Socio-ecological Drivers of Environmental Antibiotic Resistance and Public Health Vulnerability in Benin City, Nigeria: A Review
DOI:
https://doi.org/10.33003/fjs-2026-1015-5765Keywords:
Antimicrobial Resistance, Benin City, Environmental Resistome, One Health, Patent Medicine Vendors, Public Health VulnerabilityAbstract
Antimicrobial resistance (AMR) is a serious global public health problem, especially in urban areas of low- and middle-income countries, where environmental reservoirs can increase the spread of pathogens. The present review focuses on the socio-ecological determinants of environmental antibiotic resistance and its associated public health risks in the city of Benin in Nigeria. Using a socio-ecological model (SEM) and a One Health approach, peer-reviewed literature, academic dissertations and policy reports from 2000 to 2026 were systematically synthesized in the six core thematic domains of the One Health approach from PubMed, Scopus, Web of Science and Google Scholar. Informal distribution of antibiotics, non-prescription dispensing and partial course sales is possible because of the large number of patent medicine vendors (PMVs) operating without adequate regulatory oversight. Such practices and poor municipal waste management result in clear socio-ecological leakage points for pharmaceutical residues and multidrug-resistant organisms that enter drainage networks, soils and surface waters. For Benin City, spatial analytic techniques such as kernel density estimation and hotspot analysis are suggested to highlight any clustering of resistance profiles in high-density urban micro-environments, but this has not been done. The city of Benin needs integrated One Health strategies, integration of vendor stewardship, regulation of municipal waste, and local surveillance systems to mitigate environmental AMR.
References
Abdullahi, Y. B., Ahmed, N. I., Abdi, Y. H., Bashir, S. G., Abdi, M. S., Hussein, S. A., & Hussein, A. A. (2026). A one health perspective on antimicrobial resistance in Sub-Saharan Africa: synthesizing human, animal, and environmental evidence for integrated action. Discover Public Health, 23(1), 348. https://doi.org/10.1186/s12982-026-01721-8
Adamu, A. A., Gadanya, M. A., Jalo, R. I., Uthman, O. A., & Wiysonge, C. S. (2020). Factors influencing non-prescription sales of antibiotics among patent and proprietary medicine vendors in Kano, Nigeria: a cross-sectional study. Health Policy and Planning, 35(7), 819–828. https://doi.org/10.1093/heapol/czaa052
Alenzi, S. L. O., Alharthi, A. H., Alnefaie, R. A., Alzahrani, A., Alsaadi, O., Albugami, A. N. M., & Alkhayyat, A. A. (2026). The Global Epidemiology of Antimicrobial Resistance: Trends, Determinants, and Public Health Implications. Cureus, 18(1).
Arnold, K. E., Laing, G., McMahon, B. J., Fanning, S., Stekel, D. J., Pahl, O., & McIntyre, K. M. (2024). The need for One Health systems-thinking approaches to understand multiscale dissemination of antimicrobial resistance. Lancet Planetary Health, 8(2), e124–e133. https://doi.org/10.1016/S2542-5196(23)00278-4
Auta, A., Hadi, M. A., Oga, E., Adewuyi, E. O., Abdu-Aguye, S. N., Adeloye, D., & Morgan, D. J. (2019). Global access to antibiotics without prescription in community pharmacies: a systematic review and meta-analysis. Journal of Infection, 78(1), 8–18. https://doi.org/10.1016/j.jinf.2018.07.001
Bengtsson-Palme, J., Kristiansson, E., & Larsson, D. J. (2018). Environmental factors influencing the development and spread of antibiotic resistance. FEMS Microbiology Reviews, 42(1), fux053. https://doi.org/10.1093/femsre/fux053
Berendonk, T. U., Manaia, C. M., Merlin, C., Fatta-Kassinos, D., Cytryn, E., Walsh, F., Bürgmann, H., Sørum, H., Norström, M., Pons, M. N., Kreuzinger, N., Huovinen, P., Stefani, S., Schwartz, T., Kisand, V., Baquero, F., & Martinez, J. L. (2015). Tackling antibiotic resistance: The environmental framework. Nature Reviews Microbiology, 13(5), 310–317. https://doi.org/10.1038/nrmicro3439
Chen, W., Zeng, Y., Zheng, J., et al. (2026). Evaluation of antimicrobial resistance governance across 193 countries to inform the 2026 Global Action Plan update. Nature Medicine, 32, 1362–1373. https://doi.org/10.1038/s41591-026-04257-1
Diala, C. G., Edobor, O., Edim, P. D., Oraekwe, C. N., Okenwa, C. R., Onyema, A. M., & Onyeaghala, C. A. (2025). Antimicrobial Resistance (AMR) in Low-Resource Settings: A molecular and public health investigation into the role of environmental reservoirs and Over-The-Counter antibiotic use in South‒South Nigeria. Path of Science, 11(8), 5008–5016. https://doi.org/10.22178/pos.121-15
Donkor, E. S., Odoom, A., Osman, A. H., Darkwah, S., & Kotey, F. C. N. (2024). A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective. Antibiotics, 13(7), 662. https://doi.org/10.3390/antibiotics13070662
Eghomwanre, A. F., & Amadasun, F. U. (2022). Antibiogram Profile and Heavy Metal Tolerance of Bacteria Cultured from Soils Collected from Metal Scrap Dumpsites Located in Benin City. Nigeria Journal of Energy Technology and Environment, 4(1), 61–68.
