The Indian Ocean Island of Zanzibar has just completed analysis of antimicrobial resistance.
The Ministry of Health Zanzibar, with technical support from the World Health Organization (WHO) and Health Improvement Zanzibar (HIPZ), has completed the baseline analysis of 2024 antimicrobial resistance (AMR) data from the national sentinel surveillance network.
The work, covering Unguja and Pemba isles, is guiding practical improvements to strengthen routine surveillance and reporting.
The findings will support a review of treatment guidance for common serious infections, alongside measures to improve data quality and strengthen infection prevention and control.
What the data shows
The review, which collated routine data at the Makunduchi Health Centre laboratory, focused on priority pathogens commonly associated with bloodstream and urinary tract infections.
The findings highlight a clear challenge in treating common conditions: non-susceptibility to widely used third-generation cephalosporins (such as ceftriaxone) was high among bacteria isolated from urinary infections.
However, the analysis also indicates that some oral antibiotics, including nitrofurantoin, remain effective for most tested E. coli urine isolates.
These results provide the Ministry with evidence to support a review of treatment guidance, helping clinicians use antibiotics more appropriately.
Strengthening routine surveillance
Beyond resistance patterns, the initiative also looked at how the surveillance system is functioning in routine practice.
The review highlighted the need to standardize laboratory testing panels across sentinel sites, so that results from different facilities are comparable and useful for national planning.
The analysis also emphasized the importance of recording complete clinical information alongside laboratory results. By improving capture of essential patient details, the Ministry aims to strengthen routine reporting and ensure future surveillance better supports public health action.
“This baseline analysis gives us a clear basis to review treatment guidance and strengthen routine surveillance,” said Mr. Muhiddin Omar, AMR Focal Point at the Ministry of Health Zanzibar.
“We are taking practical steps to improve data quality and make laboratory testing more consistent across sentinel sites, so the data can better support action to protect public health.”
A roadmap for quality
To address these needs, national stakeholders have agreed on immediate strengthening measures. These include introducing routine checks to confirm laboratory request forms are complete at key points from the clinic through transport and on receipt at the laboratory, so that results can be reliably used for surveillance.
The Ministry will also prioritize refresher training for health workers on correct specimen collection and strengthen routine recording of essential patient and facility information.
“Our partnership with the Ministry is built on a shared vision of health system strengthening,” said Mr. Simon Kunert, CEO of Health Improvement Project Zanzibar (HIPZ).
“We are part of this collaborative effort to strengthen routine AMR surveillance in Zanzibar and help ensure the data are translated into information that clinicians and decision-makers can use.”
WHO continues to support the Ministry of Health (Zanzibar) and partners to implement these recommendations and advance the goals of the Zanzibar Action Plan on AMR.