This study aims to evaluate the bacteriological, chemical, and toxicological quality of hospital effluents in Benin. Eighteen (18) samples were collected from the south and north of Benin, and poles were set up. Bacteriological analysis was carried out according to the French National Organization for Standardization (AFNOR) standard. Identification of the bacterial species isolated was performed using the API 20E gallery and specific biochemical tests. Antibiotic residues were searched by following ELISA kit instructions. 109 bacterial isolates were obtained, with a predominance of non-enterobacteria (37.7%) and Acinetobacter spp. (24.6%), followed by Klebsiella spp. (11.48%); S. aureus and Coagulase-negative staphylococci (CoNS) were isolated at the same frequency (6.5%). Physico-chemical and toxicological parameter analyses showed that they were in conformity with the standards of discharge into the environment. The pH, temperature, electrical conductivity, total solids below, P-redox and suspended solids measured were, on average, 6.83, 27.21 °C, 693.68 µS/cm, 693.68 mg/l, 1.68 mV and 0.15 mg/l, respectively. For heavy metals, cadmium was most prevalent (0.22 mg/l), followed by nickel (0.18 mg/l) and lead (0.03 mg/l). The average antibiotic residue concentrations ranged from 0.043 to 7.65 µg/l. Ciprofloxacin, metronidazole and sulfamethoxazole had the highest residue concentrations of 7.65 ± 2.272 µg/l, 6.61 ± 0.051 µg/l and 3.88 ± 3.088 µg/l, respectively. The heavy metal concentrations obtained were below those required by Benin standards. These effluents therefore present health and environmental risks. It is then more than necessary to develop treatment methods for them before their rejection into the natural environment.

The conventional treatment of bacterial infections with antibiotics is becoming increasingly ineffective due to the emergence of multidrug-resistant (MDR) pathogens. This literature review explores the potential of bacteriophages as an alternative or adjunctive therapy to antibiotics in combating MDR infections in Africa. This analysis focuses on current research regarding the integration of phage therapy into African healthcare, highlighting its challenges and opportunities. This review begins with the AMR crisis and the need for new treatments, then covers the history, mechanisms, benefits, and limitations of phage therapy. Key African studies are summarized, identifying major obstacles such as regulatory issues, infrastructure, and research standardization. Research efforts in West Africa that have made notable progress in bacteriophage research are highlighted. This review concludes with recommendations for policymakers, researchers, and healthcare professionals to enhance the development and use of phage therapy in Africa, aiming to reduce antibiotic resistance and improve patient outcomes. By addressing the identified challenges and leveraging the unique advantages of phages, there is potential to significantly mitigate the impact of antibiotic resistance and improve patient outcomes in Africa.

Hospital wastewater poses a major public health threat in West Africa due to the high prevalence of pathogenic and multidrug-resistant bacteria. Untreated effluents facilitate the dissemination of antibiotic resistance and virulence genes into the environment, yet their genetic profiles remain poorly documented in the region. This systematic review aimed to synthesize available evidence on the genetic characteristics of bacteria identified in hospital wastewater in West Africa. A systematic review and quantitative synthesis were conducted following PRISMA guidelines. Literature searches were performed in Scopus, PubMed, and Google Scholar databases, in English and French, covering studies published between 2014 and 2025. Studies were included if they reported bacteria isolated from hospital wastewater in any of the 16 West African countries and described resistance genes, virulence genes, or mobile genetic elements. Extracted data were statistically analyzed. Among 412 records identified, 14 studies met the inclusion criteria, mainly from five West African countries. Raw hospital wastewater was 3–4 times more likely to contain multidrug-resistant bacteria than treated effluents. The most frequently reported bacteria were Escherichia coli (87%), Klebsiella pneumoniae (68%), Pseudomonas spp. (45%), and Staphylococcus aureus (42%). Common resistance genes included blaTEM, blaCTX-M,blaNDM, tetA, qnrVC, and mcr-5, frequently associated with integrons, plasmids (Col3M, IncF), and transposons (Tn3). Most hospitals lacked adequate wastewater treatment systems, with 58% discharging untreated wastewater directly into the environment, significantly increasing the genetic load of resistant bacteria. Hospital wastewater in West Africa represents a critical reservoir of multidrug-resistant bacteria carrying resistance and virulence genes that threaten human, animal, and environmental health. Strengthening wastewater treatment infrastructure, surveillance systems, staff training, and regional One Health collaboration is essential to mitigate the spread of antimicrobial resistance.