Preventing AMR Spread from Wastewater through Urban Agriculture in Cameroon

National AMR context

In Cameroon, antimicrobial resistance (AMR) is an emerging public health challenge, exacerbated by the overuse of antibiotics and untreated wastewater used in urban agriculture. Urban agriculture, which contributes significantly to food security and employs 11% of the population, often relies on untreated wastewater, exposing crops to antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs). Studies in Cameroon have linked wastewater irrigation to increased AMR in crops, highlighting urban agriculture as a potential vector for AMR dissemination. However, the health impacts of these practices and the effectiveness of current interventions remain unclear. Addressing these challenges requires cost-effective wastewater treatment interventions and alignment with the National Action Plan on AMR to mitigate risks in both natural and built environments.

Problem

In Cameroon, untreated wastewater used for irrigation in urban agriculture poses a significant public health challenge by facilitating the transmission of AMR and pathogens. This issue is particularly critical in Yaoundé, where urban agriculture plays a vital role in food security and employment yet relies on wastewater that harbors ARBs and ARGs. Despite its relevance, AMR transmission through wastewater irrigation remains under-researched, leaving a critical gap in understanding and mitigating this pathway. The lack of cost-effective and sustainable mitigation strategies exacerbates the risk of AMR dissemination, threatening public health and agricultural productivity. This project aims to interrupt the AMR transmission cycle, safeguard public health, and promote sustainable agricultural practices through targeted interventions and collaborative stakeholder engagement.

Project overview

In Cameroon, the use of untreated wastewater for irrigation in urban agriculture poses significant public health and environmental risks by facilitating the spread of AMR through ARB and ARGs. This project aims to mitigate these risks by developing and implementing cost-effective and sustainable mitigation strategies to interrupt the transmission of AMR from wastewater to the food chain. By leveraging stakeholder collaboration, genomic epidemiology, and farm-level interventions, the project will generate evidence to inform policy changes, enhance wastewater management practices, and promote sustainable agricultural productivity.

Project objectives

1. Assess the prevalence of AMR in wastewater used for irrigation and its associated risks to public health through a cross-sectional study and genomic epidemiology.
2. Design and test farm-level and market-level interventions to reduce AMR transmission from wastewater irrigation while preserving agricultural yields.
3. Use genomic epidemiology to monitor AMR transmission from wastewater to crops, markets, and households, providing critical data on this under-researched pathway.
4. Collaborate with key stakeholders, including the Ministries of Agriculture and Public Health, to integrate findings into national policies and promote sustainable wastewater reuse practices.
5. Conduct training programs, participatory mapping, and awareness campaigns to engage stakeholders and encourage adoption of sustainable practices in urban agriculture.

Solutions and outcomes

• Knowledge, attitudes, practices, barriers, and facilitators related to AMR, wastewater use, and hygiene assessed.
• Temporal and genomic data on ARBs, ARGs, and transmission pathways collected and analyzed.
• Effective, cost-effective strategies for AMR reduction identified, validated, and monitored for impacts on ARB/ARG levels, crop yield, and quality.
• Public, farmer, and policymaker awareness of AMR increased, with communities equipped to implement sustainable practices.
• Policies promoting sustainable practices and AMR reduction enacted, supported by strengthened collaboration among researchers, stakeholders, and government.
• Effective interventions adopted across LMICs, enabling broader implementation and government-supported funding.