Antimicrobial Resistance Surveillance in Nigeria Current Situation and Way Forward A Review

Antimicrobial agents are used to prevent, control and treat infectious diseases caused by microorganisms. This survey reviewed the antimicrobial resistance (AMR) situation in Nigeria. An increasing rate of resistance among different microorganisms to various antimicrobial agents was found. The reasons for this include: inappropriate use of antimicrobial drugs in humans, animals and plants, poor infectious disease prevention, control and treatment, poor surveillance, lack of access to clean water, sanitation and hygiene (WASH), poor access to quality and affordable medicines, vaccines and diagnosis, ignorance, poverty and lack of enforcement of legislations. The implications include difficulty in treating infectious diseases, higher risk of disease spreading, reduced efficacy of drugs, long hospital stay, higher cost of treatment as well as greater disability and mortality. To curb antimicrobial resistance and its effects, Nigeria developed her National Action Plan for AMR in 2017 with the Nigeria Centre for Disease Control (NCDC) as the coordinating body. Currently, there exists two tuberculosis national reference laboratories, six zonal laboratories in tertiary hospitals, PCR equipment called Genexpert for molecular-based anti-TB resistance testing in several health centers and an AMR standing committee in tertiary institutions. However, there are no existing surveillance system, laboratory information system and coordinating unit, making AMR surveillance ineffective. As resistance to new antimicrobials emerged and spread, the need for comprehensive resistance surveillance programmes that provide timely information to enable public health interventions and prevent emergence and spread of antimicrobial resistance. Manpower development, public enlightenment, adequate funding, one health approach, collaborative action, building more diagnostic laboratories, effective waste management system as well as greater research and innovation are therefore recommended for improved AMR surveillance. La Surveillance de la Résistance Antimicrobienne au Nigeria : Situation Actuelle et Voie a Suivre