Vancomycin Resistance Enterococcus in Africa in Onehealth approach: A systematic review and meta-analysis

Abstract Background Vancomycin resistance enterococci are enterococci that cannot be cured with vancomycin treatment. To combat this resistance, an integrated disciplinary action is mandatory. Therefore, this study aimed to show the prevalence of these agents with the concept of one health approach.Methods Literature search was conducted on PubMed, Google scholar and Hinari with the term “Vancomycin resistance enterococcus in Africa” in august 1-3, 2019. All available articles exported to “Endnote version 7.1” then to Microsoft word. All the articles checked to meet our criteria for the review. Those articles reported the prevalence of vancomycin resistance Enterococcus and published from 2010 to present in the English language was included for the review. There were 151 articles from the databases; of this, 37 articles included after extensive review with two independent authors.Result Out of 4112 samples collected, 1527 isolates identified with overall magnitude of VRE as 28.8% (12.9%-44.7%) in Africa with a one-health perspective. The meta-analysis indicates that there was substantial heterogeneity among the articles with consistency index (I 2 ) =99.9%. A higher rate of Vancomycin resistance enterococci was identified from South Africa 74.8%, followed by Egypt 37. 2%. Laboratory method employed for identification showed that a higher rate was from BacTec 98.8%, followed by PCR 59.2%. It is also a non-human sample source was with higher rates of VRE i.e. 32.5%.Conclusion This meta-analysis indicates there was a high rate of Vancomycin resistance enterococcus in African continent. A lot should be done to prevent and control the transmition of this resistance gene circulating in the environment.