Current Strategies and Key Barriers in Combating Antimicrobial Resistance in Nigeria: A Systematic Review

Abstract

Background: Antimicrobial resistance (AMR) is a serious global threat, causing thousands of annual deaths, and a projected increase to millions by 2050, with more cases in Africa. This systematic review aims to evaluates current control strategies and major barriers in addressing AMR in Nigeria.

Methods: Following the PRISMA (2020) guidelines, 41 relevant articles were identified out of 261 searched from AJOL, PubMed, Science direct, Cochrane library, Scopus, web of science, and google scholar databases covering the period from 2001 to 2021.

Results: High resistance was observed to ampicillin (9.6%) and chloramphenicol (8.4%), while cephalosporins, rifampicin, isoniazid, norfloxacin, meropenem, and ciprofloxacin showed lower resistance rates. Among 45 resistant cases, Staphylococcus aureus (17.8%) and Escherichia coli (15.6%) were most prevalent, followed by Klebsiella species (11.1%) and Pseudomonas aeruginosa (8.9%). Mycobacterium tuberculosis (6.7%) and other bacteria, including Salmonella typhi, Citrobacter spp., Proteus spp., and Enterobacter spp., had resistance rates between 2.2% and 4.4%. Resistant fungi included Candida spp. (4.4%) and Aspergillus spp. (2.2%). Efforts to curb AMR include WHO initiatives like Global Antimicrobial Resistance Surveillance System (GLASS) and Global Antibiotic Research and Development Partnership (GARDP), alongside national antimicrobial laws and policies regulating the use of antimicrobial products. However, Nigeria faces significant challenges, including weak surveillance systems, poor enforcement of drug laws, and limited public awareness. Additional issues involve unlicensed drug vendors and poor pharmaceutical regulation.

Conclusion: To address AMR effectively, Nigeria must enforce drug regulations, enhance public education especially in rural areas and invest in research for new antimicrobials and vaccines.