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Table 3 Factors that explain the prevailing state of AMR in eastern Africa

From: A review of 40 years of enteric antimicrobial resistance research in Eastern Africa: what can be done better?

I. Factors that favor the emergence, dissemination and/or persistence of AMR

a) Factors common to human and animal studies

• Ease of access (cheap, widely available) to antibiotics

Kenya [19,32,36,51,123]; Uganda [22]; Ethiopia [30]; Tanzania [39,85]

• Antibiotic use practices, including self-medication, high frequency of antibiotic use, sub-therapeutic use or indiscriminate use

Kenya [19,26,31,32,36,51,54,77,108,129]; Ethiopia [27,47,88,89,120,125]; Tanzania [85,113]

b) Human studies

• Over-prescription at health facilities due to limited diagnostics resources

Ethiopia [89]; Kenya [38]

• Severe infections requiring different antibiotics

Rwanda [79]

• Human importation of antibiotic resistant bacteria

Burundi [75]

• Nosocomial or community transmission of resistant bacteria

Kenya [14,36,78]; Rwanda [44]

c) Animal studies

• Resistant bacteria imported via contaminated food

Kenya [26]; Ethiopia [122,125,126]

• Antibiotic use in humans

Kenya [105-107]; Ethiopia [122,125]

• Animal-animal contact

Ethiopia [119]

• Animal-human close co-existence increasing contact

Kenya [103]

• High antibiotic use in animals in small production systems, poor farm management practices disseminating resistant bacteria

Kenya [107]; Ethiopia [126]

• Housing contamination

Ethiopia [124]

• Contamination during handling animal products.

Kenya [107]; Ethiopia [115,117,125]

II. Factors that contribute to the reduction of AMR

• High cost of antibiotic

Kenya [36]; Ethiopia [117,118]Ɨ

• Limiting antibiotic availability

Uganda [22]; Rwanda [79]; Ethiopia [118,119]Ɨ

• Periodic withdrawal of antibiotics from public use

Kenya [37]; Rwanda [79]

• Parenteral administration of antibiotics

Ethiopia [47]

• Infrequent or prudent use of antibiotics

Kenya [104,107,123]Ɨ; Ethiopia [115,117,120,125,127]Ɨ

  1. List of risk factors that are thought to contribute to the state of antimicrobial resistance in Eastern Africa as suggested both by studies on AMR in humans and animals. Country and relevant citation shown in the column on the right. ƗAnimal studies.
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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