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| Country | Authors and study population | Sample size (N) | Prevalence of Shigella | Antibiotics (%) | MDR | Conclusion |
| Tetracycline (10 µg) | Co-trimoxazole (125 µg) | Ampicillin (30 µg) | Chloramphenicol (30 µg) | Gentamicin (10 µg) | Ciprofloxacin (5 µg) | Norfloxacin (10 µg) | Nalidixic acid (30 µg) | Ceftriaxone (30 µg) | Amoxicillin (30 µg) |
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| Ethiopia | Abebe et al. (2018)—among children aged below five years with diarrhea | 204 | 17 (8.3) | — | 11 (64.7) | 14 (82.4) | 8 (47.1) | 13 (76.5) | 3 (17.6) | 0 | 0 | 3 (17.6) | — | 11 (64.7%) (>3 antibiotics) | None of the strains were sensitive to all antimicrobials tested. Antimicrobial susceptibility testing services are required for treatment [11] |
| Marami et al. (2018)—among asymptomatic food handlers | 417 | 6 (1.4) | 5 (83.3) | 4 (66.7) | 2 (33.3) | 3 (50) | 2 (33.3) | 0 | 1 (16.7) | — | 1 (16.7) | | 1 (10%) (>3 antibiotics) | Food handlers as potential sources of food borne infections [12] |
| Lamboro et al. (2016)—outpatients visiting the hospital and had diarrhea | 176 | 2 (1.1) | 2 (100) | 1 (50) | 2 (100) | 0 | 0 | 0 | 0 | 1 (50) | 0 | — | 2 (100%) (>3 antibiotics) | MDR towards maximum of four drugs was observed [13] |
| Mamuye et al. (2015)—among under 5 children with acute diarrhea | 190 | 23 (9.1) | — | 12 (52.2) | 22 (95.7) | 5 (21.7) | 4 (17.4) | 1 (4.3) | — | 5 (21.7) | 1 (4.3) | 21 (91.4) | 20 (87%) two up to six commonly used antibiotics) | High frequency of MDR; however, there is still a chance to use ciprofloxacin and ceftriaxone as a treatment option in the setting because of their low frequency of resistance rate [14] |
| Feleke et al. (2018)—among under five children with and without diarrhea | 225 | 5 (2.2) | — | — | 5 (100) | — | — | — | — | — | 0 | 5 (100) | — | Ceftriaxone should be considered when necessary within the context of use [15] |
| Terfassa and Jida (2018)—among diarrheal patients | 422 | 9 (2.1) | — | — | — | 1 (11.1) | 1 (11.1) | 0 | 0 | 1 (11.1) | 0 | 7 (77.8) | 33% drugs were MDR | Resistant to most common drugs, care should be taken in selecting antimicrobials in treating disease [16] |
| Mengist et al. (2018)—among food handlers in catering establishments | 220 | 5 (2.3) | 4 (80) | 1 (20) | 5 (100) | 4 (80) | 0 | 0 | 1 (20) | — | — | — | — | Tetracycline, ampicillin, and chloramphenicol should not be used for the treatment and prevention of Shigella species [17] |
| Mama and Alemu (2016)—among food handlers | 345 | 10 (3) | — | — | — | 0 | 0 | — | — | — | 0 | 4 (40) | — | Constant epidemiological surveillance, improvement of personal hygiene, and environmental sanitation [18] |
| Assefa and Girma (2019)——among children aged below five years with diarrhea | 422 | 18 (4.3) | 18 (100) | | | 18 (100) | | 0 | | | 0 | 18 (100) | 2 (11.1%) and 16 (88.9%) Shigella isolates were resistant to three and four drugs, respectively | Ciprofloxacin and ceftriaxone drugs of choice recommended for Shigella species [19] |
| Tadesse et al. (2019)—among asymptomatic street food vendors | 218 | 6 (2.8) | 3 (50) | — | 5 (83.3) | 4 (66.7) | 0 | 0 | | 0 | 0 | 6 (100) | Higher MDR observed to ampicillin, amoxicillin, and tetracycline | Treatment requires further knowledge of the antimicrobial susceptibility pattern [20] |
