Uganda is among 14 African countries facing a growing threat from drug-resistant infections, according to a major new study that warns weak laboratory systems and poor health data are undermining efforts to control the problem.
The study – Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) is the largest analysis of antimicrobial resistance (AMR) ever conducted on the continent.
The study reviewed more than 187,000 laboratory test results collected between 2016 and 2019, including samples from health facilities across Uganda.
Led by the Africa Centres for Disease Control and Prevention (Africa CDC), the African Society for Laboratory Medicine (ASLM), and the One Health Trust, the research paints a troubling picture for Uganda’s already strained health system, where access to diagnostics remains limited and antibiotics are widely used without testing.
Antimicrobial resistance occurs when bacteria adapt and no longer respond to medicines meant to kill them, making infections harder and more expensive to treat.
In Uganda, where infectious diseases remain a leading cause of illness and death, this trend threatens to complicate treatment of common conditions such as urinary tract infections, pneumonia, and bloodstream infections.
The study focused on bacteria frequently linked to severe illness, including Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae – all commonly seen in Ugandan hospitals.
Across the region, resistance to widely used antibiotics was found to be alarmingly high.
One key finding was the widespread resistance to third-generation cephalosporins, a critical class of antibiotics often used when first-line treatments fail.
Although resistance levels were highest in Ghana and Malawi, the study warns that similar patterns are emerging across East Africa, including Uganda, due to antibiotic overuse and limited testing.
The research also found that in six of the 14 countries studied, more than half of Staphylococcus aureus samples were resistant to methicillin, an antibiotic commonly used in hospitals.
Therefore, this raises concerns for Ugandan referral hospitals, where infection prevention and control measures are already under pressure.
Certain groups were found to be at higher risk of drug-resistant infections. People aged 65 and above were 28 per cent more likely to have resistant infections, while patients already admitted to hospitals had a 24 per cent higher risk-often due to prolonged antibiotic exposure. Previous antibiotic use was also strongly linked to resistance.
However, one of the most critical challenges highlighted by the study is Uganda’s limited diagnostic capacity. Fewer than 2 per cent of health facilities across the surveyed countries were able to routinely test for bacterial infections, and only 12 per cent of resistance data was linked to patient information.
In Uganda, many lower-level facilities still treat infections empirically, without laboratory confirmation.
The study also points to weak health information systems. Many laboratories continue to rely on handwritten records, making it difficult to track resistance trends over time or inform national planning.
Hence, without reliable data, health authorities struggle to design effective antibiotic policies or detect emerging threats early.
Supported by the UK’s Fleming Fund and the US Centers for Disease Control and Prevention (CDC), the researchers urge governments including Uganda’s -to make antimicrobial resistance a national health priority. They call for increased investment in laboratory infrastructure, routine diagnostic testing, and digital health systems.
Without urgent action, the study warns, drug resistance could reverse decades of progress in reducing preventable deaths and controlling infectious diseases.
“For African countries, AMR remains a complex problem, leaving countries with a million-dollar question: ‘Where do we start from?’” said Dr Yewande Alimi, One Health Unit Lead at Africa CDC.
Alimi added: “This study brings to light groundbreaking AMR data for African countries. We must act now and together to address AMR.”
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