{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:33:54Z","timestamp":1792884834521,"version":"4.5.0"},"reference-count":81,"publisher":"BMJ","issue":"Suppl 1","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":158,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,5,13]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This scoping review mapped antimicrobial resistance (AMR)-related interventions in WHO African region against the five strategic objectives of the WHO Global Action Plan (GAP) on AMR and identified evidence gaps limiting progress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      A scoping review using the Arksey and O\u2019Malley framework, enhanced by Levac\n                      <jats:italic>et al<\/jats:italic>\n                      and Joanna Briggs Institute methodology; reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, CINAHL, Web of Science and Scopus searched on 9 December 2025, with grey literature from Google Scholar and Google (first 100 hits).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Studies of any design reporting interventions addressing GAP strategic objectives\u2014stewardship, surveillance, infection prevention, education or economic approaches in the WHO African region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Data were charted using a pilot-tested Excel tool by GAP strategic objective and evidence gaps and research considerations were synthesised thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-nine studies (2016\u20132025) were included, with country-specific evidence concentrated in South Africa, Ethiopia, Kenya, Ghana and Nigeria. Most evaluated antimicrobial stewardship or awareness\/training interventions in tertiary hospitals, showing improvements in prescribing, knowledge and occasional cost savings but few assessed long-term effects or resistance trends. Surveillance had advanced but remained limited by weak laboratory capacity, diagnostic coverage, data quality and limited use of AMR\/antimicrobial use data in practice. Evidence on infection prevention, vaccination and One Health interventions was scarce and no full economic evaluations were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AMR research in the African region clusters around antimicrobial stewardship and awareness in tertiary hospitals, leaving infection prevention, vaccination, One Health approaches and economic evaluation substantially underrepresented across the GAP framework. Closing these gaps will require longer-term implementation research, context-specific economic analyses and broader geographical coverage to generate the evidence needed to operationalise the global AMR research agenda in Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004853","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:45:12Z","timestamp":1780919112000},"page":"e004853","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Addressing the silent epidemic of antimicrobial resistance in the African region: a scoping review of evidence gaps and research considerations"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0765-7497","authenticated-orcid":false,"given":"Chinwe","family":"Iwu-Jaja","sequence":"first","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Gahimbare","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidnekachew Degefaw","family":"Mazengiya","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-8503","authenticated-orcid":false,"given":"Joseph","family":"Okeibunor","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6832-873X","authenticated-orcid":false,"given":"Olushayo Oluseun","family":"Olu","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anelisa","family":"Jaca","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-6736","authenticated-orcid":false,"given":"Akhona V Victress","family":"Mazingisa","sequence":"additional","affiliation":[{"name":"Department of Community Health Studies, Durban University of Technology, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chidozie D","family":"Iwu","sequence":"additional","affiliation":[{"name":"School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Ahmed","family":"Yahaya","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-4779","authenticated-orcid":false,"given":"Charles Shey","family":"Wiysonge","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa"},{"name":"Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026060804450514000_4.Suppl_1.e004853.1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1717157115"},{"key":"2026060804450514000_4.Suppl_1.e004853.2","doi-asserted-by":"publisher","DOI":"10.1179\/2047773215Y.0000000030"},{"key":"2026060804450514000_4.Suppl_1.e004853.3","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.20100.1","article-title":"Vaccine impact on antimicrobial resistance to inform Gavi, the Vaccine Alliance\u2019s 2018 Vaccine Investment Strategy: report from an expert survey","volume":"8","author":"Malarski","year":"2019","journal-title":"F1000Res"},{"key":"2026060804450514000_4.Suppl_1.e004853.4","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1717161115"},{"key":"2026060804450514000_4.Suppl_1.e004853.5","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nature10388","article-title":"Antibiotic resistance is ancient","volume":"477","author":"D\u2019Costa","year":"2011","journal-title":"Nature New Biol"},{"key":"2026060804450514000_4.Suppl_1.e004853.6","unstructured":"World Health Organization . 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