RESUMO
Application of human and animal waste to fields and water sources and on-farm antimicrobial usage are documented contributors to the occurrence of antimicrobial resistance (AMR) in agricultural domains. This meta-analysis aimed to determine the prevalence of resistance to tetracycline (TET) and third generation cephalosporins (3GC) in Enterobacteriaceae isolated from food crops. TET was selected in view of its wide use in agriculture, whereas 3GC were selected because of the public health concerns of reported resistance to these critically important antibiotics in the environment. Forty-two studies from all six world regions published between 2010 and 2022 met the eligibility criteria. A random effects model estimated that 4.63% (95% CI: 2.57%, 7.18%; p-value: <0.0001) and 3.75% (95%CI: 2.13%, 5.74%; p-value: <0.0001) of surveyed food crops harboured Enterobacteriaceae resistant to TET and 3GC, respectively. No significant differences were observed between pre- and post-harvest stages of the value chain. 3GC resistance prevalence estimates in food crops were highest for the African region (6.59%; 95% CI: 2.41%, 12.40%; p-value: <0.0001) and lowest for Europe (1.84%; 95% CI: 0.00%, 6.02%; p-value: <0.0001). Considering the rare use of 3GC in agriculture, these results support its inclusion for AMR surveillance in food crops. Integrating food crops into One Health AMR surveillance using harmonized sampling methods could confirm trends highlighted here.
RESUMO
BACKGROUND: One Health (OH) has resurfaced in the light of the ravaging COVID-19 pandemic. It has been accepted by many local and global health authorities as a suitable approach for preventing and responding to infectious disease outbreaks including pandemics. MAIN BODY: One Health (OH) is a multisectoral and interdisciplinary framework for managing the animal, human, and ecosystem determinants of health. Globally, the majority of emerging infections in humans including SARS-Cov2-the causative agent of COVID-19-are transmitted from animals through environmental contacts in the last few decades. Yet, even when the biological and social interactions at the human, animal, and environmental interface that drive spillover of zoonotic diseases have been proven, OH strategies to address associated complex health challenges today are still rudimentary in many national health systems. Despite the disproportionate burden of infectious diseases in sub-Saharan Africa, OH is minimally incorporated into routine disease control and national health security programs. Challenges include poor policy support for OH in sub-Saharan Africa, and where some form of policy framework does exist, there are significant implementation bottlenecks. In this paper, we identified ideological, technical, operational, and economic barriers to OH implementation in Nigeria and sub-Saharan Africa, and highlighted possible recommendations across these domains. In order to yield sustainable benefits, a relevant OH policy approach in the sub-Saharan African health systems must derive from a buy-in of the critical mass of stakeholders in the society. CONCLUSION: The implementation of sustainable OH approaches as a countermeasure to recurring emerging infections is a developmental priority for sub-Saharan African countries. A deep understanding of the local context must be leveraged to develop integrative OH solutions that are bold, rooted in science, and proven to be compatible with the level of development in sub-Saharan Africa.
