Prevalence of antimicrobial resistance in Somalia: A systematic review

Antimicrobial resistance (AMR) is a severe but poorly documented threat in Somalia due to its fragmented healthcare system. This study reviews AMR prevalence and clinical impact in Somalia, comparing the findings to regional trends to address this critical data gap.

This study was a systematic literature review of antimicrobial susceptibility patterns in Somalia. Data on resistance rates for common Gram-positive and Gram-negative bacteria were extracted, calculated as a proportion of resistant isolates, and then narratively synthesized in summary tables.

The data reveal a critical state of AMR in Somalia. Among Gram-positive bacteria, there is a near-total prevalence of methicillin-resistant Staphylococcus aureus at 97.4%. Gram-negative bacteria like Escherichia coli show extensive resistance to common treatments (94.6% to trimethoprim-sulfamethoxazole). Multidrug resistance is rampant, with pathogens such as Acinetobacter baumannii exhibiting 100% resistance to multiple drug classes, including Reserve group carbapenems. These rates are markedly higher than in neighboring Ethiopia, highlighting a severe and escalating public health emergency.

Somalia's AMR crisis has rendered standard antibiotics ineffective. Urgent action is required, including national surveillance, local treatment guidelines, and antimicrobial stewardship to control this threat.