Epidemiology of Antimicrobial Resistance and the Wash Project: Averting a Potential Public Health Crisis in Nigeria Using the United Kingdom as a Case Study

Nnenna Victoria Ezugwu *

University of East London, School of Health, Sport and Bioscience, United Kingdom.

Alicia Gayle

University of East London, United Kingdom.

Chris Anyamene

Nnamdi Azikiwe University, Awka, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Aim: To assess the impact of WASH services in mitigating the proliferation of AMR in Nigeria, with the United Kingdom serving as a reference population.

Study Design: This is a review article.

Duration of Study: An extensive review was conducted in relevant databases, specifically focusing on research studies published in peer-reviewed journals in English. These studies were conducted in both the United Kingdom and Nigeria, with the primary objective of investigating the relationship between Water, Sanitation, and Hygiene practices and Antimicrobial Resistance. The search spanned from May 2015, coinciding with the adoption of the global action on antimicrobial resistance by the World Health Assembly, to July 2023. The literature search was completed on August 10, 2023.

Methodology: The search involved electronic databases such as EBSCO, PubMed, Science Direct, and CINAHL Complete. Additionally, relevant literature was searched on the websites of organizations such as the World Health Organization, Nigeria Centre for Disease Control and Prevention, and the Centre for Disease Control and Prevention, Public Health England. The quality of the papers was evaluated using CASP tools to determine their reproducibility, credibility, dependability, and confirmability. Out of the initial 705 articles that were drawn from the different databases, 12 studies were included in the literature review.

Results: The review of the various literature showed that WASH interventions in Nigeria are geared toward disease transmission/infection prevention and control and not the combatting of AMR while studies in the UK have shown positive advances in tackling AMR utilizing WASH services.

Conclusion: Promoting the development and provision of WASH infrastructure in diverse Nigerian settings is crucial for addressing antimicrobial resistance (AMR). This literature review serves as a call to action for stakeholders at the national, regional, and local levels in Nigeria, emphasizing the necessity of nationwide investment in WASH infrastructure, the development of policies that support the implementation of WASH in all the communities and villages, extensive health promotion campaigns to raise awareness about AMR, and community-level interventions to contain the spread of AMR in Nigeria.

Keywords: AMR, antibiotic resistance, WASH, United Kingdom, Nigeria


How to Cite

Ezugwu, N. V., Gayle , A., & Anyamene , C. (2024). Epidemiology of Antimicrobial Resistance and the Wash Project: Averting a Potential Public Health Crisis in Nigeria Using the United Kingdom as a Case Study. International Journal of TROPICAL DISEASE & Health, 45(6), 87–104. https://doi.org/10.9734/ijtdh/2024/v45i61542

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References

Murray C, Ikata K, Sharara F, Swetschinski L, Aguilar G, Gray A, Han C, Bisignano C, Rao P, Wool E, Johnson S, Browne A, Chipeta MC, Fell F, Hackett S, Haines-Woodhouse G, Hamadani BH, Kumaran EA, McManigal B, Naghavi M. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis, The Lancet. 2022;399(10325):629 – 655.

World Health Organization. Global Action Plan of Antimicrobial Resistance. Geneva; 2015. Available:https://apps.who.int/iris/handle/10665/193736 (Accessed: 20 July, 2023)

Hu KY, Logue M, Robinson N. Antimicrobial resistance is a global problem – a UK perspective, European Journal of Integrative Medicine, 36, article number 101136; 2020 Available:https://doi.org/10.1016/j.eujim.2020.101136

Ribeiro da Cunha B, Fonseca LP, Calado CR. Antibiotic discovery: Where have we come from, where do we go? Antibiotics. 2019;8(2):45.

Gandra S, Barter D, Laxminarayan R. Economic burden of antibiotic resistance: how much do we really know? Clinical Microbiolology and Infection. 2014;20(10):973–980.

Aghamohammad S, Rohani M. Antibiotic resistance and the alternatives to conventional antibiotics: The role of probiotics and microbiota in combating antimicrobial resistance, Microbiological Research, 267, article number 127275; 2023 Available:https://doi.org/10.1016/j.micres.2022.127275

Friedman N, Temkin E, Carmeli Y. The negative impact of antibiotic resistance, Clinical Microbiology and Infection. 2016;22(5):416–422.

Ventola C. The antibiotic resistance crisis: part 1: causes and threats, P and T: a peer-Reviewed Journal for Formulary Management, Medi Media. 2015;40(4): 277–283.

Fair R, Tor Y. Antibiotics and bacterial resistance in the 21st century, Perspectives in Medicinal Chemistry. 2014;6:25-64.

