
Figure 3
Figure 3
The pooled point prevalence of evidence-based use of antibiotics in intensive care units in hospitals of sub-Saharan Africa.
Figure 4
Figure 4
The pooled point prevalence of evidence-based use of antibiotics in medical wards in hospitals of sub-Saharan Africa.
Figure 5
Figure 5
The pooled point prevalence of evidence-based use of antibiotics in obstetrics and gynecology wards in hospitals of sub-Saharan Africa.
Figure 6
Figure 6
The pooled point prevalence of evidence-based use of antibiotics in surgical wards in hospitals of sub-Saharan Africa.
Figure 7
Figure 7
The pooled prevalence of evidence-based use of antibiotics for community acquired infections in hospitals of sub-Saharan Africa.
Figure 8
Figure 8
The pooled prevalence of evidence-based use of antibiotics for hospital acquired infections in hospitals of sub-Saharan Africa.
Figure 9
Figure 9
The pooled prevalence of evidence-based use of antibiotics for medical prophylaxis in hospitals of sub-Saharan Africa.
Figure 10
Figure 10
The pooled prevalence of evidence-based use of antibiotics for surgical prophylaxis in hospitals of sub-Saharan Africa.
Figure 11
Figure 11
The pooled prevalence of evidence-based use of antibiotics for unknown clinical indications in hospitals of sub-Saharan Africa.
See this image and copyright information in PMC

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