A Cross-Sectional Study of Community-Based Surveillance for Antimicrobial Resistance at the Human-Animal Interface in Tanzania

The escalating burden of antimicrobial resistance (AMR) in Africa necessitates innovative surveillance strategies, particularly at the critical human-animal interface where data remain sparse. This study established and evaluated a pilot, community-based AMR surveillance system integrating human and animal health sectors in Tanzania's Morogoro Region. Employing a cross-sectional design from June 2023 to March 2024, we trained community and animal health workers to collect faecal samples from purposively selected households reporting recent antibiotic use. Samples were obtained from humans (n=150), poultry (n=150), and livestock (n=100). Standardised laboratory protocols were used for bacterial isolation and antimicrobial susceptibility testing of *Escherichia coli* and *Salmonella* spp. against a panel of WHO-listed critically important antimicrobials. Results revealed a high prevalence of multidrug-resistant isolates across all sectors, with resistance to ampicillin, tetracycline, and ciprofloxacin exceeding 60% in human and poultry isolates. Critically, identical resistance patterns were identified in human and animal samples from the same households, suggesting potential cross-transmission. This pilot demonstrates the operational feasibility and value of a One Health-aligned, community-based surveillance model in a resource-limited setting. The findings provide crucial, locally generated evidence for policymakers, underscoring the urgent need to integrate community-level AMR monitoring into national action plans to mitigate this public health crisis.