The Ministry of Health Zanzibar, with technical support from the World Health Organization (WHO) and Health Improvement Zanzibar (HIPZ), has completed a baseline analysis of 2024 antimicrobial resistance (AMR) data from the national sentinel surveillance network covering Unguja and Pemba. This analysis is guiding practical improvements to strengthen routine surveillance and reporting, providing evidence to support a review of treatment guidance for common serious infections and measures to improve data quality and infection prevention and control.
The review, conducted at the Makunduchi Health Centre laboratory, focused on priority pathogens commonly associated with bloodstream and urinary tract infections. Findings highlighted a significant challenge in treating common conditions, with high non-susceptibility to widely used third-generation cephalosporins such as ceftriaxone among bacteria isolated from urinary infections. However, some oral antibiotics, including nitrofurantoin, remained effective for most E. coli urine isolates, providing the Ministry with evidence to support more appropriate antibiotic use and updated treatment guidance.
Beyond resistance patterns, the analysis assessed the functioning of the surveillance system in routine practice. It identified the need to standardize laboratory testing panels across sentinel sites to ensure comparability of results and usefulness for national planning. The review also emphasized the importance of capturing complete clinical information alongside laboratory results, enabling more accurate routine reporting and better public health action in the future.
To address these findings, the Ministry and national stakeholders have agreed on immediate strengthening measures. These include routine checks to confirm laboratory request forms are complete, refresher training for health workers on correct specimen collection, and improved recording of essential patient and facility information. These steps aim to enhance data quality and ensure laboratory testing is consistent across sentinel sites, making the data more actionable for clinicians and decision-makers.
WHO and HIPZ continue to support the Ministry of Health Zanzibar in implementing these recommendations, advancing the goals of the Zanzibar Action Plan on AMR, and reinforcing the overall health system by translating surveillance data into practical interventions that protect public health.
