Prevalence and patterns of antimicrobial resistance among wildlife populations in Africa: a systematic review

Antimicrobial resistance (AMR) is increasingly reported in wildlife, yet evidence from Africa remains fragmented. We conducted a systematic review of AMR in African wildlife, screening 4,802 records and including 61 studies from 21 countries. Phenotypic testing was performed in all studies, primarily using disk diffusion (82%), with genotypic assays in 86.8%. Across 4,669 bacterial isolates from 27 eligible studies, the pooled prevalence of phenotypic resistance was 59% (95% CI: 34-80%), with substantial heterogeneity (I² = 97.4%). Wild birds exhibited the highest pooled prevalence (93%), followed by non-human primates (35%) and herbivores (25%). Escherichia coli (20 studies and 3414 isolates) showed a pooled resistance prevalence of 62%. Pooled multidrug resistance was 23.1% (9 studies and 1128 isolates). Sampling was predominantly opportunistic and concentrated in human-impacted environments, limiting ecological inference. These findings highlight significant AMR occurrence across diverse wildlife taxa and substantial gaps in surveillance, coverage, and methodological consistency.