Abstract:

Introduction: Antimicrobial resistance (AMR) poses a global public health threat with a notable increase in resistance strains, particularly Extended Spectrum Beta Lactamase producing bacteria this resistance hindering antibiotic efficacy, contributing to rise medical expenses, lengthen hospital stays and eliminates preventive protection which leads to increase mortality. ESBL-producing bacteria are a common cause of healthcare and community-associated infections worldwide. The distribution of such isolates in the environment and their presence in fish as a result of sewage contamination is not well-studied. This study evaluated fish and human gut samples for the presence of ESBL producing bacteria, so as to generate concurrent data in people and fish in real time in the context of One Health to complement the existing critical gap in the environmental sector in the implementation of Tanzania National Action Plan on AMR (2023 – 2028).

Objective: To determine the prevalence, risk factors and similarities of ESBL producing bacteria in people and fish in selected sites in three regions along the shores of Lake Victoria in Tanzania

Methods: This was a cross-section study, to be conducted from May 2024 to August 2024 in three regions Lwamgasa-Geita, Lamadi- Simiyu, and Luchelele- Mwanza. A minimum of 211 patients attending primary health care (health centers and dispensaries) and 384 fish from Lake Victoria shores within 5-10km from the health care facilities were recruited, a structured data culture tools for human with (socio-demographic and variables) and fish (sex, length, weight and area) was used to retrieve information, MacConkey agar plates supplemented with 2µg/ml cefotaxime was inoculated to screen for ESBL-producing Enterobacteriaceae for both stool sample and fish gut contents. Antimicrobial susceptibility testing was done using the disk diffusion technique.

Results: A total of 526 patients and 104 fish were included from three selected regions Simiyu, Geita and Mwanza. The rate of ESBL carriage were highly in patients with the preavalence of 41.44% and were statistically significant with ESBL carriage in Fish (P-value=0.019).Also cormobidities were statistical significant with ESBL carriage in this study.(P-value=0.019).

Conclusion: ESBL carriage in fish were comparable to the study done by Moremi et al 2016 which were 13.3% but in patients the prevalence seems to be higher compared to the study done by Mshana et al 2017 which were 31.8% .The presence of ESBL carriage in environment and patients in three regions Simiyu,Geita and Mwanza signify that there is a need for multidisciplinary approach to combat the upsurge of antimicrobial resistance.