Burden of fecal colonization with extended-spectrum beta-lactamase producing enterobacteriaceae among food handlers in Africa: A systematic review and meta-analysis

Amanuale Zayede, Yitayih Wondimeneh, Sirak Biset, Mitkie Tigabie, Henok Worku, Biruktawit Abebe, Haymanot Tilahun, Eshet Gebrie and Mucheye Gizachew

PLOS ONE, 2026, vol. 21, issue 8, 1-17

Abstract: Background: Antimicrobial resistance caused by extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-PE) has emerged as a major threat to global public health. The human gastrointestinal tract represents a critical ecological niche for these organisms, enabling silent carriage and onward transmission. Food handlers are of particular concern because they can facilitate indirect transmission of resistant bacteria through food preparation and handling. Despite the availability of primary studies, evidence focusing specifically on food handlers in Africa remains fragmented. This systematic review and meta-analysis therefore aimed to estimate the pooled prevalence of fecal colonization with ESBL-PE among food handlers in Africa. Methods: This review was conducted according to a protocol registered in PROSPERO (ID: CRD420251075141). A systematic search was performed from September 5–15, 2025 in PubMed, Google Scholar, and Hinari/Research4Life to identify relevant studies. The methodological quality of the included studies was appraised using the Joanna Briggs Institute (JBI) critical appraisal tool. Data were extracted into Microsoft Excel 2019 and analyzed with Stata software version 17. Given significant heterogeneity among the studies (I2 = 98.3%, p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0340571

DOI: 10.1371/journal.pone.0340571

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