Knowledge, attitudes, practices and risk perception of rural poultry farmers in Cameroon to antimicrobial use and resistance

Knowledge, attitudes, practices and risk perception of cattle farmers in Namibia to antibiotic use and resistance

The misuse of antibiotics in livestock contributes to the emergence of antibiotic resistant bacteria. The development of antibiotic resistance in bacteria of animal origin is of public health concern since drug resistant pathogens in animals can spread to humans. Several countries have therefore introduced regulations to restrict the use of antibiotics in livestock. Namibia was the first African country to ban the use of antibiotics as growth promoters and restrict the use of antibiotics to the treatment of bacterial diseases with a prescription from a veterinarian. However, there are limited studies on antibiotic stewardship among farmers in the country. The aim of this study was to determine the antibiotic awareness and usage of cattle farmers in Oshikoto region Namibia. A questionnaire on antibiotic knowledge, attitudes and practices (KAP) was administered to 274 randomly selected cattle farmers in Namibia. To calculate the KAP scores, one mark was awarded for each correct answer and zero was awarded for incorrect or unsure responses. Respondents having ≥ 50% correct answers were considered as having good KAP scores. The KAP score ranged from 8 to 73%. Forty-three per cent of the respondents had good KAP scores. Good KAP was associated with age, farm type and education status. Semi-commercial/commercial farmers had significantly better KAP than post and homestead farmers. The findings of this study indicate that there is a need to improve antibiotic usage and resistance education programmes in order to promote rational antibiotic usage.

Knowledge, Attitudes, Practices, and Risk Perception of Antimicrobial Use and Antimicrobial Resistance Among Dairy Farm Owners/Workers in Addis Ababa, Ethiopia

Introduction

Antimicrobial resistance (AMR) is one of the most significant global health threats to the public, animals, and the ecosystem. Inappropriate use of antibiotics in food animals is considered a major driver of AMR in humans. This study was conducted to assess the knowledge, attitude, practices, and risk perception (KAPP) of dairy farm owners/workers in Addis Ababa about antibiotic use and resistance.

Methods

A face-to-face interview using a structured questionnaire was conducted with 281 respondents in four selected subcities of Addis Ababa. The responses provided by each participant were recoded into a binary scale based on the mean score of each domain. Pearson chi-square was used to check the association between the KAPP and sociodemographic characteristics of the respondents and logistic regression analysis was done to explore the factors associated with KAPP.

Results

Overall, more than half of the surveyed dairy farm owners/workers had good knowledge (57.7%) and appropriate practice (53.0%), while less than half of the respondents showed desirable attitudes (47.7%) and positive risk perceptions (42.7%). The findings revealed a strong association between the respondents' KAPP and education and between knowledge and risk perception and farming experience.

Conclusion

This study found that continuous education of dairy farm owners/workers regarding antimicrobial usage and antimicrobial resistance in dairy farms will increase their awareness and perception of risk as well as motivate them to adopt desirable attitudes and appropriate practices, and consequently limit inappropriate use of antimicrobials leading to mitigating emergence of AMR.

Understanding Vietnamese chicken farmers' knowledge and practices related to antimicrobial resistance using an item response theory approach

Introduction

Antimicrobial resistance (AMR) poses a threat to animal and human health, as well as food security and nutrition. Development of AMR is accelerated by over- and misuse of antimicrobials as seen in many livestock systems, including poultry production. In Vietnam, high AMR levels have been reported previously within poultry production, a sector which is dominated by small-scale farming, even though it is intensifying. This study focuses on understanding small- and medium-scale chicken farmers' knowledge and practices related to AMR by applying an item response theory (IRT) approach, which has several advantages over simpler statistical methods.

Methods

Farmers representing 305 farms in Thai Nguyen province were interviewed from November 2021 to January 2022, using a structured questionnaire. Results generated with IRT were used in regression models to find associations between farm characteristics, and knowledge and practice levels.

Results

Descriptive results showed that almost all farmers could buy veterinary drugs without prescription in the local community, that only one third of the farmers received veterinary professional advice or services, and that the majority of farmers gave antibiotics as a disease preventive measure. Regression analysis showed that multiple farm characteristics were significantly associated to farmers' knowledge and practice scores.

