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Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis

  • Mouiche, Mohamed Moctar Mouliom1, 2
  • Moffo, Frédéric1, 3
  • Akoachere, Jane-Francis Tatah Kihla4
  • Okah-Nnane, Ndode Herman1, 5
  • Mapiefou, Nabilah Pemi1
  • Ndze, Valantine Ngum6
  • Wade, Abel7
  • Djuikwo-Teukeng, Félicité Flore8
  • Toghoua, Dorine Godelive Tseuko9
  • Zambou, Henri René10
  • Feussom, Jean Marc Kameni10, 11
  • LeBreton, Matthew2
  • Awah-Ndukum, Julius1, 3, 12
  • 1 University of Ngaoundéré, Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, Ngaoundéré, Cameroon , Ngaoundéré (Cameroon)
  • 2 MOSAIC, Yaoundé, Cameroon , Yaoundé (Cameroon)
  • 3 University of Dschang, Laboratory of Animal Physiology and Health, Department of Zootechnics, Faculty of Agronomy and Agricultural Sciences, Dschang, Cameroon , Dschang (Cameroon)
  • 4 University of Buea, Department of Microbiology and Parasitology, Faculty of Science, Buea, Cameroon , Buea (Cameroon)
  • 5 Wakwa Regional Center, Institute of Agricultural Research for Development, Veterinary Research Laboratory, Ngaoundéré, Cameroon , Ngaoundéré (Cameroon)
  • 6 Johns Hopkins Cameroon Program, Yaoundé, Cameroon , Yaoundé (Cameroon)
  • 7 National Veterinary Laboratory (LANAVET), Yaounde, Cameroon , Yaounde (Cameroon)
  • 8 Université des Montagnes, Faculty of Heath Science, Bangangté, Cameroon , Bangangté (Cameroon)
  • 9 National Public Health Laboratory (LNSP), Yaounde, Cameroon , Yaounde (Cameroon)
  • 10 Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon , Yaounde (Cameroon)
  • 11 Ministry of Livestock, Fisheries and Animal Industries (MINEPIA), Cameroon Epidemiological Network for Animal Diseases (RESCAM), Yaoundé, Cameroon , Yaoundé (Cameroon)
  • 12 University of Bamenda, College of Technology, Bambili, Cameroon , Bambili (Cameroon)
Published Article
BMC Public Health
Springer (Biomed Central Ltd.)
Publication Date
Aug 19, 2019
DOI: 10.1186/s12889-019-7450-5
Springer Nature


BackgroundAntimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on a One health approach, aimed at describing the current status of AMR in Cameroon.MethodsPubMed, Google Scholar and African Journals Online databases were searched for articles published in English and French in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search string with strict inclusion/exclusion criteria. Free-text and grey literature were obtained by contacting the authors directly. The pooled prevalence and 95% confidence intervals were calculated for each pathogen–antibiotic pairs using random-effects models.ResultAmongst 97 full-text articles reviewed, 66 met the eligibility criteria. The studies originated from the Centre (24; 36.4%), South-West (16; 24.2%), West (13; 19.7%), Littoral (9; 13.6%) and other (4; 6.1%) regions of Cameroon. These studies reported AMR in human (45; 68.2%), animals (9; 13.6%) and the environment (12; 18.2%). Overall, 19 species of bacteria were tested against 48 antibiotics. These organisms were resistant to all classes of antibiotics and showed high levels of multidrug resistance. Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp were reported in 23, 19 and 18 of the human studies and revealed multidrug resistance (MDR) rates of 47.1% [95% CI (37.3–57.2%)], 51.0% [95% CI (42.0–59.9)] and 45.2% [95% CI (38.0–54.7)], respectively. Salmonella spp was reported in 6 of the animal studies and showed a MDR rate of 46.2% [95% CI (39.2–53.5%)] while Staphylococcus spp in 8 of environment studies showed MDR rate of 67.1% [95% CI (55.2–77.2%)].ConclusionThis review shows that resistance to commonly prescribed antibiotics in Cameroon is high. The findings emphasize the urgent need to address gaps in the standardization of AMR diagnostics, reporting and use of available information to optimize treatment guidelines for the arsenal of antibiotics. Effective AMR surveillance through continued data sharing, large-scale collaboration, and coordination of all stakeholders is essential to understand and manage the AMR national burden.

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