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

BACKGROUND: Antimicrobial 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. METHODS: PubMed, 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. RESULT: Amongst 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%)]. CONCLUSION: This 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.

Phylogeny of seven Bulinus species originating from endemic areas in three African countries, in relation to the human blood fluke Schistosoma haematobium.

BACKGROUND: Snails species belonging to the genus Bulinus (Planorbidae) serve as intermediate host for flukes belonging to the genus Schistosoma (Digenea, Platyhelminthes). Despite its importance in the transmission of these parasites, the evolutionary history of this genus is still obscure. In the present study, we used the partial mitochondrial cytochrome oxidase subunit I (cox1) gene, and the nuclear ribosomal ITS, 18S and 28S genes to investigate the haplotype diversity and phylogeny of seven Bulinus species originating from three endemic countries in Africa (Cameroon, Senegal and Egypt). RESULTS: The cox1 region showed much more variation than the ribosomal markers within Bulinus sequences. High levels of genetic diversity were detected at all loci in the seven studied species, with clear segregation between individuals and appearance of different haplotypes, even within same species from the same locality. Sequences clustered into two lineages; (A) groups Bulinus truncatus, B. tropicus, B. globosus and B. umbilicatus; while (B) groups B. forskalii, B. senegalensis and B. camerunensis. Interesting patterns emerge regarding schistosome susceptibility: Bulinus species with lower genetic diversity are predicted to have higher infection prevalence than those with greater diversity in host susceptibility. CONCLUSION: The results reported in this study are very important since a detailed understanding of the population genetic structure of Bulinus is essential to understand the epidemiology of many schistosome parasites.

Population genetic structure of Schistosoma bovis in Cameroon.

BACKGROUND: Schistosomiasis is neglected tropical parasitic disease affecting both humans and animals. Due to the human health impact, population genetic studies have focused on the three main human-infecting schistosome species: Schistosoma mansoni, S. haematobium and S. japonicum. Here we present novel data on the population genetic structure of Schistosoma bovis, a highly widespread and prevalent schistosome infecting ruminants, and therefore of veterinary importance. METHODS: Adult S. bovis were sampled in the two main abattoirs of Cameroon (Yaoundé and Douala). Twenty-two cows originating from four distinct localities were sampled and a total of 218 parasites were recovered. All parasites were genotyped using a panel of 14 microsatellite markers and a sub-sample of 91 parasites were sequenced and characterized with the mitochondrial (cox1) and nuclear (ITS) genetic markers. RESULTS: No significant difference in allelic richness, heterozygosity, nucleotide diversity and haplotype diversity was observed between the populations. Additionally, no strong genetic structure was observed at the country scale. Our data also show that S. bovis is more polymorphic than its sister species, S. haematobium, and that the haplotype diversity is similar to that of S. mansoni while the nucleotide diversity does not significantly differ from that of S. haematobium. The resulting negative Tajima's D* and Fu and Li's D* indices could be a signature of population demographic expansion. No S. haematobium/S. bovis hybrids were observed in our populations, thus all samples were considered as pure S. bovis. CONCLUSIONS: This study provides novel insights into genetic diversity and population genetic structure of S. bovis. No strong genetic structure was observed at the country scale but some genetic indices could be associated as a signature of population demographic expansion.