Bacteriology testing and antimicrobial resistance detection capacity of national tiered laboratory networks in sub-Saharan Africa: an analysis from 14 countries 

Overview:   

Accurate detection of antimicrobial resistance (AMR) depends on having a strong network of laboratories. However, in sub-Saharan Africa, many gaps limit the ability of laboratories to detect and monitor AMR effectively. This One Health Trust co-authored article explored these gaps in laboratory networks across 14 countries and showed how these issues impact AMR detection, surveillance, and policies.   

The Question:   

What are the key challenges in laboratory networks for detecting AMR in sub-Saharan Africa, and how do these gaps affect surveillance and national AMR policies?   

The Findings: 

The study revealed several issues including:   

1. Limited laboratory coverage: Out of over 53,000 laboratories, only 1 percent were equipped for bacterial testing, providing less than 50 percent of the population in 7 countries with geographic access to antimicrobial susceptibility testing (AST).;  
2. Resource gaps: While most labs had access to water (88 percent) and power (87 percent), only 23 percent were ISO15189 accredited, and just 13 percent used electronic information systems.; 
3. National reference labs and private labs performed better on AMR readiness scores compared to district and government labs. Labs processing more bacterial cultures annually also scored higher.; 
4. Expanding bacterial testing capacity accounted for less than 20 percent of interventions in 12 of the 14 national AMR action plans.  

The article highlights the need to expand bacterial testing to lower-tier laboratories, increase the number of designated AMR sentinel sites, and implement better information systems and quality management across laboratory networks. 

Read the article in the Lancet Microbe here.