Antimicrobial resistance remains a major challenge in public health. Many reports of resistance to
common antibiotics have been documented. The carbapenems are one of the last line antibiotics
against many members of the Enterobacterales. However, the actual prevalence of carbapenem-resistant
Enterobacterales in Somalia is unknown. Thus, this present investigation was done to ascertain the
actual prevalence. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA) guideline in the conduct of this study. Searches were conducted in electronic databases such as
PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar to find published articles providing
information on the prevalence of carbapenem-resistant Enterobacterales in Somalia. Data were extracted
and analyzed using the OpenMeta analyst software. Study quality was evaluated using the JBI prevalence
tool. The resistance rate of Enterobacterales to carbapenems were estimated using the random-effect
model. A pooled resistance rate of 4.3% (95% CI, 2.5–7.2) was obtained for imipenem, 2.8% (95% CI,
0.8–8.8) for meropenem, and 13.9% (95% CI, 3.1–44.7) for ertapenem. The heterogeneity test showed low
heterogeneity, except for studies contributing to the estimated resistance to ertapenem which had a high
heterogeneity (I2=91.52%; Q=11.788; p<0.001). This first systematic review and meta-analysis suggests
that carbapenem antibiotics can be relied on as last line antibiotics to treat Enterobacterale infections in
Somalia.
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