Conclusion

The study highlights the complexity when tailoring interventions to move towards more medically rational antibiotic use at farms in a setting with high access to over-the-counter veterinary drugs and low access to veterinary services, since many on-farm factors relevant for the specific context need to be considered.

Antibiotic Residues in Foods of Animal Origin in Cameroon: Prevalence, Consumers' Risk Perceptions, and attitudes

The use of antibiotics in food animals and the nonobservance of the withdrawal period might result in the accumulation and persistence of residues in foods. The contamination of foods by antibiotic residues might induce health risks including allergy, gastrointestinal dysbiosis, antimicrobial resistance, and cancer to consumers. Therefore, this study was initiated to investigate the presence of antibiotic residues in raw eggs, raw milk, and beef collected at the wholesale and retail points in the three major cities of Cameroon and consumers' perceptions of the risk of antibiotic residues in foods. Qualitative antibiotic residue kits (PremiTest® and Delvotest®) were used to screen 407 samples of foods collected in markets of three towns (Ngaoundéré, Yaoundé, and Douala) in Cameroon. A structured questionnaire was used to evaluate the knowledge and attitudes of 1462 consumers toward microbial drug residues in foods of animal origin. Prevalence of residues of 70.55%, 17.39%, and 69.63% for beef, eggs, and milk, respectively, was observed. More than 1/3 of the respondents believed that the consumption of contaminated foods with antibiotic residues is a risk to their health and thought that allergies and intoxication they often experience are related to the consumption of contaminated foods. Most of them showed their willingness to pay more to acquire quality foods, free from antibiotic residues.

Antimicrobial use and resistance in food animal production: food safety and associated concerns in Sub-Saharan Africa

The use of antimicrobials in food animal (FA) production is a common practice all over the world, with even greater usage and dependence in the developing world, including Sub-Saharan Africa (SSA). However, this practice which serves obvious economic benefits to producers has raised public health concerns over the last decades, thus driving the selection and dissemination of antimicrobial resistance and adversely impacting food safety and environmental health. This review presents the current and comprehensive antimicrobial usage practices in food animal production across SSA. We further highlighted the overall regional drivers as well as the public health, environmental, and economic impact of antimicrobial use in the production of food animals. Antimicrobial use is likely to increase with even exacerbated outcomes unless cost-effective, safe, and sustainable alternatives to antibiotics, especially probiotics, prebiotics, bacteriocins, antimicrobial peptides, bacteriophages, vaccines, etc. are urgently advocated for and used in food animal production in SSA. These, in addition to the implementation of strong legislation on antimicrobial use, and improved hygiene will help mitigate the public health concerns associated with antimicrobial use in food animals and improve the well-being and safety of food animals and their products.

Education and Awareness on Antimicrobial Resistance in the WHO African Region: A Systematic Review

This review documents the status of AMR education and awareness in the WHO African region, as well as specific initiatives by its member states in implementing education and awareness interventions, as a strategic objective of the Global Action Plan on AMR, i.e., improve knowledge and understanding on AMR through effective communication, education, and training. A systematic search was conducted in Google Scholar, PubMed, and African Journals Online Library according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, for articles published in English. Retrieval and screening of articles was performed using a structured search protocol following a pre-set inclusion/exclusion criterion. Eighty-five published articles reporting 92 different studies from 19 Member States met inclusion criteria and were included in the final qualitative synthesis. Nigeria (21) and Ethiopia (16) had most of the studies, while the rest were distributed across the remaining 17 Member States. The majority of the articles were on knowledge, attitude, and practices with regard to AMR and antimicrobial use and most of them documented a general lack and suboptimal knowledge, poor attitude and practices, and widespread self-medication. This review shows low levels of knowledge of AMR coupled with extensive misuse of antimicrobial medicines by different target audiences. These findings underscore the urgent need for enhanced and context-specific educational and positive behavioural change interventions.

Intention to adopt improved indigenous chicken breeds among smallholder farmers in Machakos county, Kenya. Do socio-psychological factors matter?

