A one health systematic review and meta-analysis of Salmonella prevalence and antimicrobial resistance in Ethiopia

BACKGROUND: Salmonella is a major enteric pathogen known to cause gastroenteritis in humans and animals, with antimicrobial-resistant strains posing a global health threat. However, national-level estimates of the prevalence and antimicrobial resistance (AMR) profiles of Salmonella across human, animal, and environmental sources are scarce in Ethiopia. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence and AMR profile of Salmonella isolated from humans, animals and the environment in Ethiopia. METHODS: ). Subgroup analysis and meta-regression were conducted to explore sources of heterogeneity, and publication bias was evaluated using a funnel plot, Begg's and Egger's tests. RESULTS: = 88%), significantly influenced by region, with the highest prevalence in Tigray (14.52%) and Oromia (8.14%). Environmental isolates showed a slightly higherprevalence (8.43%), followed by isolates from animals (7.78%) and humans (4.79%). High levels of AMR were detected among Salmonella isolates, particularly to ampicillin, oxytetracycline, amoxicillin_clavulanic acid, tetracycline, and streptomycin. Resistance was also detected to critical antibiotics such as ceftazidime (12.4%), cefotaxime (8.5%), ceftriaxone (3.2%), and ciprofloxacin (2.2%). CONCLUSIONS: These findings should be interpreted with caution due to uneven geographic distribution of the included studies across the country. Overall, the results underscore the need for strengthened Salmonella surveillance, prevention and antimicrobial stewardship in Ethiopia's human, animal, and environmental sectors.