Tracking Antimicrobial Resistance in Africa: What Data from 14 Countries Reveals

Overview: 

Antimicrobial resistance (AMR) remains a significant global health challenge, particularly in Africa where limited national-level data and surveillance hinders a comprehensive understanding of the scale, patterns, and drivers of resistance. To address these gaps, researchers conducted a large-scale retrospective analysis of AMR data collected from laboratories across 14 African countries between 2016 and 2019. This collaborative OHT study is the largest retrospective study on resistance to antibiotics in Africa published yet and highlights the need for major investments to enhance laboratory capabilities and healthcare access.    

The Question:  

How common is bacterial AMR across different African countries? How reliable and widespread is testing data available for tracking AMR in the region? 

The Findings:   

Analyzing over 187,000 bacterial samples collected from 205 laboratories in 14 countries including Burkina Faso, Cameroon, Gabon, Ghana, Kenya, Eswatini, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe, the researcher‘s found widespread resistance to key antibiotics used to treat severe bacterial infections. 

The most frequently isolated pathogens were Escherichia coli (22.2 percent) and Staphylococcus aureus (15 percent), both of which showed high resistance rates. In some countries, up to 70 percent of these bacterial isolates were resistant to key antibiotics.  

The study highlights substantial gaps in testing capacity and data quality. The number of culture-positive samples with antibiotic susceptibility test (AST) results per 100,000 people ranged from as low as 9 in Sierra Leone to 452 in Eswatini. Only 12 percent of records included patient clinical information, limiting the ability to assess treatment outcomes and risk factors. 

The findings also highlight systemic barriers to effective AMR surveillance, including limited access to bacteriology diagnostics, under-resourced laboratories, and inconsistent data reporting systems. In many settings, testing is often performed only on the most severely ill patients, which may skew resistance estimates and obscure the full burden of AMR. 

Read the article in PLOS Medicine here.