ReviewNature microbiology2020
Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission.
Review in Nature microbiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
86 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The neglected model validation of antimicrobial resistance transmission models - a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Antimicrobial resistance profile ofFrontiers in public health · 2024Pooled it
- Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya.Nature communications · 2025Trial
- Drinking Water Chlorination Impact on Fecal Carriage of Extended-Spectrum Beta-Lactamase-ProducingEnvironmental health perspectives · 2022Trial
- Genomic epidemiology of extended-spectrum beta-lactamase-producingJAC-antimicrobial resistance · 2026Article
- Predictors and risk factors of typhoid fever in urban informal settlements of Nairobi, Kenya.BMC infectious diseases · 2026Article
- Bacteriophages AgainstViruses · 2026Review
- Assessing the validity and reliability of geotracking devices in urban settings of Nairobi, Kenya.Spatial and spatio-temporal epidemiology · 2026Article
- Genetic diversity and occurrence of antibiotic resistance genes from community wastewater in Dhaka and Cox's Bazar, Bangladesh.One health (Amsterdam, Netherlands) · 2026Article
- Biological activities of metal oxide nanoparticles modified with hexadeca-substituted cobalt(ii) phthalocyanine bearing fluorinated substituents.RSC advances · 2026Article
- Wastewater-based surveillance of ESKAPE pathogens in resource-limited countries (RLCs): an essential tool for monitoring antibiotic resistance.Environmental monitoring and assessment · 2026Review
- Cross-sectional survey of resistant priority pathogen carriage in the hospital setting in Timor-Leste 2020-2021.Antimicrobial resistance and infection control · 2026Article
- Ecological context structures duplication and mobilization of antibiotic and metal resistance genes in bacteria.bioRxiv : the preprint server for biology · 2026Article
- Evolution and rise of antimicrobial resistance in key public health bacteria within and across the One Health sectors.Future microbiology · 2026Review
- Persistent antimicrobial resistance during soil remediation driven by residual heavy metal co-selection.The ISME journal · 2026Article
- Comparative resistome from toilet waste in three different income areas, Bangkok, Thailand.Frontiers in microbiology · 2026Article
- Role of the gut microbiome in frequent gut colonization with extended-spectrum β lactamase-producing Enterobacterales among Peruvian children.Gut microbes · 2025Article
- Third-generation Cephalosporin resistance in Sub-Saharan Africa: a systematic review and meta-analysis.Communications medicine · 2025Article
- Antimicrobial resistance, equity and justice in low- and middle-income countries: an intersectional critical interpretive synthesis.Nature communications · 2025Article
- Environmental hazards from pollution of antibiotics and resistance-driving chemicals in an urban river network from Malawi.npj antimicrobials and resistance · 2025Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
Antimicrobial resistance (AMR) is a growing public health challenge that is expected to disproportionately burden lower- and middle-income countries (LMICs) in the coming decades. Although the contributions of human and veterinary antibiotic misuse to this crisis are well-recognized, environmental transmission (via water, soil or food contaminated with human and animal faeces) has been given less attention as a global driver of AMR, especially in urban informal settlements in LMICs-commonly known as 'shanty towns' or 'slums'. These settlements may be unique hotspots for environmental AMR transmission given: (1) the high density of humans, livestock and vermin living in close proximity; (2) frequent antibiotic misuse; and (3) insufficient drinking water, drainage and sanitation infrastructure. Here, we highlight the need for strategies to disrupt environmental AMR transmission in urban informal settlements. We propose that water and waste infrastructure improvements tailored to these settings should be evaluated for their effectiveness in limiting environmental AMR dissemination, lowering the community-level burden of antimicrobial-resistant infections and preventing antibiotic misuse. We also suggest that additional research is directed towards developing economic and legal incentives for evaluating and implementing water and waste infrastructure in these settings. Given that almost 90% of urban population growth will occur in regions predicted to be most burdened by the AMR crisis, there is an urgent need to build effective, evidence-based policies that could influence massive investments in the built urban environment in LMICs over the next few decades.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.