Antibiotic Use Across One Health Sectors in Uganda: Temporal Alignment Between Antibiotic Introduction and Policy Guidance: A Scoping Review and Meta-Analysis
Abstract
Abstract Background Antimicrobial resistance (AMR) remains a major global health threat, driven by antibiotic use across human, animal, and environmental sectors. In Uganda, despite a National Action Plan and sector‑specific policies, inappropriate antibiotic use persists through empiric prescribing, over‑the‑counter access, and non‑therapeutic use in livestock production. These patterns reflect longstanding structural and historical legacies rooted in colonial medical and veterinary systems. This review traces the evolution of antibiotic use and stewardship alongside corresponding policy developments in Uganda and applies meta‑analysis to estimate historical antibiotic use in human and animal health. Objectives The objectives of the scoping review were (i) To determine the most commonly used antibiotics in different One Health sectors (human, animal, and environmental) in Uganda and (ii) To determine temporal alignment between antibiotic introduction and policies and guidelines on antibiotic use in Uganda. For the meta-analysis we aimed to determine the prevalence of antibiotic use in the different One Health sectors in Uganda. Methods We conducted a scoping review following Joanna Briggs Institute methodology and reported according to PRISMA-ScR, based on a preregistered protocol on the Open Science Framework. Eligibility criteria included studies and documents on antibiotic use in Uganda across One Health sectors, covering antibiotic use, introduction timelines, and AMR…
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