Prevalence and antimicrobial resistance patterns of isolates in human stools and animal origin foods in Ethiopia: A systematic review and meta-analysis.

OBJECTIVE

Foodborne diseases caused by non-typhoid and the emergence of antimicrobial resistance remain as a public health challenge, especially in developing countries. The current study aimed to estimate the pooled prevalence and the antimicrobial resistance patterns of non-typhoid in Ethiopia.

METHODS

Literature search was conducted from major electronic databases and indexing services. Both published and unpublished studies addressing the prevalence and antimicrobial resistance profiles of in Ethiopia from 2010 to 2020 and those studies reported sample size and the numbers of isolates/number of positive samples were included in the study. Data were extracted using format prepared in Microsoft Excel. The identified data were exported to EndNote to remove duplicated studies, then after the remained articles were screened using title, abstract, and full text to identify studies that meet the inclusion criteria and finally appraised for methodological validity using JBI guideline. The pooled prevalence of and its drug resistance pattern was computed by a random-effects model. I test statistic was used to test heterogeneity across studies. The presence of publication bias was evaluated using the Begg's and Egger's tests.

RESULTS

A total of 49 eligible articles, 33 of them on human stools, 15 of them on animal origin foods, and one both on human stools and animal origin foods, were included in the study. The pooled prevalence of among human stools and animal origin foods in Ethiopia was 4.8% (95% CI: 3.9, 5.9) and 7.7% (95% CI: 5.6, 10.4), respectively. The subgroup analysis detected high pooled prevalence, 7.6% (95% CI: 5.3, 10.7) among outpatients and low, 3.7% (95% CI: 2.6, 5.1) in food handlers. The pooled resistant level of was 80.6% (95% CI 72.6, 86.7) for ampicillin and 63.5% (95% CI 53.7, 72.4) for tetracycline. Low pooled resistance pattern was reported in ciprofloxacin, 8.7% (95% CI 5.6, 13.3) and ceftriaxone 12.2% (95% CI 7.9, 18.3). There was some sort of publication bias.

CONCLUSION

High pooled prevalence of among human stools and animal origin foods which were 4.8% and 7.7% respectively, and high resistance, >72% to ampicillin and tetracycline were detected in Ethiopia. Antimicrobial stewardship efforts and infection control strategies are required to mitigate this major public health concern.