Consumption of poultry meat, eggs, and other animal-sourced commodities has dramatically risen by almost 86 %, with the demand of indigenous chicken products almost doubling over the past few decades. In Kenya, poultry farmers prefer indigenous chicken (IC) due to their resilience to harsh climatic conditions, high feed conversion rates, delicious end products, ability to scavenge and potential to reduce greenhouse gas emissions among other factors. Despite the high demand for poultry and its products, the gap between demand and production remains high. Poultry farmers try to keep pace with the demand by integrating the recommended improved IC breeds into their production system. Although there exists some understanding on the determinants of the farmers to adopt improved IC, still there is scanty information on how socio-psychological factors influence the intention to adoption improved IC among the farmers in Kenya. Thus, this study sought to investigate the determinants of intention to adopt improved IC while specially focusing on the role of socio-psychological factors. A total of 374 IC farmers in Machakos county were selected using a multistage sampling technique. Partial Least Square - Structural Equation Modelling (PLS-SEM) was employed to analyze the data. Results from descriptive statistics showed that approximately 90 % of IC farmers in the study area were aware of the improved indigenous chicken breeds. However, the adoption of the improved IC was below average (44.9 %). The path analysis results revealed that Subjective Norm (SN) was the main determinant of farmer's intention to adopt improved IC breeds, followed by Attitude (ATT) and Perceived Behavioral Control (PBC). The study recommends more emphasis to be given to psycho-social issues through well designed public and private interventions that will promote adoption of improved breeds among IC farmers.

Knowledge and practice of antimicrobial usage and resistance among poultry farmers: A systematic review, meta-analysis, and meta-regression

A systematic review was conducted to summarize and synthesize the existing research on poultry farmers' knowledge, practices, and awareness regarding antimicrobial use (AMU) and antimicrobial resistance (AMR). It was undertaken by systematically searching databases, screening and characterizing relevant studies, extracting data, and evaluating the risk of bias. The outcomes were stratified into several subgroups, and pooled prevalence of each subgroup was calculated using a random-effect meta-analysis. Meta-regression was used for selected outcomes to further investigate the potential sources of heterogeneity across studies. Poultry farmers had knowledge and practice gaps on antimicrobial use. While most (65%; 95% CI: 50%-80%) used antimicrobials on poultry for therapeutic purposes, a portion used them to prevent disease (45%; 95% CI: 34%-55%) or boost growth (29%; 95% CI: 13%-46%) and productivity (20%; 95% CI: 6%-34%). 60% (95% CI: 50%-69%) of farmers approached veterinarians for antimicrobial advice, although many consulted drug sellers and fellow farmers. Insufficient antimicrobial residue knowledge (45%; 95% CI: 29%-62%), as well as inadequate awareness and faulty practice on withdrawal periods, were identified. Only 43% (95% CI: 34%-53%) were knowledgeable about AMR. Around half of farmers understood AMR's impacts on poultry, human health, and the environment. Meta-regression demonstrated that the source of heterogeneity for therapeutic antimicrobial use was the type of poultry farmers sampled and their educational qualifications; geographical region was significantly associated with antimicrobial usage based on farmers' experience; and the country's economic state was correlated with farmers' understanding of antimicrobial residue. This study recommends implementing legislation for judicious antimicrobial use, and farmer awareness campaigns to reinforce knowledge about prudent AMU and AMR.

Knowledge, Attitude, and Practice of Antibiotic Use and Resistance among Poultry Farmers in Nepal