| Ameya et al. (2018)—among under the age of five children | 167 | 8 (4.8) | — | 2 (25) | — | 4 (50) | 2 (25) | 0 | 1 (12.5) | — | — | 8 (100) | Multidrug resistance was observed in majority of the isolate | Improving hygiene status of under five children and regular drug susceptibility test is important to reduce the problem [21] |
| Gebrekidan et al. (2015)—among acute diarrheal outpatients | 216 | 15 (6.9) | — | 10 (66.7) | 15 (100) | 7 (46.7) | 2 (13.3) | 1 (6.7) | 1 (6.7) | — | — | 13 (86.7) | 12 (80%) of the isolates were multidrug resistance (resistance for more than two antibiotics) | Periodic epidemiological surveillance is of great importance to control the diseases and MDR of Shigella species [22] |
| Diriba et al. (2020)—among food handlers | 220 | 7(3.2) | — | — | 7 (100) | 4 (57.1) | — | 1 (14.3) | 1 (14.3) | — | 3 (42.9) | — | 85.7% of Shigella isolates were recorded as MDR | Constant epidemiological surveillance and hygiene are recommended to control pathogens [23] |
| Tosisa et al. (2020)—diarrheic children | 239 | 6 (2.5) | 4 (66.7) | 3 (50) | 5 (83.5) | 2 (33.3) | 0 | 0 | — | 1 (16.7) | — | 3 (50) | Five Shigella species were MDR | A further study targeting other causes of diarrhea should be conducted to establish the major causes of childhood diarrhea in the study area [24] |
| Legese et al. (2020)—among food handlers | 301 | 11 (3.7) | — | 1 (9.1) | 11 (100) | 2 (18.2) | 1 (9.1) | 0 | — | — | 1 (9.1) | 5 (45.5) | 90.9% Shigella species were resistant to at least three antimicrobials | Physicians should prescribe based on the laboratory result [25] |
| Teshome et al. (2019)—patients with diarrhea | 232 | 22 (9.5) | 16 (72.7) | — | 16 (72.7) | 12 (54.5) | — | 13 (59.1) | — | 5 (22.7) | — | 5 (22.7) | — | Treatments need to be based on species identification [26] |
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| Kenya | Olipher et al. (2020)—patients with diarrhea | 400 | 47 (11.8) | 14 (29.8) | — | 18 (39.3) | 11 (23.4) | — | 12 (25.5) | — | 8 (17) | — | — | — | Different geographical settings have responded differently to antibiotics [27] |
| Njuguna et al. (2016)—acute bloody diarrhea | 284 | 67 (23.6) | 56 (83.6) | — | 39 (58.2) | 14 (20.9) | — | 2 (3.0) | — | 3 (4.5) | 0 | — | Over half of the isolated Shigella species were MDR | There is an urgent need for a rational use of antimicrobials [28] |
| Onyango et al. (2019)—from Street vended Food | 186 | 13 (7) | 0 | — | 0 | 4 (30.8) | — | — | 0 | 0 | — | 0 | — | More attention to food hygiene practices to eliminate the risk of spreading antibiotic-resistant pathogenic [29] |
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| South Sudan | Mogga et al. (2015)—patients with diarrhea | 286 | 15 (5.2) | 2 (13.3) | 1 (6.7) | 0 | 1 (6.7) | 4 (26.7) | 0 | — | 1 (6.7) | 0 | — | — | To inform antibiotic choices, further study of antimicrobial resistance trends isneeded in the area [30] |
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| Sudan | Moglad (2020)—from different samples sources of patients | 144 | 1 (0.7) | — | — | 1 (100) | — | — | 0 | 0 | — | — | — | MDR has increasing gradually | Proper assessments and research to manage the progress of the resistant strain [31] |
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| Somalia | Ali Noret al. (2021)—among children aged below five years with diarrhea | 180 | 37 (20.6) | 37 (100) | 37 (100) | 37 (100) | — | — | 8 (21.6) | — | — | 16 (43.2) | — | Among the serogroups, most of the MDR phenotypes were found in S. flexneri (65.9%) | There is an urgent need for AMR surveillance and continuous monitoring [32] |
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