Eghomwanre, A. F., Obayagbona, N. O., Osarenotor, O., & Enagbonma, B. J. (2016). Evaluation of Antibiotic Resistance Patterns and Heavy Metals Tolerance of Some Bacteria Isolated from Contaminated Soils and Sediments from Warri, Delta State, Nigeria. Journal of Applied Science and Environmental Management, 20(2), 287–291. https://doi.org/10.4314/jasem.v20i2.8
Gillings, M. R., Gaze, W. H., Pruden, A., Smalla, K., Tiedje, J. M., & Zhu, Y. G. (2015). Using the class 1 integron-integrase gene as a proxy for anthropogenic pollution. The ISME Journal, 9(6), 1269–1279. https://doi.org/10.1038/ismej.2014.226
Isokpehi, N. A., Beshiru, A., Green, E., Igbinosa, I. H., Ogofure, A. G., & Igbinosa, E. O. (2025). Characterization of Enterococcus species in surface drinking water from Akoko Edo Nigeria reveals contamination levels and risks to public health. Scientific Reports, 15(1), 38120. https://doi.org/10.1038/s41598-025-13068-2
Kilanowski, J. F. (2017). Breadth of the socio-ecological model. Journal of Agromedicine, 22(4), 295–297. https://doi.org/10.1080/1059924X.2017.1358971
Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., Pant, S., Gandra, S., Levin, S. A., & Laxminarayan, R. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proceedings of the National Academy of Sciences, 115(15), E3463–E3470. https://doi.org/10.1073/pnas.1717295115
Larsson, D. J., & Flach, C. F. (2022). Antibiotic resistance in the environment. Nature Reviews Microbiology, 20(5), 257–269. https://doi.org/10.1038/s41579-021-00649-x
Molobe, I. D., & Odukoya, O. O. (2021). The prevalence of drug use and illicit trafficking: A descriptive cross-sectional study of irregular migrant returnees in Nigeria. Journal of Migration and Health, 3, 100034. https://doi.org/10.1016/j.jmh.2021.100034
Murray, C. J., Ikuta, K. S., Sharara, F., Swetschinski, L., Aguilar, G. R., Gray, A., & Tasak, N. (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet, 399(10325), 629–655. https://doi.org/10.1016/S0140-6736(21)02724-0
Naghavi, M., Vollset, S. E., Ikuta, K. S., Swetschinski, L. R., Gray, A. P., Wool, E. E., & Dekker, D. M. (2024). Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. The Lancet, 404(10459), 1199–1226. https://doi.org/10.1016/S0140-6736(24)01867-1
Okeke, I. N., Aboderin, O. A., Byarugaba, D. K., Ojo, K. K., & Opintan, J. A. (2007). Growing problem of multidrug-resistant enteric pathogens in Africa. Emerging Infectious Diseases, 13(11), 1640. https://doi.org/10.3201/eid1311.070674
Okeke, I. N., de Kraker, M. E., Van Boeckel, T. P., Kumar, C. K., Schmitt, H., Gales, A. C., & Laxminarayan, R. (2024). The scope of the antimicrobial resistance challenge. The Lancet, 403(10442), 2426–2438. https://doi.org/10.1016/S0140-6736(24)00876-6
Oluwafemi, J., Babalola, S. O., Mukaila, I. O., & Badewa, A. O. (2022). GIS-Based Approach to Risk Mapping of Lassa Fever Outbreak in Akure South Local Government Area, Nigeria. The International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences, XLVI-4/W3-2021, 147–153.