The abuse and misuse of antibiotics is one of the main drivers of antimicrobial resistance (AMR). Globally, AMR in food-producing animals is a significant public health concern. This study, therefore, assessed the knowledge, attitudes, and practices related to antibiotic usage (AMU) and AMR among poultry farmers in Nepal. We conducted a cross-sectional survey of 605 poultry farmers from six districts of Nepal from May to June 2022 to assess the status of knowledge, attitude, as well as practices toward prudent antibiotic usage (AMU) and AMR. The majority of the participants in our study were from the Chitwan district (31.6%; n = 191/605), aged 30-44 (54.2%; n = 328/605), males (70.4%; n = 426/605), and farmers with a higher secondary (28.76%; n = 174/605) level of education. The tetracyclines (28%, n = 228/828), aminoglycosides (23%, n = 188/828), and fluoroquinolones (15%, n = 126/828) were the most used antibiotics classes among poultry farmers. Although 87.8% (n = 531/605) of poultry farmers used antibiotics, 49.8% (n = 301/605) of them were aware of AMR, and 55.7% (n = 337/605) knew that the misuse of antimicrobials could affect human and environmental health. There were significant differences in the knowledge, attitude, and practices toward prudent AMU and AMR among farmers who reared different birds. The mean knowledge, attitude, and practice score of the respondents were 7.81 ± 3.26, 5.8 ± 2.32, and 7.59 ± 3.38 when measured on a scale of 12, 10, and 15, respectively. Based on a cut-off of 75% of the maximum score, 49.4% (n = 299/605), 62.8% (n = 380/605), and 12.73% (n = 77/605) of the respondents had good knowledge, attitude, and practices toward prudent AMU and AMR, respectively. The multivariable logistic regression analyses revealed that the positive predictors of good knowledge and attitude were male gender, higher level of education, district, and the types of birds (layers). Similarly, those of the male gender (OR: 3.36; 95% CI: 1.38-8.20; p = 0.008) and those that rear layers (OR: 4.63; 95% CI: 1.75-12.25; p = 0.003) were more likely to practice prudent usage of antimicrobials. The findings of this study show poor practice toward prudent antibiotic usage despite good knowledge of AMR. This study provides essential baseline data on the knowledge, attitudes, and practices of poultry farmers in Nepal and offers valuable insights that could help in the design of interventions and policies aimed at addressing illicit AMU and AMR in poultry in Nepal.

Livestock producers' knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia

Introduction

Inappropriate antimicrobial use (AMU) in livestock production is an important aspect of the global burden of antimicrobial resistance (AMR). In Ethiopia, a low-income country with a large and increasing livestock population, AMU in food animals is not properly regulated. Hence, farmers are fully free to use antimicrobials to their (perceived) benefit. Therefore, understanding farmers' mindsets is important to improve antimicrobial stewardship in the livestock sector.

Methods

This cross-sectional study was conducted to assess livestock disease management practices and knowledge, attitude, and behavior (KAB) among livestock producers regarding AMU, residues, and resistance, as well as factors potentially explaining differences in KAB. We determined the KAB of livestock owners of three selected districts of central and western Ethiopia (n = 457), using a pretested questionnaire administered through face-to-face interviews. Logistic regression was used to evaluate the association between potential explanatory variables and the KAB scores of the respondents.

Results

The results showed that 44% of the farmers used antimicrobials in the past few years, where antibiotics (21%) and trypanocides (11%) were most widely used to manage livestock diseases. Furthermore, most farmers showed poor knowledge about AMU, residues, and AMR (94%) and unfavorable attitudes (<50% correct answers) toward contributing factors for AMR (97%). On the contrary, 80% of the respondents had overall good behavior scores (≥50% correct answers) related to AMU. Multivariate analysis results showed that having good knowledge, keeping ≥2 animal species, and the occurrence of ≥4 livestock diseases on the farm in a year were strong predictors of bad behavior scores (p < 0.05). The findings of the current investigation also revealed that the incidence of livestock diseases on the farm and a higher level of formal education significantly contributed to better knowledge and desirable attitudes but bad AMU behavior.

Conclusion

A low level of awareness about and undesirable attitudes toward AMU and AMR could potentially affect farmers' behavior toward judicious AMU, thus requiring awareness creation efforts on livestock disease management practices.

Knowledge, attitudes and practices regarding antimicrobial usage, spread and resistance emergence in commercial poultry farms of Rajshahi district in Bangladesh

Background

Inappropriate and injudicious use of antimicrobials in broiler and layer farms has become a common practice in lower and middle-income countries including Bangladesh. This study aimed to assess poultry farmers’ knowledge, attitude, and practices regarding antimicrobial usage (AMU), and their beliefs in factors that affect antimicrobial resistance (AMR) spread and emergence in humans through commercial poultry farms in Bangladesh.

