Abstract
Antimicrobial resistance (AMR) is escalating especially in waterborne bacteria, feared to cause over ten-million annual global deaths by 2050. In Eastern Uganda, bacterial contamination of household drinking water containers and sources such as boreholes is increasingly reported, but data on related AMR and contamination enables are scarce, complicating redress. On 260 random water samples, conventional culture and Kirby-Bauer disk diffusion assays were applied at Makerere University. Pre-validated semi structured questionnaires aided studying the contamination enablers. Thematic synthesis, descriptive and inferential statistics (p < 0.05), were used to analyze data, with STATA version-15. Bacterial (167 isolates), representing eleven species were obtained from 41.2% of samples (mainly from jerricans), mostly Escherichia coli (N = 47, 28.1%), and Klebsiella spp (N = 34, 20.4%). Over 59 (49.2%) of isolates were resistant to at least one high-powered drug; 34% were multi-drug resistant. E. coli showed highest resistance to Cefoxitin (48%), K. pneumoniae to Ceftazidime (28%), and Salmonella spp to Nalidixic acid (70%). Contamination enablers emerged in seven themes, the largest being type of water source (N = 11), and sociodemographic (N = 7). Hence, this water is largely unsafe, and some of these bacteria are associated with persistent epidemics, including typhoid fever in Eastern Uganda, warranting concerted efforts to avert the burden.
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Abbreviations
- NWSC:
-
National Water and Sewerage Cooperation
- RHRW:
-
Roof-Harvested Rain Water (RHRW)
- SSA:
-
Sub-Saharan Africa
- UBOS:
-
Uganda Bureau of Statistics
- UTI:
-
Urinary Tract Infection
- VHTs:
-
Village Health Teams
- WASH:
-
Water Sanitation and Hygiene
- WHO:
-
World Health Organization
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Acknowledgements
We wish to thank the office of the Resident City Commissioner (RCC) of Mbale City, which authorized conducting of this study. We also thank the Village Health Teams and Village Local Council leaders who supported the research team during field data collection. We gladly acknowledge the assistance of Emmanuel Tumwebaze of Makerere University in conducting the laboratory experiments.
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AW and ASE conceived the research idea, and were involved in field data collection and manuscript writing. Then JES, NN, AK, ASO, AMO, and SL were involved in data collection, data analysis and manuscript writing. HMK was the overall supervisor and administrator, and was involved in manuscript writing. All the authors proofread and approved the final draft of the manuscript.
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This research was conducted in conformity to the national guidelines for the conduct of research in the post COVID-19 pandemic era, set by Uganda National Council for Science and Technology93. The study sought ethical approval from the Research Ethics Committee of Islamic University in Uganda (Ref. IUIUREC-2024-69). Written informed consent to participate in this study was obtained in writing from the study participants. The chairpersons of the Village Local Councils, and the Mbale District Health Officer (DHO) granted their approval for community entry and research conduct.
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Walusansa, A., Elmi, A.S., Ssenku, J.E. et al. Antimicrobial-resistance in clinically harmful bacteria contaminating household drinking water in Eastern Uganda highlights urgent need for enhanced antibiotic resistance stewardship. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47699-w
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DOI: https://doi.org/10.1038/s41598-026-47699-w
