Inequities in Pediatric Genomic Surveillance of Antimicrobial Resistance Between Africa and Europe (2000–2025)
1
Pure And Chemistry, Ladoke Akintola University Of Technology, Ogbomoso, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Antimicrobial resistance (AMR) is a major driver of infection-related morbidity and mortality among children under five years, particularly in Africa. While whole-genome sequencing (WGS) has become central to AMR surveillance in high-income regions, the representation of pediatric populations within genomic surveillance systems in Africa remains unclear. This study assessed the coverage and gaps of pediatric-focused genomic AMR surveillance across Africa and compared it with Europe between 2000 and 2025.
METHODS:
We conducted a comparative genomic surveillance using publicly available bacterial genome data from the National Centre for Biotechnology Information (NCBI) Pathogen Detection database, alongside surveillance reports from WHO GLASS (Global Antimicrobial Resistance and Use Surveillance System), the Africa CDC Pathogen Genomics Initiative, and the European Centre for Disease Prevention and Control (ECDC). National surveillance documentation and peer-reviewed studies from Nigeria, South Africa, Kenya, Ghana, Tanzania, Egypt, the United Kingdom, Germany, France, very the Netherlands were reviewed. Data were evaluated for geographic origin, availability of age-disaggregated metadata, and explicit inclusion of children under five years.
RESULTS:
Of approximately 620,000 bacterial AMR genomes available globally during the study period, about 90% originated from high-income countries. Europe and the United Kingdom contributed an estimated 55–60% of genomes, whereas all African countries combined accounted for less than 5%. In African datasets, fewer than 10% of genomes contained age metadata, and only 2–3% were attributable to children under five. In contrast, European datasets showed over 65% completeness of age metadata, with approximately 18–22% of genomes derived from pediatric cases.
CONCLUSIONS:
Pediatric genomic surveillance of AMR in Africa remains critically limited despite a high disease burden. We recommend continent-wide pediatric AMR genomic surveillance coordinated by Africa CDC and mandatory age-disaggregated reporting within WHO GLASS.
Antimicrobial resistance (AMR) is a major driver of infection-related morbidity and mortality among children under five years, particularly in Africa. While whole-genome sequencing (WGS) has become central to AMR surveillance in high-income regions, the representation of pediatric populations within genomic surveillance systems in Africa remains unclear. This study assessed the coverage and gaps of pediatric-focused genomic AMR surveillance across Africa and compared it with Europe between 2000 and 2025.
METHODS:
We conducted a comparative genomic surveillance using publicly available bacterial genome data from the National Centre for Biotechnology Information (NCBI) Pathogen Detection database, alongside surveillance reports from WHO GLASS (Global Antimicrobial Resistance and Use Surveillance System), the Africa CDC Pathogen Genomics Initiative, and the European Centre for Disease Prevention and Control (ECDC). National surveillance documentation and peer-reviewed studies from Nigeria, South Africa, Kenya, Ghana, Tanzania, Egypt, the United Kingdom, Germany, France, very the Netherlands were reviewed. Data were evaluated for geographic origin, availability of age-disaggregated metadata, and explicit inclusion of children under five years.
RESULTS:
Of approximately 620,000 bacterial AMR genomes available globally during the study period, about 90% originated from high-income countries. Europe and the United Kingdom contributed an estimated 55–60% of genomes, whereas all African countries combined accounted for less than 5%. In African datasets, fewer than 10% of genomes contained age metadata, and only 2–3% were attributable to children under five. In contrast, European datasets showed over 65% completeness of age metadata, with approximately 18–22% of genomes derived from pediatric cases.
CONCLUSIONS:
Pediatric genomic surveillance of AMR in Africa remains critically limited despite a high disease burden. We recommend continent-wide pediatric AMR genomic surveillance coordinated by Africa CDC and mandatory age-disaggregated reporting within WHO GLASS.
| eISSN: | 2654-1459 |
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