Methods

A cross-sectional study was conducted among 204 farmers (95.6% male; mean_age = 35.14 ± 10.25 years) in the Rajshahi district of Bangladesh who were recruited from three upazilas (sub-districts) through a multistage sampling technique. Data were collected from June to November 2021 via face-to-face interviews using a semi-structured questionnaire.

Results

The proportion of farmers who reported having received information regarding AMU from veterinarians was higher in layer compared to broiler farms (65.9% vs. 44.9%, p < 0.001). A higher proportion of layer compared to broiler farmers believed that antimicrobial residues and pathogens in poultry can pass to humans through the consumption of contaminated eggs (28.1% vs. 5.8%, p < 0.05). The mean score of the farmers’ attitude towards addressing AMU was 4.49 (SD = 1.37) out of 7, with the higher score indicating a better attitude. The mean score of better attitudes towards addressing AMU was significantly higher among educated participants (bachelor’s or higher levels of education (p = 0.006). A higher proportion of layer (56.3%) farmers did not keep a record of AMU when compared to broiler farmers (37.7%) (p = 0.012). More broiler (50.7%) compared to layer (38.5%) farmers continued using the full dose of antimicrobials (p = 0.042). The most frequently used antimicrobials in broiler and layer poultry farms were Colistin (broiler vs layer: 73.9% vs. 86.75%; p = 0.024), and Ciprofloxacin (broiler vs. layer: 95.7% vs. 84.4%; p = 0.021). Farmers’ beliefs were significantly associated with the spread of AMR pathogens from contaminated eggs to humans (p < 0.001).

Conclusions

The findings reflected that majority of farmers had inadequate knowledge of AMU, less knowledgeable beliefs aboutAMU, and inappropriate AMU (e.g., poor record keeping, incomplete doses) in chicken production systems. The government should ensure education or advisory services for poultry farmers on proper AMU, enforce current veterinary laws and regulations on antimicrobials, and implement AMU surveillance systems.

Knowledge, Attitudes, Practices and Zoonotic Risk Perception of Bovine Q Fever (Coxiella burnetii) among Cattle Farmers and Veterinary Personnel in Northern Regions of Cameroon

A cross-sectional survey was conducted to investigate the knowledge, attitudes, practices and zoonotic risk perception of Q fever among 484 selected cattle farmers (438) and veterinary personnel (46) in three northern regions of Cameroon. Data collection was conducted using questionnaires and responses were recoded into binary scale. An ANOVA test was used to assess significant differences in mean knowledge, attitude, practice and zoonotic risk perception (KAPP) scores between regions, while Linear regression was done to explore the relationship between demographic characteristic and KAPP. Overall, surveyed had low mean scores for knowledge (0.02 ± 0.11), desirable attitude (0.30 ± 0.16), appropriate practice (0.43 ± 0.13) and negative perception of zoonotic risks (0.05 ± 0.11). The means knowledge, attitude, practice and risks perception scores of cattle farmers were lower than those of veterinary personnel. The nature of respondent was negatively associated to knowledge and risks perception, while regions were negatively correlated to attitude and practice. These results revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. To improve awareness, control programs are needed to update knowledge on medical personnel and to prevent animal-to-human transmission.

Knowledge, Attitudes, and Practices of Community Pharmacy Professionals on Poultry Antibiotic Dispensing, Use, and Bacterial Antimicrobial Resistance in Zambia: Implications on Antibiotic Stewardship and WHO AWaRe Classification of Antibiotics

