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

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.