Antibiotic-resistant Escherichia coli (E. coli) at one health interfaces in Africa: A scoping review.

One Health represents a cohesive strategy designed to sustainably harmonize and enhance the health of humans, animals, and ecosystems. This implies that addressing the global rising antimicrobial resistance problem requires a One Health (OH) approach. Thus, using a Joanna Briggs Institute scoping review design, this review mapped existing literature on antibiotic-resistant (ABR) Escherichia coli in Africa from a OH perspective. The review protocol was developed and registered (https://osf.io/48x2d) before implementation. PubMed, ScienceDirect, Web of Science, Sabinet, and African Journals Online databases were searched systematically using predefined terms for all eligible articles between January 2010 and May 2024.The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) was used. Of 507 search results, 63 were finally analysized using a three-level screening process. The data showed that OH studies on ABR E. coli were highest in the Eastern African region, with studies at the human-animal interface predominating. Reported ABR E. coli prevalence rates ranged from 0.64 % - 98.3 %. The studies reported diverse extended-spectrum beta-lactamase (ESBL) genes (n = 44), mcr genes (n = 3), other resistance genes (n = 82), and mobile genetic elements (plasmids, integrons, insertion sequences, and transposons). Moreso, this review showed that: research on ABR at OH interfaces is in its infancy in Africa, with ABR E. coli data unavailable for 68.5 % (n = 37) of the countries, and the food chain was the most inferred transmission route of ABR E. coli. Notwithstanding the relatively small number of studies at OH interfaces in Africa, these results emphasize antimicrobial stewardship, good hygiene and biosecurity practices, AMR surveillance, and research using the OH approach to ensure good health human, animal, plant and environmental health.