Drug-resistant infections surge in Lagos, NIMR scientist

2026-02-24 - 00:16

By Chioma Obinna A Senior Researcher at the Nigeria Institute of Medical Research, NIMR, Dr. Emelda Chukwu yesterday warned that Nigeria may be heading toward a post-antibiotic era as drug-resistant infections surge across hospitals in Lagos. Speaking during the February Media Chat organised by the Management of NIMR, Chukwu, while briefing journalists in Lagos, said antimicrobial resistance, AMR, is fast becoming one of the countries most dangerous and underestimated health threats, with alarming levels of resistance now detected even against last-resort antibiotics. “Antimicrobial resistance is the situation whereby microorganisms mutate in such a way that medicines originally meant to kill them can no longer do so. They evolve and boycott the drugs. We are now seeing an increase in resistance that is threatening to overturn decades of medical progress,” Chukwu explained. She said surveillance conducted across four selected hospitals in Lagos State revealed alarmingly high resistance to third-generation cephalosporins, a powerful class of antibiotics reserved for severe infections that fail to respond to earlier treatments. “These are broad-spectrum antibiotics we keep as reserve drugs. But we are now seeing that even these third-generation medicines are losing their effectiveness. That is a major red flag,” she said. According to her, the findings show that resistance is no longer theoretical but already entrenched in clinical cases across Lagos. “When our reserve antibiotics begin to fail, patient safety is at serious risk. It limits treatment options and increases complications, hospital stay, and mortality.” Chukwu traced the surge largely to misuse and abuse of antibiotics. “Human behaviour is a major driver. Irrespective of whether you use antibiotics correctly, if your neighbour does not, resistant organisms can spread. Resistance does not respect boundaries,” she warned. Her team’s sentinel surveillance network provided baseline data to guide national response efforts and helped hospitals develop facility-specific antibiograms to improve empirical treatment decisions. “About 80 percent of prescriptions are empirical. If doctors are guided by data from their own facilities, it can significantly improve outcomes,” she said. Beyond hospitals, Chukwu’s research uncovered another looming danger in Lagos’ wastewater canals. Using environmental and wastewater surveillance across all 20 local government areas in the state, her team detected multiple pathogens of public health importance, including antimicrobial-resistant bacteria and cholera-causing Vibrio cholerae O1. “Out of the 20 local governments surveyed, nine had Vibrio cholerae O1 incubating in their wastewater canals. That was extremely alarming,” she said. The findings prompted a policy advisory to Lagos authorities warning of a possible cholera outbreak. “We issued a warning, and in 2024, cholera came massively, spreading across 36 states with significant morbidity and mortality. Wastewater surveillance proved to be a reliable early warning system.” She said the research demonstrates that wastewater-based epidemiology is a cost-effective tool for epidemic intelligence and pandemic preparedness. “We do not know what the next pandemic will be. But this approach allows us to detect threats early and act before they spiral out of control.” The environmental survey also exposed risky behaviours fueling outbreaks. Residents were found to dump refuse and defecate directly into drainage canals, causing blockages that overflow during the rainy season and contaminate homes and food. “When the canals overflow, they carry pathogens back into people’s homes. It becomes a cycle of reinfection,” she explained. Chukwu stressed that surveillance alone is not enough without behavioural change and stronger antimicrobial stewardship. Her team conducted studies on knowledge, attitude and practices among prescribers and the general public, identifying pressure on doctors to prescribe antibiotics and poor public awareness as major gaps. “Even prescribers are under pressure to prescribe. The public believes antibiotics are cure-alls. These practices are fueling resistance,” she said. She called for sustained awareness campaigns, stricter stewardship programmes and coordinated One Health interventions linking human, animal and environmental health. “Antimicrobial resistance is not a future threat. It is here with us. If we do not act decisively, we risk losing the gains made since the discovery of antibiotics in the 1920s. This is about national health security. The time to strengthen surveillance and change behaviour is now,” Chukwu warned.