Burden and transmission dynamics of paediatric antimicrobial resistance in Benin City, Nigeria: a One Health study protocol
11 affiliations
- 1Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- 2Department of Microbiology, University of Benin, Benin City, Nigeria
- 3GSOUTH Education, Abuja, Nigeria
- 4Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
- 5Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Nigeria
- 6Department of Applied Biosciences, School of Health, Science and Education, Coventry University Group, Coventry, UK
- 7Department of Veterinary Microbiology, University of Maiduguri, Maiduguri, Nigeria
- 8Trivision Technologies Limited, Abuja, Nigeria
- 9Institute of Child Health, University of Benin, Benin City, Edo state, Nigeria
- 10Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
- 11Translational Medical Sciences, University of Nottingham, Nottingham, UK
Abstract
Introduction: Antimicrobial resistance (AMR) poses a critical threat to global health security and disproportionately affects children in sub-Saharan Africa. In Nigeria, the burden of multidrug-resistant pathogens in paediatric populations is increasing; however, data from the South-South region, particularly Edo State, remain scarce. This study aims to determine the prevalence, patterns and transmission dynamics of AMR among paediatric patients in Edo State, Nigeria, using a One Health approach that integrates human, animal and environmental health interfaces.
Methods and analysis: This mixed-methods study will enrol 455 hospitalised children (<18 years) at the University of Benin Teaching Hospital (UBTH). Clinical (urine, blood, rectal and nasopharyngeal swabs), environmental and animal samples will be collected to isolate and characterise locally recoverable bacterial pathogens prioritised with reference to the WHO 2024 priority pathogen list. Antimicrobial susceptibility testing will be performed using the Kirby-Bauer disc diffusion method in accordance with Clinical and Laboratory Standards Institute guidelines. Selected clinically or epidemiologically important resistant isolates will be stored at −80°C for possible future molecular characterisation, resources permitting. Key informant interviews with caregivers, healthcare providers and policymakers will explore the systemic enablers and barriers to paediatric AMR stewardship. Quantitative data will be analysed using descriptive statistics and logistic regression, while qualitative data will undergo thematic analysis guided by Braun and Clarke’s framework.
Ethics and dissemination: Ethical approval has been obtained from the UBTH Health Research Ethics Committee (Ref: ADM/E 22/A/VOL.VII/14831247). Written informed consent will be obtained from all participants. Findings will inform antibiotic stewardship, strengthen surveillance and guide AMR policy at institutional, state and national levels. Results will be disseminated through peer-reviewed publications, policy briefs, institutional reports and engagement with national and international health agencies.
Related
- INTerrupting prolifERation of Carbapenem resistance in Indonesia: clinical and genomic Evaluation of Pathways of Transmission (INTERCEPT) : a Study Protocol
- Effects of a community-based intervention bundle on household transmission of extended spectrum β-lactamase-producing Escherichia coli in rural Burkina Faso to target community-level drivers of antimicrobial resistance in sub-Saharan Africa: a cluster-randomised trial
- Metagenomic next-generation sequencing of matched donor–recipient pairs reveals pathogen transmission dynamics and informs antimicrobial therapy in liver transplantation: a retrospective cohort study
- Incidence of and household responses to paediatric diarrhoeal disease and acute respiratory infection in Chitwan, Nepal: protocol for a prospective cohort study
- Protocol for the development of a paediatric core outcome set for arthrogryposis multiplex congenita: an international multi-interest-holder consensus study.
BibTeX
@article{elimian2026burden,
title = {{Burden and transmission dynamics of paediatric antimicrobial resistance in Benin City, Nigeria: a One Health study protocol}},
author = {Kelly Osezele Elimian and Ephraim Ibadin and Jeremiah Igunma and Afamefuna Dunkwu-Okafor and Emmanuel Wemambu and Jonathan Inetianbor and Jasinia Musa and Ifeanyi Franklin Ike and Nina Viberg and Ayebo Evawere Sadoh and Tanya Monaghan and Tobias Alfven},
journal = {BMJ Public Health},
year = {2026},
month = nov,
doi = {10.1136/bmjph-2025-004340},
url = {https://doi.org/10.1136/bmjph-2025-004340},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Burden and transmission dynamics of paediatric antimicrobial resistance in Benin City, Nigeria: a One Health study protocol
AU - Kelly Osezele Elimian
AU - Ephraim Ibadin
AU - Jeremiah Igunma
AU - Afamefuna Dunkwu-Okafor
AU - Emmanuel Wemambu
AU - Jonathan Inetianbor
AU - Jasinia Musa
AU - Ifeanyi Franklin Ike
AU - Nina Viberg
AU - Ayebo Evawere Sadoh
AU - Tanya Monaghan
AU - Tobias Alfven
PY - 2026
DA - 2026/11/03
JO - BMJ Public Health
DO - 10.1136/bmjph-2025-004340
UR - https://doi.org/10.1136/bmjph-2025-004340
AB - Introduction: Antimicrobial resistance (AMR) poses a critical threat to global health security and disproportionately affects children in sub-Saharan Africa. In Nigeria, the burden of multidrug-resistant pathogens in paediatric populations is increasing; however, data from the South-South region, particularly Edo State, remain scarce. This study aims to determine the prevalence, patterns and transmission dynamics of AMR among paediatric patients in Edo State, Nigeria, using a One Health approach that integrates human, animal and environmental health interfaces. Methods and analysis: This mixed-methods study will enrol 455 hospitalised children (<18 years) at the University of Benin Teaching Hospital (UBTH). Clinical (urine, blood, rectal and nasopharyngeal swabs), environmental and animal samples will be collected to isolate and characterise locally recoverable bacterial pathogens prioritised with reference to the WHO 2024 priority pathogen list. Antimicrobial susceptibility testing will be performed using the Kirby-Bauer disc diffusion method in accordance with Clinical and Laboratory Standards Institute guidelines. Selected clinically or epidemiologically important resistant isolates will be stored at −80°C for possible future molecular characterisation, resources permitting. Key informant interviews with caregivers, healthcare providers and policymakers will explore the systemic enablers and barriers to paediatric AMR stewardship. Quantitative data will be analysed using descriptive statistics and logistic regression, while qualitative data will undergo thematic analysis guided by Braun and Clarke’s framework. Ethics and dissemination: Ethical approval has been obtained from the UBTH Health Research Ethics Committee (Ref: ADM/E 22/A/VOL.VII/14831247). Written informed consent will be obtained from all participants. Findings will inform antibiotic stewardship, strengthen surveillance and guide AMR policy at institutional, state and national levels. Results will be disseminated through peer-reviewed publications, policy briefs, institutional reports and engagement with national and international health agencies.
SN - 2753-4294
ER -