National AMR context
Antimicrobial resistance is a major and growing health challenge in Côte d’Ivoire across human, animal and environmental sectors. National surveillance data indicates increasing resistance among important human pathogens, including extended-spectrum beta-lactamase-producing Enterobacterales and methicillin-resistant Staphylococcus aureus. Resistant E. coli and Klebsiella spp. have also been identified in environmental and animal samples. Côte d’Ivoire’s National Action Plan on AMR prioritises integrated One Health surveillance, reduction of environmental contamination, infection prevention and control, and generation of evidence to guide public policy. The Ebrié Lagoon is particularly important because it supports fishing, transport and other livelihoods while receiving substantial domestic, industrial, agricultural and hospital effluents. Rapid urbanisation and inadequate sanitation and wastewater treatment increase the potential for resistant bacteria and antimicrobial residues to circulate between people, animals, food systems and the environment. The project directly supports national priorities by strengthening evidence on these interconnected AMR transmission pathways.
Problem
There is insufficient integrated evidence on how multidrug-resistant bacteria circulate between human, animal and environmental reservoirs in Abidjan. The Ebrié Lagoon and surrounding communities are exposed to untreated or inadequately treated effluents from households, hospitals, industry and agriculture, while people depend on the lagoon and nearby food-production systems for fishing, market gardening and other activities. Resistant bacteria have been documented separately in humans, animals and environmental samples, but the extent of cross-transmission and the genetic relatedness of strains across these compartments remain poorly characterised. Without this information, it is difficult to identify contamination hotspots, determine the most important transmission pathways, or prioritise interventions. The project therefore addresses a critical evidence gap by examining MDR bacteria, particularly ESBL-producing E. coli and Klebsiella spp., across human populations, aquatic animals, lagoon water, effluents, vegetables and other environmental samples in Cocody and Port-Bouët.
Project overview
This six-month cross-sectional scoping study will describe reservoirs and transmission pathways of multidrug-resistant bacteria across human, animal and environmental compartments in Cocody and Port-Bouët, two municipalities bordering the Ebrié Lagoon. Samples will be collected from people through rectal swabs, aquatic animals, lagoon water, effluents, market-garden areas and other relevant environmental sources, with GPS coordinates recorded to support spatial mapping. Laboratory analyses will include culture and bacterial identification, antimicrobial susceptibility testing, ESBL characterisation/genotyping and comparison of genetic profiles across sectors. The study will estimate the prevalence and diversity of MDR bacteria, assess carriage among adults with relevant occupational or environmental exposure, investigate potential human–animal–environment clonal links, identify factors associated with colonisation or contamination, and map AMR hotspots. The evidence is intended to provide a One Health baseline for selecting and designing locally appropriate interventions and future implementation research.
Intended outcomes
The project is expected to generate an integrated baseline describing the burden, diversity and spatial distribution of multidrug-resistant bacteria in selected human, animal and environmental compartments in Abidjan. It will identify MDR species and resistance profiles, compare genetic profiles of isolates from the same geographical areas, and provide evidence on potential cross-sector transmission and contamination hotspots. Findings will strengthen understanding of the role of the Ebrié Lagoon and associated food and wastewater systems in AMR dissemination and contribute to Côte d’Ivoire’s integrated One Health surveillance priorities. The results will also support selection of targeted interventions for future implementation research, including environmental sanitation or biofiltration approaches, behaviour-change and awareness activities for lagoon communities, and improved hygiene and biosecurity practices in food-chain settings. Dissemination is expected through national stakeholders, scientific publications and conferences, genomic data sharing, and ICARS communication channels.
About the Team Europe Initiative
This project is funded through the Team Europe Initiative (TEI) Action on Fighting Antimicrobial Resistance and Strengthening the One Health Workforce in Africa, a collaborative effort to support locally led, evidence-informed action on antimicrobial resistance (AMR) across the continent. Through work on AMR mitigation, implementation research, workforce development, health economics, and One Health, the initiative aims to strengthen capacity and generate practical, context-specific approaches that can support sustainable AMR action in African countries.
