Economic Impact Modelling of Antimicrobial Resistance in Livestock-Associated Foodborne Disease on Nigeria’s Health System

Antimicrobial resistance in livestock-associated foodborne pathogens generates economic costs for patients, healthcare systems, and national productivity, yet these costs have not been modelled for Nigeria. This study developed an economic impact model for antimicrobial resistance in livestock-associated foodborne disease on Nigeria's health system. A multi-component methodology was employed. The model structure incorporated disease burden estimation, cost-of-illness analysis, and productivity loss modeling. Primary clinical data were obtained from 300 patients with confirmed Salmonella and Campylobacter infection at tertiary hospitals across six states. Resistance profiles and treatment outcome data were collected alongside direct medical cost data. Indirect productivity loss was estimated using the human capital approach. Monte Carlo sensitivity analysis was applied to quantify uncertainty ranges. The model estimated that antimicrobial-resistant foodborne illness attributable to livestock-associated pathogens cost Nigeria's health system an estimated 14.7 to 31.2 billion naira annually, with 68.4% of costs attributable to extended hospitalization due to treatment failure. Productivity losses to working-age adults added an estimated 8.3 billion naira. Resistant Salmonella contributed 71.2% of the total economic burden. Scenario modeling showed that a 30% reduction in livestock antimicrobial use would generate healthcare cost savings exceeding three times the intervention cost within five years. The study provides the first evidence-based economic impact model for livestock-associated antimicrobial resistance in Nigeria, offering a policy-relevant tool for justifying investment in antimicrobial stewardship programs. Keywords: antimicrobial resistance, economic impact, foodborne disease, Nigeria, health system costs