Surveillance for Antibiotic Resistance in Nigeria: Challenges and Possible Solutions

Abstract

There is no doubt that antibiotics have saved the human race from a lot of suffering due to bacterial disease burden. Without these drugs, millions of people would have succumbed to infectious diseases. Regrettably, antibiotic resistance (ABR) threatens the effective treatment of these pathogens. The incidence of ABR and the emergence of multidrug-resistance bacteria are on the increase and has been considered a major public health issue. In view of this, we conducted this review of relevant published articles using extensive literature search made through PubMed, Google scholar, Scopus and HINARI on the emergence and spread of ABR, challenges and possible solutions to ABR surveillance especially in Nigeria. Findings from our review revealed that surveillance for ABR in pulmonary tuberculosis was the only system in good function in Nigeria. Regrettably, most hospitals have poor ABR systems for other bacteria. This setback was found to be linked to multifactorial reasons. Urgent and coordinated action is required at all levels to ensure preservation of these life-saving drugs for future utility. Detection of resistance and monitoring its spread requires appropriate laboratory-based surveillance. In addition, there is need to sustain the efficiency of diagnostic laboratories, improved surveillance, better regulation and education of the public, clinicians/prescribers in the appropriate use of antibiotics.

Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications

“…Surveillance provides current and salient information needed to develop and monitor antibiotic stewardship programmes, antibiotic formularies, infection control policies, public health interventions, novel antimicrobials, and antibiotic therapy guidelines [ 167 ]. It can be executed at the local, regional, national or international level, involving the monitoring of a single bacterial infection or the organism, as well as it can be effected based on funds offered by companies or non-profitable organizations [ 168 , 169 ]. The procedure provides data on the antibiotic-resistant bacteria, resistance genes, and predict the rise of antibiotic resistance as depicted from the trend in the antibiotic resistance profiles.…”

“…Furthermore, in Nigeria, the surveillance system for antibiotic resistance in pulmonary tuberculosis referred to as the National Tuberculosis and Leprosy Control Programme (NTBLCP) is commended by Nasir and co-authors [ 169 ] as the only functioning system in which services for drug-resistant TB is provided by four reference laboratories of the country. Also, WHO [ 172 ] has introduced the nested PCR equipment in numerous healthcare facilities in Nigeria, therefore, facilitating the molecular-based anti-TB resistance testing regarding rifampicin resistance.…”

“… Due to the high burden of infectious diseases and low socioeconomic status of these countries, there is a lack of available resources [ 204 ]. According to Nasir et al [ 169 ], the developing countries lack the funds to purchase reagents and consumables essential for testing antibiotic resistance, thus lack necessary plans for the surveillance of antibiotic-resistant bacteria. The cost necessary for the adequate surveillance, together with the small margin profits in the veterinary sector presents a financial drawback to support surveillance in the veterinary and agricultural sector [ 166 ].…”

Environmental and Socio- Economic Factors as Drivers of Tuberculosis in Nigeria: Paradigm to Adopt Mathematical Approach for Research and Intervention

“…Ministry of Health through the National Tuberculosis and Leprosy Control Programme is collaborating with international development partners to carry out TB surveillance in Nigeria (Nasir et al, 2015). This involve providing operational guidelines to the health personnel, and medical equipment such as mobile x-rays, laboratory reagents (Nasir et al, 2015).…”

Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

“…Antibiotic prescription practices vary widely between countries and healthcare facilities; factors which have been reported to influence antibiotic use includes infectious disease burden, prescription habit of clinicians, microbial resistance pattern, regulatory control, standard treatment guidelines, availability and economic factors [23][24][25][26][27][28][29][30][31]. In resource scarce setting where routine empirical antibiotic use is widespread, prescription pattern also vary widely [22].…”