Evidence map›Paper›PMID 39400654›Full record

SynthesisJournal of epidemiology and global health2024

Molecular Epidemiology and AMR Perspective of Diarrhoeagenic Escherichia coli in Africa: A Systematic Review and Meta-analysis.

John Bosco Kalule, Linda A Bester, Daniel L Banda, Firehiwot Abera Derra, Chisomo Msefula, Anthony M Smith, Abraham Ajayi, Happiness Kumburu, Geoffrey Kwenda, Kaunda Yamba and 9 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of epidemiology and global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Burden ofBMJ global health · 2026
    Pooled it
  2. Pooled it
  3. Metagenomic Profiling of DiarrheagenicCurrent issues in molecular biology · 2026
    Article
  4. Article
  5. Article
  6. Comprehensive antibiotic resistome comparison ofCurrent research in microbial sciences · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

John Bosco Kalule *Makerere University, College of Veterinary Medicine Animal Resources and Biosecurity (CoVAB), Biotechnical and Diagnostic Sciences, Kampala, Uganda. kaluleb@gmail.com.
Linda A Bester *Biomedical Resource Unit, College of Health Sciences, University of KwaZulu-Natal ZA, Westville, South Africa.
Daniel L BandaDepartment of Medical Laboratory Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Mzimba, Malawi.
Firehiwot Abera DerraFood Safety and Food Microbiology National Reference Laboratory, Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Chisomo MsefulaAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia.
Anthony M SmithDepartment of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK.
Abraham AjayiMolecular Biology and Biotechnology Department, Nigerian Institute of Medical Research (NIMR), Yaba Lagos, Nigeria.
Happiness KumburuKilimanjaro Clinical Research Institute, Moshi, Tanzania.
Geoffrey KwendaDepartment of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia.
Kaunda YambaUniversity Teaching Hospitals, Lusaka, Zambia.
John MwabaDepartment of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia.
Yasmina J FakimUniversity of Mauritius, Reduit, Mauritius.
Nyasha SitholeAfrica CDC, Addis Ababa, Ethiopia.
Aquillah M KanziAfrican Society for Laboratory Medicine (ASLM), Johannesburg, South Africa.
Patrick M K NjageResearch Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark.
Francis ChikuseAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia.
Sofonias K TessemaAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia.
Stella I SmithMolecular Biology and Biotechnology Department, Nigerian Institute of Medical Research (NIMR), Yaba Lagos, Nigeria.
Ebenezer Foster-NyarkoDepartment of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDiarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent.

methodsThe review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines.

resultsThe reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30-55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17-32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce.

conclusionDespite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa.

Indexed as

DiarrheaEscherichia coliEscherichia coli InfectionsMolecular EpidemiologyAfricaAnti-Bacterial AgentsDrug Resistance, BacterialHumansPrevalenceAnti-Bacterial AgentsAfricaAntimicrobial resistanceDiarrhoeagenic Escherichia coliFood and water-borne diseases

Identifiers

PMID39400654
PMCPMC11652460

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.