Evidence Hub

The Emerging Threat of Antibiotic Residues in the Aquatic Environments of East Africa: A Systematic Review

Dedefo D, Hasen G, Umeta B, Assefa D, Mekasha YT, Genet S, Achalu DL, Waktola HD et al.

Environmental health insights, 2026

Abstract

Background: Antibiotic contamination of aquatic ecosystems, driven by poor waste management, is a critical public and environmental health concern in East Africa, though comprehensive regional data remain limited.

Objectives: This systematic review synthesizes evidence on the presence, concentration, and impact of antibiotic residues in East African water bodies.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Google Scholar were searched for studies published between 2010 and 2023 that reported the detection or quantification of antibiotic residues in aquatic environments of East African countries. Data on antibiotic classes, water matrices, detection frequencies, concentration ranges, analytical methods, and limits of detection were extracted and synthesized descriptively.

Results: Of the 5,551 records identified, 20 studies met inclusion criteria. All eligible studies originated from Kenya (70%), Uganda (20%), and Ethiopia (10%). A total of 49 antibiotics belonging to 11 classes were investigated across wastewater, rivers, lakes, surface water, and groundwater. Antibiotics concentration ranged from 0.0008 to 240 830 μg/l, with the highest levels detected in wastewater effluents. Sulfamethoxazole was the most frequently detected antibiotics (80.36%), followed by norfloxacin and enoxacin. Overall, 73.5% (36/49) of detected antibiotics exceeded 0.1 μg/l, a concentration associated with ecological risk and AMR selection…

How strong is the evidence?

Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free