Occupational and Community Exposure to Antimicrobial-Resistant Bacteria in Dumpsite Environments: A Systematic Review of Evidence from Sub-Saharan Africa

Rapid urbanization in low- and middle-income countries (LMICs) has led to waste generation that exceeds the capacity for safe and regulated management, resulting in widespread poorly managed dumpsites often located near residential areas. These environments are embedded within human living spaces and may expose populations to antimicrobial-resistant (AMR) bacteria through multiple pathways, yet the extent of this risk remains poorly understood. Dumpsites contain heterogeneous waste, including healthcare, industrial, electronic, animal, and pharmaceutical waste, which may facilitate the emergence and spread of AMR bacteria through exposure to antibiotic residues, heavy metals, and other contaminants. Human populations such as waste pickers, workers, and nearby residents may be exposed through direct contact, inhalation, and contaminated food or water. Although antimicrobial resistance is a major global health threat, environmental drivers—particularly dumpsites—remain underexplored. Evidence on dumpsite-associated AMR in sub-Saharan Africa (SSA) is fragmented, limiting understanding of exposure pathways and public health risks. This review is therefore justified by the need to synthesize existing evidence to inform waste management policy, occupational health protection, and One Health AMR strategies.