The use of untreated livestock manure in urban agriculture sustains soil fertility but risks disseminating antimicrobial resistance (AMR) in resource-limited settings. This study characterized antibiotic-resistant bacteria (ARB) prevalence across manure–soil–vegetable pathways in Blantyre, Malawi. Using a cross-sectional design, we collected 35 samples (poultry/pig manure, farm/home soils, Brassica rapa subsp. chinensis, Brassica rapa, and Amaranthus spp.) from five livestock farms. Microbiological analysis with API 20E identification and disk diffusion testing revealed clear differences in contamination: Escherichia coli dominated pig manure (52%) and farm soil (35%), with detection in vegetables suggesting possible transfer (e.g., 20% in Brassica rapa subsp. chinensis), while Klebsiella pneumoniae contaminated all sample types (peak: 60% vegetables and 67% home soils). All manure isolates exhibited sulfamethoxazole–trimethoprim resistance, with 50% of pig manure E. coli showing cefotaxime resistance. Soil isolates mirrored these patterns (100% ampicillin resistance in K. pneumoniae and 77% cefotaxime resistance in farm soil E. coli). Vegetables displayed severe multidrug resistance (100% E. coli and 80% K. pneumoniae resistant to ≥3 classes), including critical gentamicin resistance (100% E. coli). Composting for ≤6 weeks, as practiced on the studied farms, did not eliminate ARBs, suggesting that longer durations may be needed. Notably, this study provides the first phenotypic evidence of presumptive Pasteurella-like organisms on edible leafy vegetables, specifically 45% in Amaranthus spp. and 6.1% in Brassica rapa, suggesting a potential zoonotic transmission route from livestock farms that requires molecular confirmation. These findings demonstrate manure-amended farms as AMR reservoirs, necessitating extended composting and antibiotic stewardship to mitigate One Health risks.

Urban and peri-urban farmers in Malawi increasingly use treated and untreated wastewater for vegetable production, but little is known about the extent of heavy metal accumulation in both exotic and indigenous vegetables, particularly with respect to differences between edible tissues (leaves vs. stems). This study addresses this gap by measuring the concentrations of cadmium (Cd), chromium (Cr), lead (Pb), zinc (Zn), and copper (Cu) in wastewater, soils, and six vegetables including three exotic and three indigenous irrigated with effluent from the Soche Wastewater Treatment Plant in Blantyre. Metal concentrations were determined using Atomic Absorption Spectrophotometry. Wastewater contained Zn (0.01 ± 0.001 mg/L) and Cu (0.02 ± 0.018 mg/L), both below World Health Organization (WHO) and Malawi Bureau of Standards (MBS) limits (Zn: 0.2 mg/L; Cu: 2 mg/L), while Cd, Cr, and Pb were below detection limit. In soils, Zn reached 56.4 ± 0.5 mg/kg, exceeding the WHO limit of 36 mg/kg; other metals remained within WHO permissible values. Vegetables showed species- and tissue-specific variation in metal accumulation: Cr reached 4.65 mg/kg in Cucurbita moschata stems, Cd up to 0.31 mg/kg in Amaranthus retro-flexus leaves, and Pb up to 4.09 mg/kg in Brassica rapa stems—all above FAO/WHO permissible limits (2.3, 0.2, and 0.3 mg/kg, respectively). Duncan’s post hoc analysis confirmed significant differences (p < 0.05) across matrices and plant parts, with leaves generally accumulating more Zn and Cu than stems. Principal component analysis (PCA) revealed that Zn, Cu, Cr, and Pb in the wastewater-soil-vegetable system largely share a common source, likely wastewater effluent and historical soil contamination, while Cd showed a more sporadic distribution, highlighting differential accumulation pathways. Health risk assessments revealed high Health Risk Index (HRI) values, with Brassica rapa stems (HRI = 92.3) and Brassica rapa subsp. chinensis leaves (HRI = 82.2) exceeding the safe threshold (HRI > 1), indicating potential chronic risks. This study reveals potential health risks associated with wastewater irrigation due to heavy metal accumulation in edible vegetables, and therefore recommends further research on metal speciation, seasonal variation, and bioaccumulation at different crop growth stages.

Background/objectives: Antimicrobial resistance (AMR) is a growing public health concern, and misuse of antibiotics in livestock farming contributes to its emergence. In Blantyre, Malawi, small-scale pig and poultry farming is widespread, but the knowledge, attitudes, and practices (KAP) driving antimicrobial use (AMU) remain poorly understood. This study aimed to assess the KAP regarding AMU and manure management among pig and poultry farmers in Blantyre, Malawi. Methods: This cross-sectional study surveyed 118 randomly selected farmers to assess AMU patterns, sources of antibiotics, adherence to withdrawal periods, disposal practices, and awareness of AMR and regulations. Data was collected using a structured questionnaire and analyzed with descriptive statistics and inferential tests (with statistical significance set at p < 0.05). Results: Antibiotic use was reported by 88% of farmers, primarily for therapy (93.3%) and prophylaxis (85.6%), including for viral diseases such as Newcastle disease in poultry and African swine fever in pigs. Oxytetracycline (91.5%), penicillin (50.8%), and trimethoprim-sulfamethoxazole (39.8%) were the most used antibiotics, predominantly sourced from agrovet shops (73.7%). While 61% of farmers knew antibiotic misuse could lead to AMR, significant gaps were observed: 68.6% had no formal training, 55.9% were unaware of regulations, and 42% sold/consumed products before the end of the withdrawal period. Most farmers disposed of expired antibiotics (80.5%) and packaging (92.4%) in household waste. Higher education and prior training were significantly associated with good knowledge. Conclusions: This study reveals significant knowledge–practice gaps and high-risk behaviors, such as misuse for viral diseases and unsafe disposal, that exacerbate AMR risks. Interventions must prioritize targeted farmer education, strengthening of veterinary extension services, and stricter regulation of agrovet shops to promote antimicrobial stewardship and support Malawi’s National Action Plan on AMR.

Intestinal infectious diseases remain among the leading causes of death, mainly in sub-Saharan Africa. In Malawi’s commercial hub, Blantyre, the spatiotemporal dynamics of these diseases have not been extensively studied, despite their significant public health burden. We studied high-risk areas and analyze the spatial and temporal patterns of intestinal infectious diseases, including cholera, schistosomiasis, and Other Diarrheal Diseases (ODDs) in Blantyre district from 2018 to 2023. Descriptive statistics were used to evaluate the epidemic characteristics of the intestinal infectious diseases. Spatial autocorrelation with Local Moran’s I was employed to detect spatial clusters, and the Kulldorf retrospective method for space-time analysis. ODDs had the highest incidence rates, ranging from 2714/100,000 to 3631/100,000, while cholera had the lowest, ranging from 0 to 320/100,000. Temporal characteristics showed that ODDs and cholera peaked during the rainy season (October-March), while schistosomiasis occurred from April to June. Spatial clustering of schistosomiasis declined from two High-High (HH) clusters in Blantyre's northern and western parts (2018- 2020) to one (2021-2023). Cholera exhibited High-High (HH) clusters only in the northern part from 2021 to 2023. ODDs expanded from two to three HH clusters extending southward between 2018-2020 and 2021-2023. Space-time analysis identified nine most likely clusters for schistosomiasis and ODDs and two for cholera. Most likely, clusters were in the city, with secondary clusters in the northern and western parts. Given their high incidence, focused public health strategies for schistosomiasis and ODDs should be prioritized in future planning.