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

• Type of Material: Article
• Authors: Ayako Wendy Fujita, Emory University; Kaitlyn Werner, Emory University; Jesse Jacob, Emory University; Rea Tschopp, Armauer Hansen Research Institute; Gezahegne Mamo, Addis Ababa University; Adane Mihret, Armauer Hansen Research Institute; Alemseged Abdissa, Armauer Hansen Research Institute; Russell Kempker, Emory University; Paulina Rebolledo, Emory University
• Language: English
• Date: 2022-04-15
• Publisher: ELSEVIER SCI LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijid.2022.03.041
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
• Volume: 119
• Start Page: 120
• End Page: 129
• Grant/Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
• Keywords: STAPHYLOCOCCUS; BACTERIA; Ethiopia; SPECTRUM; PROFILE; One Health; MORTALITY; AFRICA; DRUG-RESISTANCE; ADDIS-ABABA; antimicrobial resistance; Science & Technology; ANTIBIOTICS; PREVALENCE; Infectious Diseases; Life Sciences & Biomedicine

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.