Prevalence of carbapenem-resistant Enterobacterales (CRE) in Somalia: A systematic review and meta-analysis

Antimicrobial resistance remains a major challenge in public health. Many reports of resistance to common antibiotics have been documented. The carbapenems are one of the last line antibiotics against many members of the . However, the actual prevalence of carbapenem-resistant in Somalia is unknown. Thus, this present investigation was done to ascertain the actual prevalence. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline in the conduct of this study. Searches were conducted in electronic databases such as PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar to find published articles providing information on the prevalence of carbapenem-resistant in Somalia. Data were extracted and analyzed using the OpenMeta analyst software. Study quality was evaluated using the JBI prevalence tool. The resistance rate of to carbapenems were estimated using the random-effect model. A pooled resistance rate of 4.3% (95% CI, 2.5–7.2) was obtained for imipenem, 2.8% (95% CI, 0.8–8.8) for meropenem, and 13.9% (95% CI, 3.1–44.7) for ertapenem. The heterogeneity test showed low heterogeneity, except for studies contributing to the estimated resistance to ertapenem which had a high heterogeneity (I=91.52%; Q=11.788; p<0.001). This first systematic review and meta-analysis suggests that carbapenem antibiotics can be relied on as last line antibiotics to treat infections in Somalia.