Globally, the inappropriate dispensing and use of antibiotics in animals has contributed to the development of bacterial antimicrobial resistance (AMR). In Zambia, there is insufficient information among community pharmacy professionals on antibiotic use (ABU) and AMR in food-producing animals. This study assessed community pharmacy professionals’ knowledge, attitudes, and practices regarding poultry antibiotic dispensing, use, and bacterial AMR in the Lusaka district of Zambia. A cross-sectional study was conducted among 178 community pharmacy professionals between February and April 2022 using a semi-structured questionnaire. Data were analyzed using Stata version 17. Of the total participants (n = 178), 51.1% (n = 91) were pharmacists. The most dispensed antibiotic was oxytetracycline, a Watch antibiotic, mainly without prescriptions. Good knowledge of ABU and AMR was associated with work experience for more than one year (p = 0.016), while good practices were associated with male gender (p = 0.039) and work experience of more than one year (p = 0.011). The study found moderate knowledge, positive attitudes, and moderate practices of pharmacy professionals on poultry ABU and AMR. There was high dispensing of poultry antibiotics without prescriptions, which calls for strict implementation of antimicrobial stewardship and surveillance programs in poultry production in Zambia to reduce AMR.

A Public Health Insight into Salmonella in Poultry in Africa: A Review of the Past Decade: 2010-2020

Poultry is a cheap source of animal protein and constituent of diets in Africa. Poultry can serve as a reservoir for Salmonella and cause food-borne infections in humans. This review describes Salmonella contamination of food, poultry, and the farming environment, antimicrobial resistance profiles, and serotypes of Salmonella, as well as the farming systems, antimicrobial use (AMU), hygiene, and husbandry conditions used to rear poultry in Africa. Using the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines, PubMed, Science Direct, and Web of Science databases were searched using a set of predefined keywords. Full-length research articles in English were examined for the period 2010-2020 and relevant information extracted for the narrative synthesis. Of the articles that met the inclusion criteria, 63.1% were conducted on farms and among households, while 36.9% were undertaken at government-controlled laboratories, which quarantine imported birds, processing plants, and retail outlets. The farming systems were intensive, semi-intensive, and extensive. AMU was described in 11.5% of the studies and varied within and across countries. Multidrug-resistant (MDR) Salmonella isolates were detected in 30 studies and the prevalence ranged from 12.1% in Zimbabwe to 100% in Egypt, Ethiopia, Nigeria, Senegal, and South Africa. A total of 226 different Salmonella serotypes were reported. Twenty-four (19.7%) of the studies reported food-borne Salmonella contamination in eggs, poultry, and poultry products at retail outlets and processing plants. The apparent extensive use of antimicrobials and circulation of MDR Salmonella isolates of various serotypes in Africa is a concern. It is important to implement stricter biosecurity measures on farms, regulate the use of antimicrobials and implement surveillance systems, in addition to food safety measures to monitor the quality of poultry and poultry products for human consumption.

A Qualitative Study of Antibiotic Use Practices in Intensive Small-Scale Farming in Urban and Peri-Urban Blantyre, Malawi: Implications for Antimicrobial Resistance

The routine use of antimicrobials in meat production has been identified as a driver of antimicrobial resistance (AMR) in both animals and humans. Significant knowledge gaps exist on antibiotic use practices in farming, particularly in sub-Saharan Africa. This paper sought to generate in-depth understanding of household antibiotic use practices in food animals in urban- and peri-urban Blantyre. We used a qualitative research methodology focusing on households that kept scavenging animals and those engaged in small-scale intensive farming of food animals. Methods used were: medicine-use surveys with 130 conducted with a range of households; in-depth interviews (32) with a range of participants including farmers, community based veterinary health workers and veterinary shop workers; and stakeholder interviews (17) with policy makers, regulators, and academics. Six months of ethnographic fieldwork was also undertaken, with households engaged in farming, veterinary officers and veterinary stores. Our findings suggest antibiotic use in animals was more common in households that used small-scale intensive farming techniques, but rare in households that did not. For farmers engaged in small-scale intensive farming, antibiotics were often considered vital to remain solvent in a precarious economic and social environment, with limited access to veterinary services. A complex regulatory framework governed the import, prescription, and administration of antibiotics. Veterinary stores provided easy access to antibiotics, including colistin, an antibiotic on the WHO's critically important antibiotics for human health. Our work suggests that the high dependence on antibiotics for small-scale intensive farming may contribute to the growth of drug resistant infections in Malawi. The socio-economic drivers of antibiotic use mean that interventions need to take a holistic approach to address the high dependence on antibiotics. Key interventions could include improving farmers' access to affordable veterinary services, providing information about appropriate antibiotic use including withdrawal periods and feed supplementation, as well as improvements in regulation (nationally and internationally) and enforcement of current regulations. Taken together these approaches could lead to antibiotic use being optimised in feed animals.

