Cropping up Crisis at the Nexus Between COVID-19 and AMR in Africa: A Scoping Review and Synthesis of Early Evidence

Abstract

Objective In this study, we aim to synthesize some evidence on the impacts that COVID-19 is having on the epidemiology of Antimicrobial Resistance (AMR) in Africa since it was declared global pandemic by WHO in March 2020. Methodology A scoping review was undertaken by collecting and curating relevant resources from peer-reviewed articles and also from the gray literature. Mixed approaches of extracting data (qualitative and quantitative) were employed in synthesizing evidence, as suggested by Health Evidence Network (HEN). Findings A model constructed based on the synthesis of early evidences available on the effects of factors linked to COVID-19 in impacting the evolution of AMR in Africa predicted that, in cumulative terms, those factors favoring the evolution of AMR outpace those disfavoring it by no less than three folds. Conclusion COVID-19 is fueling the evolution of AMR almost unhindered in Africa. Due recognition of this crisis, concerted efforts for resource mobilization and global cooperation are needed to tackle it.

A pandemic within a pandemic? Admission to COVID-19 wards in hospitals is associated with increased prevalence of antimicrobial resistance in two African settings

“…Patients who develop severe or critical COVID-19 illness, defined as those requiring oxygen support, are more likely to acquire co-infections, such as bacterial pneumonia, that can be difficult to differentiate from COVID-19, and the WHO recommends empiric antibiotics to treat all likely pathogens [9,10]. In mild to moderate cases of COVID-19, the use of antibiotics is discouraged, unless there is clinical suspicion of bacterial infection, to reduce the risk of the short-term side-effects of antibiotics for patients, as well as the potential long-term threats associated with increased AMR [11].…”

“…The impact of contracting severe COVID-19, requiring hospitalisation, on a patient's risk of developing a secondary bacterial infection, and the likelihood of resistance has not been widely studied in resource limited settings. Whilst there are a number of editorials and opinion pieces, there are few data from the African continent [11]. It is critical to reduce the risk of seriously ill COVID-19 patients contracting HAIs, whilst also trying to protect healthcare workers from COVID-19, and a greater understanding of the links between severe COVID-19 infection, HAIs, AMR and COVID-19 ward IPC and AMS can help to ensure the safety of both patients and staff.…”