Omoregie, A. E., & Okoro, E. O. (2024). Local climate conditions and prevalence of typhoid fever disease patterns in a vulnerable community of Ikpoba Okha LGA of Edo State, Nigeria. Journal of Applied Sciences and Environmental Management, 28(11), 3731–3736. https://doi.org/10.4314/jasem.v28i11.31
Oteri, J., Hussaini, M. I., Bawa, S., Ibizugbe, S., Lambo, K., Mogekwu, F., Wiwa, O., Seaman, V., Kolbe-Booysen, O., Braka, F., Nsubuga, P., & Shuaib, F. (2021). Application of the Geographic Information System (GIS) in immunisation service delivery; its use in the 2017/2018 measles vaccination campaign in Nigeria. Vaccine, 39(Suppl 3), C29–C37. https://doi.org/10.1016/j.vaccine.2021.01.021
Partridge, S. R., Kwong, S. M., Firth, N., & Jensen, S. O. (2018). Mobile genetic elements associated with antimicrobial resistance. Clinical Microbiology Reviews, 31(4), e00088-17. https://doi.org/10.1128/CMR.00088-17
Pharmacists Council of Nigeria (PCN). (2022). Guidelines for patent medicine vendors. Abuja: PCN Publications.
Ramirez-Plascencia, H. H. F., Colima-Fausto, A. G., Licona-Lasteros, K. C., Díaz-Zaragoza, M., Cazarez-Navarro, G., Macias-Barragan, J. G., & Rodriguez-Preciado, S. Y. (2025). Presence of Microorganisms in the Environment: One Health Approach. Microorganisms, 13(11), 2435. https://doi.org/10.3390/microorganisms13112435
Rizzo, L., Manaia, C., Merlin, C., Schwartz, T., Dagot, C., Ploy, M. C., & Fatta-Kassinos, D. (2013). Urban wastewater treatment plants as hotspots for antibiotic resistant bacteria and genes spread into the environment: a review. Science of the Total Environment, 447, 345–360. https://doi.org/10.1016/j.scitotenv.2013.01.032
Sati, H., Carrara, E., Savoldi, A., Hansen, P., Garlasco, J., Campagnaro, E., & Nyaruhirira, A. U. (2025). The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. The Lancet Infectious Diseases, 25(9), 1033–1043. https://doi.org/10.1016/S1473-3099(25)00118-5
Tadesse, B. T., Ashley, E. A., Ongarello, S., Havumaki, J., Wijegoonewardena, M., González, I. J., & Dittrich, S. (2017). Antimicrobial resistance in Africa: a systematic review. BMC Infectious Diseases, 17(1), 616. https://doi.org/10.1186/s12879-017-2713-1
Ugbo, E. N., Kotey, F. C., & Donkor, E. S. (2025). Antibiotic resistance genes circulating in Nigeria: a systematic review and meta-analysis from the One Health perspective. BMC Medical Genomics, 18(1), 113. https://doi.org/10.1186/s12920-025-02163-y
Von Wintersdorff, C. J., Penders, J., Van Niekerk, J. M., Mills, N. D., Majumder, S., Van Alphen, L. B., & Wolffs, P. F. (2016). Dissemination of antimicrobial resistance in microbial ecosystems through horizontal gene transfer. Frontiers in Microbiology, 7, 173. https://doi.org/10.3389/fmicb.2016.00173
Vors, L., Debil, F., Saint-Cyr, L., Giacomini, A., Fortané, N., & Lhermie, G. (2026). A socio-ecological approach to the determinants of animal health management: A scoping review. PLoS ONE, 21(3), e0344746. https://doi.org/10.1371/journal.pone.0344746
World Health Organization (WHO). (2023). Urban health and vulnerability report. https://www.who.int
World Health Organization (WHO). (2025). Global antimicrobial resistance report. https://www.who.int
Yu, X., Wang, H., Wang, J., Yuan, X., Zhou, X., He, Q., Mokrousov, I., Sun, L., Dong, Y., & Zou, Z. (2026). Using implementation science to bridge the gaps between political commitment and action in antimicrobial resistance governance under the one health approach in the WHO Southeast Asia and Western Pacific regions. The Lancet Regional Health - Western Pacific, 66, 101783. https://doi.org/10.1016/j.lanwpc.2025.101783
Zhang, A. N., Gaston, J. M., Dai, C. L., Zhao, S., Poyet, M., Groussin, M., & Zhang, T. (2021). An omics-based framework for assessing the health risk of antimicrobial resistance genes. Nature Communications, 12(1), 4765. https://doi.org/10.1038/s41467-021-25096-3
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Uyi Frank Amadasun, Aimuanmwosa Frank Eghomwanre
This work is licensed under a Creative Commons Attribution 4.0 International License.
