Abstract
Water is essential for the survival of humans, animals and plants. Numerous research has been conducted on the prevalence and antibiotic resistance of Escherichia coli (E. coli) in water from various African countries, however, there is lack of comprehensive analysis of published literature. We conducted a systematic review and meta-analysis following the PRISMA guidelines where articles published in English language between January 2000 and March 2022 were searched from ScienceDirect, PubMed, Google Scholar, Scopus, African Journal Online (AJO), and Africa Index Medicus (AIM). Comprehensive Meta-Analysis (CMA) Ver 3.0 software was used to analyze the data. The pooled prevalence estimate (PPE) with 95% confidence interval was calculated using the random-effects model (CI). The overall PPE and antimicrobial resistance trends of E. coli isolated from water was screened from 4009 isolates which were isolated from 2586 samples. We extracted data from 17 studies including drinking water (n = 6), rivers (n = 5), wastewaters (n = 4) and wastewater/river (n = 1) which are all covering 27 countries in Africa with 3438 isolates. The PPE of E. coli in water was 71.7% (0.717; 95% CI: 0.562-0.833). The highest PPE antibiotic resistance was against penicillin followed by erythromycin, and ampicilin with resistance rates of 93.4%, 92.3%, and 69.4%, respectively. This systematic review provides critical evidence of E. coli consolidated prevalence and antibiotic resistance profiles, as well as regions where future studies and enhanced reporting could be beneficial in the African continent.