A Review of the Important Weapons against Antimicrobial Resistance in Sub-Saharan Africa

Abstract

Antimicrobial resistance (AMR) is one of the top 10 global health threats facing humanity, and the sub-Saharan Africa (SSA) is among the heavily affected regions due to its weak health systems and limited resources. Due to an escalating number of AMR pathogens and the scarcity of new antimicrobials, efforts in the prevention of infections and the search for alternative treatment options are ongoing. The objective of this review was to assess important weapons against AMR in SSA. The highlighted weapons include vaccines, education and awareness, infection prevention and control (IPC) using water, sanitation, and hygiene (WASH), alternative treatment options, the One Health (OH) approach, AMR surveillance, operational national action plans (NAPs) on AMR, antimicrobial stewardship (AMS) programs, and good governance and regulations. Despite not being used at a satisfactory level in SSA, advanced techniques in dealing with AMR in SSA include (i) metagenomics, (ii) whole-genome sequencing (WGS) in AMR surveillance to track resistance trends and know when to intervene, and (iii) use of artificial intelligence in AMR prediction based on genomics data. The fight against AMR threat in SSA has embraced a number of currently available strategies, and developing new ones will lower the consequences of such a threat for future generations.

Education and Awareness on Antimicrobial Resistance in the WHO African Region: A Systematic Review

“…Despite a majority of countries (74%, 23/31) in the region holding regular public awareness campaigns against AMR and its drivers [95], our review of the literature highlighted poor levels of awareness and knowledge on AMR across societal strata. One of the key weapons against AMR is public awareness/engagement which, if conducted taking into account context-specific determinants and elements of behaviour change, has the potential of engendering behavioural change among the public bearing in mind that AMR is a society-wide issue demanding specified roles to be played by everyone [96]. The fact that the public is generally unaware of AMR and its dare consequences calls for aggressive orientation and community engagements among member countries with the full participation of the governments' relevant sectors, civil society, non-governmental organisation, and the media for concerted and coordinated activities towards communicating AMR and its deleterious consequences to the populace in an effective manner for enhanced understanding.…”

Exploring Prescription Practices: Insights from an Antimicrobial Stewardship Program at a Tertiary Healthcare Facility, Rwanda

“…This study also revealed that KFH staff demonstrated awareness of the importance of hand hygiene in infection prevention and control (IPC). Improper hygienic practices lead to infections that promote use of antimicrobials known as a driver of AMR [ 23 , 24 ]. Additionally, participants mentioned other practices such as routine fumigation and environmental swabbing that contribute to maintaining a hygienic hospital environment and mitigating the spread of resistant pathogens.…”

“…Additionally, participants mentioned other practices such as routine fumigation and environmental swabbing that contribute to maintaining a hygienic hospital environment and mitigating the spread of resistant pathogens. Previous studies highlighted water, sanitation, hygiene, and IPC among important weapons to reduce the AMR burden [ 23 , 25 ]. While awareness of these practices is positive, it is essential to go beyond mere knowledge.…”

The importance of “one health approach” to the AMR study and surveillance in Angola and other African countries

“…The fight against the AMR hurdle in Sub-Saharan Africa has used a variety of currently available approaches. According to Gahamanyi et al [ 117 ], these important weapons against AMR include vaccine production, promotion of AMR education and awareness among health professionals and the community, and strengthening infection prevention and control by improving water, sanitation, and hygiene facilities. Using alternative treatment options, adopting the “One Health Approach”, initiating AMR surveillance, developing and implementing national action plans on AMR, applying antimicrobial stewardship programs, and promoting good governance and regulations are also possible measures against AMR.…”