Ndihokubwayo J, Yahaya A, Dest A, Ki-Zerbo G, Odei E, Keita B, Pana A, Nkhoma W. Antimicrobial resistance in the African Region: Issues, challenges and actions proposed, World Health Organization, Regional Office for Africa; 2013 Available:https://www.afro.who.int/sites/default/files/2017–06/amr-paper-march-2013-jbn-and-all.pdf (Accessed: 20 July, 2023)

O’Neil J. Antimicrobials in agriculture and the environment: reducing unnecessary use and waste, The Review on Antimicrobial Resistance; 2015 Available:https://amrreview.org/sites/default/files/Antimicrobials%20in%20agriculture%20and%20the%20environment%20%20Reducing%20unnecessary%20use%20and%20waste.pdf.

Peleg AY, Hooper DC. Hospital-acquired infections due to gram-negative bacteria, The New England Journal of Medicine. 2010;362(19):1804–1813.

Shaikh S, Fatima J, Shakil S, Rizvi S, Kamal M. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment, Saudi Journal of Biological Sciences. 2015;22(1): 90–101.

Moyo P, Mangoya E, Mhango D, Mashe M, Ansari Z, Dzinamarira M. Prevention of antimicrobial resistance in sub-Saharan Africa: What has worked? What still needs to be done? Journal of Infection and Public Health. 2023;16:10.

Dadgostar P. Antimicrobial resistance: Implications and costs, Infection and Drug Resistance. 2019;12:3903-3910.

O’Neill J. Tackling drug-resistant infections globally: Final report and recommendations. The Review on Antimicrobial Resistance; 2016 Available: http://amr-review.org (Accessed: 20 April 2023)

Ghafur A. Overconsumption of antibiotics, The Lancet Infectious Diseases. 2015; 15(4):377.

Gajdács M, Urbán E, Stájer A, Baráth Z. Antimicrobial resistance in the context of the Sustainable Development Goals: A brief review. European Journal of Investigation in Health, Psychology and Education. 2021;11:71 - 82.

World Health Organization WHO Coronavirus (COVID-19) Dashboard; 2023 Available: https://covid19.who.int (Accessed: 6 May 2023)

Chukwu, E., Oladele, D., Awoderu, O., Afocha, E., Lawal, R., Abdus-Salam, I., Ogunsola, F. and Audu, R. (2020). A national survey of public awareness of antimicrobial resistance in Nigeria, Antimicrobial Resistance & Infection Control, 9(1): 72.

Adeniji F. Global analysis of strategies to tackle antimicrobial resistance. International Journal of Pharmacy Practice. 2018;26(1):85-89.

Fadare J, Ogunleye O, Iliyasu G, Adeoti A, Schellack N, Engler D, Massele A, Godman B. Status of antimicrobial stewardship programmes in Nigerian tertiary healthcare facilities: Findings and implications, Journal of Global Antimicrobial Resistance. 2019;17:132-136.

Fadare J, Olatunya O, Oluwayemi O, Ogundare O. Drug prescribing pattern for under-fives in a paediatric clinic in South-Western Nigeria, Ethiopia Journal of Health Science. 2015a;25:73-78.

Ekwochi U, Chinawa J, Osuorah C, Odetunde O, Obu H, Agwu S. The use of unprescribed antibiotics in management of upper respiratory tract infection in children in Enugu, South East Nigeria, Journal of Tropical Pediatrics. 2014;60: 249-252.

Fadare J, Adeoti O, Aina F, Solomon O, Ijalana J. The influence of health insurance scheme on the drug prescribing pattern in a Nigerian tertiary healthcare facility, Nigerian Medical Journal. 2015b;56:344-348.

Olufunmiso O, Tolulope I, Roger C. Multidrug and vancomycin resistance among clinical isolates of Staphylococcus aureus from different teaching hospitals in Nigeria, African Health Sciences. 2017;17: 797-807.

Bernabe K, Langendorf C, Ford N, Ronat J, Murphy R. Antimicrobial resistance in West Africa: A systematic review and meta-analysis, International Journal of Antimicrobial Agents. 2017;50:629-639.

Adenipekun E, Jackson C, Ramadan H, Iwalokun B, Oyedeji K, Frye J, Barret JB, Hiott L, Woodley TA, Oluwadun A. Prevalence and multidrug resistance of Escherichia coli from community-acquired infections in Lagos, Nigeria, Journal of Infection in Developing Countries. 2016;10:920-931.

Naylor N, Atun R, Zhu N, Kulasabanathan K, Silva S, Chatterjee A, Knight G, Robotham J. Estimating the burden of antimicrobial resistance: A systematic literature review, Antimicrobial Resistance and Infection Control. 2018;7:58.

Titilawo Y, Obi L, Okoh A. Antimicrobial resistance determinants of Escherichia coli isolates recovered from some rivers in Osun State, South-Western Nigeria: Implications for public health, The Science of the Total Environment. 2015;523:82-94.

