Expanding surveillance for “superbugs” in Tanzania

May 26, 2022 by Nate Goldfarb

Worldwide, over 1.2 million deaths are attributed to antimicrobial-resistant pathogens each year. Left unaddressed, experts estimate annual deaths could jump to 10 million by 2050.


Escherichia coli bacteria (shown) are among the microorganisms that can develop a resistance to antibiotics. PATH works with governments and health systems around the world to strengthen surveillance of antimicrobial resistant pathogens. Photo: NIAID.

Given the opportunity, bacteria, viruses, fungi, and parasites can develop resistance to antibiotics, antivirals, fungicides, and pesticides, particularly when these medicines are overprescribed or inappropriately managed. Once established, resistant pathogens (aka “superbugs”) can spread easily through human, animal, and plant populations.

Superbugs already claim more than a million lives each year, and experts project that could increase to 10 million by 2050.

Preventing the spread of antimicrobial resistance (AMR) requires that public health decision-makers know quickly and accurately where resistant pathogens are emerging and how they are moving through the population. The challenge is that AMR is difficult to detect without laboratory confirmation.

Tanzania hospitals expand AMR testing capabilities

The Infectious Disease Detection and Surveillance (IDDS) project, funded by the US Agency for International Development, aims to support counties in antimicrobial resistance detection and build national and subnational capacities to improve diagnostic networks and surveillance systems. Over the past three years, the IDDS project (implemented by an ICF-led consortium with PATH as a technical sub partner), has been working closely with the National Public Health Laboratory in Dar es Salaam, Tanzania, to perform standardized microbiological culture and antimicrobial susceptibility testing in four designated hospitals to detect AMR.

In 2021, the hospitals participating in the project were able to test more than 2,000 bacterial isolates against common antibacterial agents used for clinical treatment, more than doubling their testing capacity in the first quarter of 2021 from the same time period in 2020 (see figure below).

AMR testing in Tanzania.png

Over one year, the four participating hospitals more than doubled their testing capacity for AMR, as demonstrated by the increase in the number of specimens collected. Source: PATH.

Surveillance results spur action

The labs discovered that, of the two most common pathogens isolated in Tanzania samples (S. aureus and E. coli), about 50 percent were resistant to commonly prescribed antibiotics. Abbas Wandella, IDDS surveillance specialist for PATH says, “These results underscore the need to ensure the appropriate use of antibiotics in Tanzania so that resistant bacteria have fewer opportunities to emerge and spread.”

“These results underscore the need to ensure the appropriate use of antibiotics in Tanzania so that resistant bacteria have fewer opportunities to emerge and spread.”
— Abbas Wandella, IDDS surveillance specialist, PATH

Now that Tanzania has strengthened its capacity to conduct routine AMR surveillance, policymakers will be able to make evidence-based decisions on how antimicrobials are prescribed and used in agricultural, human, and animal health sectors. Data from Tanzania also will be shared on global data-sharing platforms, such as the World Health Organization’s WHONET data platform and Global Antimicrobial Resistance and Use Surveillance System (GLASS), both of which are used to help guide clinical practice, global policy, and pharmaceutical research.

Learn more about PATH’s work on antimicrobial resistance.