From Crisis Response to Preventive Administration: A Policy Framework for Microbial Surveillance and Antimicrobial Resistance Management in Nigerian Urban Centres

Abstract

This comprehensive review synthesizes current scientific evidence to evaluate the critical public health threats emanating from urban microbial pollution in Nigeria and assesses the potential of microbial-based surveillance, remediation, and management solutions. Nigeria's rapid urbanization, characterized by overcrowded slums, inadequate sanitation, and overwhelmed waste management systems, has created pervasive reservoirs for pathogens and antimicrobial resistance (AMR) genes . This review analyzes the composition and health risks of microbial contaminants in key environmental matrices: wastewater canals harboring enteropathogens and non-tuberculous mycobacteria , bioaerosols emitted from waste sites and high-traffic public spaces containing resistant bacteria and fungi , and medical waste streams acting as vectors for AMR dissemination . It identifies that drivers such as the ease of over-the-counter antibiotic access, weak regulatory enforcement, and public knowledge gaps have escalated AMR into a present crisis, straining healthcare and increasing mortality. Crucially, the review advocates for a paradigm shift towards microbial-based intelligence systems, such as wastewater-based epidemiology (WBE), as a cornerstone for proactive public health management. WBE provides a cost-effective, community-wide surveillance tool for early outbreak detection and AMR tracking. We propose an integrated "One Health" policy framework that synergizes enhanced microbial surveillance, targeted infrastructure investment in sanitation and affordable housing, strict antimicrobial stewardship, and robust public education. By harnessing microbial data for decision-making and deploying microbiological solutions for environmental remediation, Nigerian urban public health administration can transition from reactive crisis management to sustainable, preventive, and data-driven health security.