Awulu Oche A, Jenkins Akinbowale, Balogun Babatunde A, Chukwu Emelda E, Fasina Folorunso O, Egwuenu Abiodun, Oduyebo Oyinlola O, Bamidele Tajudeen A, Cadmus Simeon, Aworh Mabel K, Adekola Adewole A, Desbois Andrew P, Chah Kennedy F, Brunton Lucy A
Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom.
Arctech Innovation, London, United Kingdom.
One Health. 2025 May 21;20:101082. doi: 10.1016/j.onehlt.2025.101082. eCollection 2025 Jun.
A One Health approach is essential to prioritise intervention areas to tackle antimicrobial resistance (AMR). This study aimed to identify and evaluate critical drivers and antimicrobial stewardship (AMS) challenges within Nigeria's human and animal health sectors. Human (22) and animal (33) health professionals in Nigeria were asked via an online questionnaire to rank priority pathogens, AMS challenges, and AMR drivers identified by subject matter experts. Descriptive statistics and the Fisher's exact test were used to evaluate differences in rankings between sectors. Subsequently, a scoping literature review of peer-reviewed research and grey literature was conducted to evaluate the evidence supporting the rankings. spp. (28.5 %) and (28.2 %) were selected as the top-ranked priority pathogens for AMR. The Fisher's exact test showed a significant association ( = 0.049) between profession and ranking of , which was ranked higher by animal health professionals than their human health counterparts. Priority AMS challenges in both human and animal health sectors were "ease of access to over-the-counter antimicrobials" (14.9 % and 20.1 %, respectively) and "lack of awareness of AMR/AMS" (14.1 % and 20.4 %, respectively). "Lack of infection prevention and control (IPC)" (24.5 %) was the highest-ranked AMR driver across sectors. Differences were observed between the rankings human and animal health professionals gave to the challenge of access to veterinary expertise ( = 0.011), as medical doctors ranked this component higher than veterinarians. "Lack of IPC" ( = 0.022) and "environmental degradation" ( = 0.048) were ranked higher by medical doctors than veterinarians. Conversely, "unsanitary processes in the abattoir(s)" was ranked higher among veterinarians ( = 0.032). Of the 84 articles reviewed, 62 supported the rankings of AMS challenges in both sectors, while 24 captured relevant AMR drivers. Our findings underscore the need for a One Health approach in Nigeria to improve AMS and curb AMR.
采用“同一健康”方法对于确定应对抗菌药物耐药性（AMR）的干预重点领域至关重要。本研究旨在确定和评估尼日利亚人类和动物卫生部门内的关键驱动因素及抗菌药物管理（AMS）挑战。通过在线问卷，让尼日利亚的22名人类卫生专业人员和33名动物卫生专业人员对主题专家确定的优先病原体、AMS挑战及AMR驱动因素进行排序。使用描述性统计和费舍尔精确检验来评估不同部门之间排序的差异。随后，对同行评审研究和灰色文献进行了范围界定文献综述，以评估支持这些排序的证据。金黄色葡萄球菌（28.5%）和大肠杆菌（28.2%）被选为AMR排名最高的优先病原体。费舍尔精确检验显示，职业与大肠杆菌的排名之间存在显著关联（P = 0.049），动物卫生专业人员对其的排名高于人类卫生同行。人类和动物卫生部门的优先AMS挑战均为“非处方抗菌药物获取便捷”（分别为14.9%和20.1%）以及“对抗菌药物耐药性/抗菌药物管理缺乏认识”（分别为14.1%和20.4%）。“缺乏感染预防与控制（IPC）”（24.5%）是各部门中排名最高的AMR驱动因素。在获取兽医专业知识的挑战方面，人类和动物卫生专业人员的排序存在差异（P = 0.011），因为医生对这一因素的排名高于兽医。医生对“缺乏IPC”（P = 0.022）和“环境退化”（P = 0.048）的排名高于兽医。相反，“屠宰场不卫生流程”在兽医中的排名更高（P = 0.032）。在所审查的84篇文章中，62篇支持两个部门AMS挑战的排序，24篇涉及相关的AMR驱动因素。我们的研究结果强调了尼日利亚采用“同一健康”方法以改善抗菌药物管理和遏制抗菌药物耐药性的必要性。
