Prevalence and multidrug resistance patterns of bacterial pathogens in wastewater and drinking water systems from hospital and non-hospital environments in Ethiopia: a systematic review and meta-analysis
Abstract
Wastewater systems worldwide can transport bacterial pathogens alongside antimicrobial resistance genes and pharmaceutical residues. The presence of these pathogens and resistance genes in wastewater systems poses significant public health risks, especially in regions like Ethiopia, where limited wastewater treatment and sanitation infrastructure exist. The spread of infectious diseases and the exacerbation of antimicrobial resistance through wastewater can contribute to the growing global health challenge, with specific implications for local healthcare systems. This systematic review and meta-analysis aimed to assess the prevalence of bacterial pathogens and their multidrug resistance patterns within wastewater and drinking water systems in Ethiopia, focusing on both hospital and non-hospital environments. A comprehensive search was conducted across electronic databases and grey literature using relevant terms and phrases. Studies meeting the eligibility criteria were extracted into MS Excel and analyzed using STATA version 17 software. A random-effects model was employed to estimate the pooled prevalence of bacterial pathogens in hospital and non-hospital wastewater. Heterogeneity was evaluated using the Cochrane Q test and I² statistics, with a significance threshold of p < 0.05. Publication bias was assessed using a funnel plot and Egger’s test. A sensitivity analysis was also performed to determine the influence of individual studies on the overall effect size. Studies…
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