Prevalence and Distribution of Beta-Lactamase Genes in Enterobacteriaceae across One Health Interface in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

: Antimicrobial resistance (AMR) in Sub-Saharan Africa (SSA) represents a major public health crisis, with beta-lactamase-producing Enterobacteriaceae at its core. Despite several regional studies, a comprehensive One Health–focused synthesis of beta-lactamase gene prevalence across human, animal, and environmental reservoirs in SSA has been lacking. : We conducted a PRISMA-guided systematic review and meta-analysis of studies from 2005 onward across PubMed, ScienceDirect, Google Scholar, and African Journals Online. Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for prevalence studies. Pooled prevalence was calculated using random-effects meta-analysis with logit transformation. Publication bias was assessed using funnel plots and Egger’s regression test, and sensitivity analyses were conducted. Of 2,045 identified records, 93 were eligible for meta-analysis, representing studies from 16 SSA countries. : The pooled prevalence of ESBL genes, based strictly on genotypic (molecular) detection, was 26% (95% CI: 20–34%) in human isolates, 31% (95% CI: 20–45%) in animal isolates, and 22% (95% CI: 17–29%) in environmental isolates (all I² >89%). AmpC prevalence ranged from approximately 18% to 30% across sources, while carbapenemase prevalence reached 35% (95% CI: 24–47%) in animal isolates compared to 11% in humans and the environment. The ESBL gene bla CTX-M-15 dominated, present in 61% of human, 85% of animal, and 37% of environmental samples. Co-occurrence of multiple resistance genes was frequently observed. : These findings highlight widespread beta-lactamase-producing Enterobacteriaceae across SSA, with critically high levels of bla CTX-M-15 and notable carbapenemase prevalence in animals, though the limited number of animal-source studies warrants cautious interpretation. Comprehensive One Health interventions, including integrated surveillance, antimicrobial stewardship, and investment in laboratory capacity, are urgently needed.