Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis.
Mohamed Moctar Mouliom Mouiche, Frédéric Moffo, Jane-Francis Tatah Kihla Akoachere, Ndode Herman Okah-Nnane, Nabilah Pemi Mapiefou, Valantine Ngum Ndze, Abel Wade, Félicité Flore Djuikwo-Teukeng, Dorine Godelive Tseuko Toghoua, Henri René Zambou, Jean Marc Kameni Feussom, Matthew LeBreton, Julius Awah-Ndukum
Author Information
Mohamed Moctar Mouliom Mouiche: Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon. mouichemoctar4@gmail.com. ORCID
Frédéric Moffo: Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
Jane-Francis Tatah Kihla Akoachere: Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.
Ndode Herman Okah-Nnane: Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
Nabilah Pemi Mapiefou: Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
Abel Wade: National Veterinary Laboratory (LANAVET), Yaounde, Cameroon.
Félicité Flore Djuikwo-Teukeng: Faculty of Heath Science, Université des Montagnes, Bangangté, Cameroon.
Dorine Godelive Tseuko Toghoua: National Public Health Laboratory (LNSP), Yaounde, Cameroon.
Henri René Zambou: Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon.
Jean Marc Kameni Feussom: Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon.
Matthew LeBreton: MOSAIC, Yaoundé, Cameroon.
Julius Awah-Ndukum: Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
BACKGROUND: Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on a One health approach, aimed at describing the current status of AMR in Cameroon. METHODS: PubMed, Google Scholar and African Journals Online databases were searched for articles published in English and French in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search string with strict inclusion/exclusion criteria. Free-text and grey literature were obtained by contacting the authors directly. The pooled prevalence and 95% confidence intervals were calculated for each pathogen-antibiotic pairs using random-effects models. RESULT: Amongst 97 full-text articles reviewed, 66 met the eligibility criteria. The studies originated from the Centre (24; 36.4%), South-West (16; 24.2%), West (13; 19.7%), Littoral (9; 13.6%) and other (4; 6.1%) regions of Cameroon. These studies reported AMR in human (45; 68.2%), animals (9; 13.6%) and the environment (12; 18.2%). Overall, 19 species of bacteria were tested against 48 antibiotics. These organisms were resistant to all classes of antibiotics and showed high levels of multidrug resistance. Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp were reported in 23, 19 and 18 of the human studies and revealed multidrug resistance (MDR) rates of 47.1% [95% CI (37.3-57.2%)], 51.0% [95% CI (42.0-59.9)] and 45.2% [95% CI (38.0-54.7)], respectively. Salmonella spp was reported in 6 of the animal studies and showed a MDR rate of 46.2% [95% CI (39.2-53.5%)] while Staphylococcus spp in 8 of environment studies showed MDR rate of 67.1% [95% CI (55.2-77.2%)]. CONCLUSION: This review shows that resistance to commonly prescribed antibiotics in Cameroon is high. The findings emphasize the urgent need to address gaps in the standardization of AMR diagnostics, reporting and use of available information to optimize treatment guidelines for the arsenal of antibiotics. Effective AMR surveillance through continued data sharing, large-scale collaboration, and coordination of all stakeholders is essential to understand and manage the AMR national burden.
