Evaluating a Multi-Sectoral One Health Intervention on Antimicrobial Resistance at the Human-Livestock-Wildlife Interface in the Serengeti Ecosystem, Tanzania

Antimicrobial resistance (AMR) poses a critical threat to public health in Africa, with complex dynamics at the human-livestock-wildlife interface. This study evaluated a multi-sectoral One Health intervention on AMR patterns in the Serengeti ecosystem, Tanzania (2023–2025). The programme integrated community education, enhanced veterinary and clinical stewardship, and improved biosecurity. Using a quasi-experimental, pre-post design, ten intervention villages were compared with ten control villages. Data were collected via repeated cross-sectional surveys, analysing faecal samples from humans, livestock, and wildlife for extended-spectrum beta-lactamase (ESBL)-producing *Escherichia coli*, alongside structured questionnaires on knowledge and practices. By 2025, the intervention villages showed a statistically significant reduction in ESBL-E. coli prevalence in livestock (22% reduction, p<0.01) and humans (15% reduction, p<0.05) relative to controls, with no significant change in wildlife. A marked improvement in community knowledge regarding AMR and appropriate antimicrobial use was also observed. The findings demonstrate that a locally adapted, multi-sectoral One Health approach can effectively mitigate AMR prevalence at critical interfaces in a low-resource setting. This study provides a replicable model for sub-Saharan Africa, underscoring the imperative for integrated policies to safeguard public health and socio-economic stability.