Social and Ecological Determinants of Antimicrobial Resistance in Africa: a Systematic Review of Epidemiological Evidence

Overview

Journal Antimicrob Steward Healthc Epidemiol

Publisher Cambridge University Press

Specialty Infectious Diseases

Date 2024 Sep 11

PMID 39257424

Authors

Catherine Bennett

Will Russel

Rebecca Upton

Frank Frey

Bineyam Taye

Affiliations

Soon will be listed here.

Abstract

Background: Antimicrobial resistance (AMR) is one of the greatest global health problems for humans, animals, and the environment. Although the association between various factors and AMR is being increasingly researched, the need to understand the contribution of social and ecological determinants, especially in developing nations, remains. This review fills these knowledge gaps by synthesizing existing evidence on the social and ecological determinants of AMR in Africa.

Results: Twenty-four studies were selected based on predefined criteria from PubMed. 58.33% (n = 14) and 29.17% (n = 7) of the studies reported on ecological and social determinants of AMR, respectively, and 3 (12.5%) studies documented both social and environmental determinants of AMR. Sociodemographic factors include increased household size, poor knowledge, attitudes toward AMR, low educational levels, and rural residences. Indicators of poor water sanitation and hygiene, framing practices, and consumption of farm products were among the common ecological determinants of AMR and AM misuse in Africa.

Conclusion: Our review demonstrates the importance of social and ecological determinants of AMR among African populations. The findings may be valuable to researchers, policymakers, clinicians, and those working in lower-income countries to implement AMR prevention programs utilizing a holistic approach.

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