Yusuf-Omoloye N, Adeyemi F, Sule W, Yusuf W, Ajigbewu O, Adegbite-Badmus M, Oyafajo L, Oyedara O, Wahab A, Akinde S. Culture-dependent and molecular characterization of Vancomycin-Resistant Enterococci from clinical, food, and water samples across Osun State, Southwest Nigeria, Scientific African, 21, article number e01813; 2023 Available:https://doi.org/10.1016/j.sciaf.2023.e01813

Okafor C, Iroha I, Ude I, Onuoha S, Ejikeugwu C, Ovia K, Eromonsele B, Agah V, Okoronkwo C, Gabriel-Ibeh I, Okoroafor I, Nwachukwu O; 2022.

Adekanmbi A, Soyoye O, Adelowo C. Characterization of methicillin-resistance gene mecA in coagulase negative staphylococci (CoNS) recovered from wastewater of two healthcare facilities in Nigeria, Gene Reports, 17, article number 100541; 2019.

Available:https://doi.org/10.1016/j.genrep.2019.100541

Pinto J, Keestra S, Tandon P, Cumming O, Pickering A, Moodley A, Chandler C. Biosecurity and water, sanitation, and hygiene (WASH) interventions in animal agricultural settings for reducing infection burden, antibiotic use and antimicrobial resistance: A One Health mixed systematic review, Lancet Planet Health, 20237(5): 418-434..

Cullet P, Bhullar L. The Regulation of Planetary Health Challenges: A Co-Benefits Approach for AMR and WASH, Environmental Policy and Law. 2022;52(3-4):289-299.

Storr J, Kilpatrick C, Lee K. Time for a renewed focus on the role of cleaners in achieving safe health care in low- and middle-income countries, Antimicrobial Resistance and Infection Control. 2021;10:59. Available:https://doi.org/10.1186/s13756-021-00922-x

Independent Commission for Aid Impact. The UK’s changing approach to water, sanitation and hygiene Information note; 2022 Available:https://icai.independent.gov.uk/html-version/annual-report-2022-2023/

Fakayode IB, Ogunjobi AA. Quality assessment and prevalence of antibiotic resistant bacteria in government approved mini-water schemes in Southwest, Nigeria. International Biodeterioration an Biodegradation. 2018;133:151-158.

Alhaji N, Maikai B, Kwaga J. Antimicrobial use, residue and resistance dissemination in freshwater fish farms of north-central Nigeria: One health implications, Food Control, 130, article number 108238; 2021.

Available:https://doi.org/10.1016/j.foodcont.2021.108238

Maina M, Tosas-Auguet O, McKnight J, Zosi M, Kimemia G, Mwaniki P, Schultsz C, English M. Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya, Plos One. 2019;14(10). article number e0222922. Available:https://doi:10.1371/journal.pone.0222922

Zeitoun M, Sittah G, Shomar R, El Ach N. AMR and Covid-19 on the Frontline: A Call to Rethink War, WASH, and Public Health, Annals of Global Health. 2021;87(1):21.

Nigeria Center for Disease Control and Prevention. STOP Cholera Strengthening Water, sanitation and hygiene (WASH) in Nigeria; 2022. Available:https://ncdc.gov.ng/news/420/stop-cholera%3A-strengthening-water%2C-sanitation-and-hygiene%A0%28wash%29-in-nigeria (Accessed: 8 August, 2023)

Department of Health and Social Care. Tackling antimicrobial resistance 2019–2024: The UK’s five-year national action plan; 2019 Available:https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2019-to-2024 (Accessed: 10 August, 2023)

Sreeja M, Gowrishankar N, Adisha S, Divya K. Antibiotic resistance-reasons and the most common resistant pathogens – a review, Research Journal of Pharmacy and Technology. 2017;10:1886-1890.

Sulis G, Daniels B, Kwan A, Gandra S, Daftary A, Das J, Pai M. Antibiotic overuse in the primary health care setting: A secondary data analysis of standardized patient studies from India, China and Kenya, British Medical Journal Global Health. 2020;5:3393.

Uddin T, Chakraborty A, Khusro A, Zidan B, Mitra S, Bin Emran T, Dhama K, Ripon M, Gajdács M, Sahibzada M, Hossain M, Koirala N. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects, Journal of Infection and Public Health. 2021;14:1750-1766.

Vinodhini K, Bhoomadevi A. Study on infection control practices among healthcare workers in a speciality hospital, Chennai, Pollution Research. 2016; 35:549-555.

Rossolini G, Arena F, Pecile P, Pollini S. Update on the antibiotic resistance crisis, Current Opinion in Pharmacology. 2014;18:56-60.

