Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis
Abstract Introduction Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes...
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Springer
2024-10-01
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| Series: | Journal of Epidemiology and Global Health |
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| Online Access: | https://doi.org/10.1007/s44197-024-00301-w |
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| author | John Bosco Kalule Linda A. Bester Daniel L. Banda Firehiwot Abera Derra Chisomo Msefula Anthony M. Smith Abraham Ajayi Happiness Kumburu Geoffrey Kwenda Kaunda Yamba John Mwaba Yasmina J. Fakim Nyasha Sithole Aquillah M. Kanzi Patrick M. K. Njage Francis Chikuse Sofonias K. Tessema Stella I. Smith Ebenezer Foster-Nyarko |
| author_facet | John Bosco Kalule Linda A. Bester Daniel L. Banda Firehiwot Abera Derra Chisomo Msefula Anthony M. Smith Abraham Ajayi Happiness Kumburu Geoffrey Kwenda Kaunda Yamba John Mwaba Yasmina J. Fakim Nyasha Sithole Aquillah M. Kanzi Patrick M. K. Njage Francis Chikuse Sofonias K. Tessema Stella I. Smith Ebenezer Foster-Nyarko |
| author_sort | John Bosco Kalule |
| collection | DOAJ |
| description | Abstract Introduction Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent. Methods The review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines. Results The reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30–55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17–32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce. Conclusion Despite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa. |
| format | Article |
| id | doaj-art-d4759dc2b52c4425b06b4855e2ecede4 |
| institution | Kabale University |
| issn | 2210-6014 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Epidemiology and Global Health |
| spelling | doaj-art-d4759dc2b52c4425b06b4855e2ecede42024-12-22T12:12:03ZengSpringerJournal of Epidemiology and Global Health2210-60142024-10-011441381139610.1007/s44197-024-00301-wMolecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysisJohn Bosco Kalule0Linda A. Bester1Daniel L. Banda2Firehiwot Abera Derra3Chisomo Msefula4Anthony M. Smith5Abraham Ajayi6Happiness Kumburu7Geoffrey Kwenda8Kaunda Yamba9John Mwaba10Yasmina J. Fakim11Nyasha Sithole12Aquillah M. Kanzi13Patrick M. K. Njage14Francis Chikuse15Sofonias K. Tessema16Stella I. Smith17Ebenezer Foster-Nyarko18Makerere University, College of Veterinary Medicine Animal Resources and Biosecurity (CoVAB), Biotechnical and Diagnostic SciencesBiomedical Resource Unit, College of Health Sciences, University of KwaZulu-Natal ZADepartment of Medical Laboratory Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health SciencesFood Safety and Food Microbiology National Reference Laboratory, Food Science and Nutrition Research Directorate, Ethiopian Public Health InstituteAfrica Centres for Disease Control and Prevention, African UnionDepartment of Infection Biology, London School of Hygiene and Tropical MedicineMolecular Biology and Biotechnology Department, Nigerian Institute of Medical Research (NIMR)Kilimanjaro Clinical Research InstituteDepartment of Biomedical Sciences, School of Health Sciences, University of ZambiaUniversity Teaching HospitalsDepartment of Pathology and Microbiology, University Teaching HospitalUniversity of MauritiusAfrica CDCAfrican Society for Laboratory Medicine (ASLM)Research Group for Genomic Epidemiology, National Food Institute, Technical University of DenmarkAfrica Centres for Disease Control and Prevention, African UnionAfrica Centres for Disease Control and Prevention, African UnionMolecular Biology and Biotechnology Department, Nigerian Institute of Medical Research (NIMR)Department of Infection Biology, London School of Hygiene and Tropical MedicineAbstract Introduction Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent. Methods The review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines. Results The reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30–55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17–32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce. Conclusion Despite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa.https://doi.org/10.1007/s44197-024-00301-wDiarrhoeagenic Escherichia coliAfricaFood and water-borne diseasesAntimicrobial resistance |
| spellingShingle | John Bosco Kalule Linda A. Bester Daniel L. Banda Firehiwot Abera Derra Chisomo Msefula Anthony M. Smith Abraham Ajayi Happiness Kumburu Geoffrey Kwenda Kaunda Yamba John Mwaba Yasmina J. Fakim Nyasha Sithole Aquillah M. Kanzi Patrick M. K. Njage Francis Chikuse Sofonias K. Tessema Stella I. Smith Ebenezer Foster-Nyarko Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis Journal of Epidemiology and Global Health Diarrhoeagenic Escherichia coli Africa Food and water-borne diseases Antimicrobial resistance |
| title | Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis |
| title_full | Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis |
| title_fullStr | Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis |
| title_short | Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis |
| title_sort | molecular epidemiology and amr perspective of diarrhoeagenic escherichia coli in africa a systematic review and meta analysis |
| topic | Diarrhoeagenic Escherichia coli Africa Food and water-borne diseases Antimicrobial resistance |
| url | https://doi.org/10.1007/s44197-024-00301-w |
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