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Burden and transmission dynamics of paediatric antimicrobial resistance in Benin City, Nigeria: a One Health study protocol

Year: 2026

Type: article

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.

Source: BMJ Public Health

DOI: 10.1136/bmjph-2025-004340