Zhou N, Cheng Z, Zhang X, Lv C, Guo G, Liu H, Dong K, Zhang Y, Liu C, Chang YF, Chen S, Guo X, Zhou XN, Li M, Zhu Y. Global antimicrobial resistance: A system-wide comprehensive investigation using the Global One Health Index, Infectious Disease of Poverty. 2022;11(92).

Article number 100. Available: https://doi.org/10.1186/s40249-022-01016-5

Aslam B, Wang W, Arshad MI, Khurshid M, Muzammil S, Rasool MH, Nisar MA, Alvi RF, Aslam MA, Qamar MU, Salamat MKF, Baloch Z. Antibiotic resistance: A rundown of a global crisis, Infection and Drug Resistance. 2018;11:1645-1658.

Pulingam P, Parumasivam T, Gazzali A, Sulaiman A, Chee J, Lakshmanan M, Chin C, Sudesh K. Antimicrobial resistance: Prevalence, economic burden, mechanisms of resistance and strategies to overcome, European Journal of Pharmaceutical Sciences. 2022;170. article number 106103 Available:https://doi.org/10.1016/j.ejps.2021.106103

Essack S. Water, sanitation and hygiene in national action plans for antimicrobial resistance, Bulletin of the World Health Organization. 2021;99(8):606-608.

Kotwani A, Joshi P, Jhamb U, Holloway K. Prescriber and dispenser perceptions about antibiotic use in acute uncomplicated childhood diarrhea and upper respiratory tract infection in New Delhi: Qualitative study, Indian Journal of Pharmacology. 2017;49(6):419–431.

Maillard JY, Bloomfield SF, Courvalin P, Essack SY, Gandra S, Gerba CP, Rubino JR, Scott EA. Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper, American Journal of Infection and Control. 2020;48(9):1090–1099.

Kavya IK, Kochhar N, Ghosh A, Shrivastava S, Rawat V, Ghorai S, Sodhi K, James A, Kumar M. Perspectives on systematic generation of antibiotic resistance with special emphasis on modern antibiotics, Total Environment Research Themes, 8, article number 100068; 2023. Available:https://doi.org/10.1016/j.totert.2023.100068

Caruso B, Sevilimedu V, Fung I, Patkar A, Baker K. Gender disparities in water, sanitation, and global health, The Lancet. 2015;386(9994):650–651.

WaterAid Wards without water: the challenges of providing maternal care in rural Malawi; 2021.

Available:https:// washmatters.wateraid.org/blog/wards-without-water-the-challenges-of-providing-maternal-care-in-rural malawi-photo-essay (Accessed: 8 August, 2023)

Mannava P, Murray J, Rohko K, Sobel H. Status of water, sanitation and hygiene services for childbirth and newborn care in seven countries in East Asia and the Pacific, Journal of Global Health. 2019;9(2). article number 020430. Available:https://doi.org/10.7189/jogh.09.020430

United Nations Children’s Fund. Committing to Child Survival: A Promised Renewed. Progress Report; 2015. Available:http://www.apromiserenewed.org/wp-content/uploads/2016/01/APR-Report-2015-e-version(Accessed: 10 July, 2023)

Drug resistance profile of biofilm forming Pseudomonas aeruginosa isolated from aquatic environment in South Eastern Nigeria, Environmental Challenges, 8, article number 100530. Available from: https://doi.org/10.1016/j.envc.2022.100530

Public Health England Guidance for managing common infections, including upper and lower respiratory, and urinary tract infections; 2019 Available:https://www. gov.uk/government/publications/managing-common-infections-guidance-forprimary-care (Accessed: 8 August, 2023)

World Health Organization and United Nations Children’s Fund. Global Action Plan on Water, Sanitation and Hygiene in Health Care Facilities; 2016 Available:http://www.who.int/water_sanitation_health/facilities/healthcare/wash-in-hcf-global-action-plan-2016-03-16.pdf?ua=1 (Accessed: 10 August, 2023)

World Health Organization. Standards for Improving Quality of Maternal and Newborn Care in Health Facilities; 2016 Available:http://apps.who.int/iris/bitstream/10665/249155/1/9789241511216-eng.pdf?ua=1(Accessed: 10 August, 2023)

World Health Organization. Antimicrobial resistance; 2018 Available:http://www.who.int/mediacentre/factsheets/fs194/en/ (Accessed: 10 July 2023)

World Health Organization, Food and Agriculture Organization of the United Nations and World Organisation for Animal Health ‎. Technical brief on water, sanitation, hygiene and wastewater management to prevent infections and reduce the spread of antimicrobial resistance; 2020 Available:https://apps.who.int/iris/handle/10665/332243 (Accessed: 20 April 2023)