A one health perspective on the prevalence and antimicrobial resistance of Campylobacter in Ethiopia: A systematic review and meta-analysis

Campylobacter is an important water- and food-borne pathogen with notable genetic similarity among strains isolated from humans, animals, and environmental sources. This systematic review and meta-analysis synthesized available evidence on the prevalence, antimicrobial resistance, and associated risk factors of Campylobacter in humans, animals, and the environment in Ethiopia. Articles published from 1997 to 2024 were systematically searched and retrieved from PubMed, Science Direct, Web of Science, and Google Scholar. The review was conducted in accordance with the PRISMA guidelines, and data from eligible articles were extracted using a standardized data extraction template. Heterogeneity was evaluated using Cochran’s Q statistic, the I² statistic, and Egger’s test for small-study effects. Data extraction and analysis were conducted using Microsoft Excel and Stata 14. Of the 11,573 samples analyzed across 26 studies, 3204 were positive for Campylobacter , yielding a pooled prevalence of 19.9 %. The highest prevalence was observed in environmental samples (33.4 %), followed by humans (31.4 %) and animals (24 %). Regionally, Oromia showed the highest prevalence (30.4 %), while Addis Ababa and Tigray reported the lowest (11.0 %). Cephalothin and ampicillin exhibited the highest antimicrobial resistance (100 %), whereas gentamicin showed the lowest (7.1 %). Campylobacter jejuni and Campylobacter coli were the most frequently identified species and demonstrated the highest resistance levels. Major risk factors for campylobacteriosis included frequent animal contact, consumption of undercooked or contaminated food and water, and low parental education levels among affected children. This study highlights the distribution and increasing prevalence of Campylobacter and associated antimicrobial resistance within a One Health framework. Future research should encompass wider geographic coverage and include diverse sources such as poultry, companion animals, vegetables, and wastewater to generate more comprehensive epidemiological data. Such efforts will help address existing knowledge gaps and support the development of targeted interventions to reduce foodborne infections and mitigate antimicrobial resistance. • The prevalence of Campylobacter is significantly increasing in Ethiopia. • Environmental samples had the highest prevalence of Campylobacter . • Among Campylobacter species, C. jejuni was the most frequently detected. • Cephalothin and Ampicillin showed the highest levels of AMR. • Children with a history of exposure, were at higher risk of acquiring Campylobacter.