Cross-Sectional Survey of Prophylactic and Metaphylactic Antimicrobial Use in Layer Poultry Farming in Cameroon: A Quantitative Pilot Study

An evaluation of the patterns of antimicrobial use in livestock can help understand the increasing level of antimicrobial resistance worldwide. This study aimed at evaluating antimicrobial usage in modern layer poultry farms in the West Region of Cameroon. In this light, 70 layer poultry farms and 4 veterinary pharmacies were surveyed. Data on antimicrobial use were collected through interviews using a quantitative-frequency questionnaire and consultation of medical records. The four veterinary pharmacies sold a total of 2.8 tons of antimicrobials (active ingredients) during 2011. At the level of farms, 297 kg of antimicrobials (active ingredients) were used in the 50 layer poultry farms surveyed. Tetracycline, sulfonamides, quinolones, and β-lactams (aminopenicillins) were the most sold and used drugs in layer farms. As for treatment indication, metaphylactic (58.1%) and prophylactic (41.9%) treatments were the most observed practices, and nearly all (99%) treatments were administered per os as remedies to respiratory (33.4%) and digestive (24.7%) tract symptoms. Overall, 78.2% of antimicrobials sold in pharmacies and 67.3% used in the farms belonged to the class of critically important antimicrobials of the WHO categorization of antimicrobials according to their importance to human medicine. Doxycycline, sulfonamide, ampicillin, and streptomycin, which have been banned for layer poultry in the production of eggs for human consumption, were still used in Cameroon. The treatment incidences based on the used daily dose (TI_UDD) and animal daily dose (TI_ADD) were 11.59 and 10.45, respectively. In regard to dosage correctness based on the UDD/ADD ratio, aminoglycosides (100%), macrolides (90.6%), and tetracyclines (74.5%) were the most underdosed, while trimethoprim sulfonamides (45.8%) and β-lactams (35.7%) were overdosed. This study highlights an irrational antimicrobial usage in layer poultry farms. Regulation of the use of antimicrobials and the education of farmers on adequate antimicrobial use are essential to preserve the effectiveness of drugs in both humans and animals.

Knowledge, Attitudes, and Risk Perception of Broiler Grow-Out Farmers on Antimicrobial Use and Resistance in Oyo State, Nigeria

Assessing knowledge, attitudes, and risk perception of Nigerian broiler grow-out farmers (n = 152) to antimicrobial resistance (AMR) with a five sectional purposive-structured-questionnaire: demographics; knowledge; attitudes; risk-perception; and response to regulation of antimicrobial practices. Data were analyzed using descriptive statistics, chi-square test, and binary logistic regression. Respondents’ knowledge score, in total, was lower than average, with all (100%) respondents having the understanding that antibiotics kill/reduce bacteria, most participants (>73%) believing that feeding antibiotics to broiler chickens is a necessity for weight gain, and many (>69%) thinking that no negative side-effects exist with the use of antibiotics. Poor attitude towards antimicrobial usage was prevalent (>63%) with unsatisfactory performance in most instruments: >60% of farmers reported using antimicrobials every week and still use antimicrobials when birds appear sick, and most (>84%) arbitrarily increase the drug dosages when used. However, a satisfactory performance score was reported (68%) in risk perception of AMR with >63% perceiving that inappropriate use of antibiotics is the main factor causing the emergence of resistant bacteria; >65.8% expressed that AMR in broiler chickens is not essential for public health, that AMR cannot develop from broiler bacteria diseases, that increasing the frequency of antimicrobial use cannot increase AMR in future, and that usage cannot lead to antibiotic residue in broiler-meat products leading to AMR development in human. None of the respondents were aware of any regulation for monitoring antimicrobial use. Significant factors associated with knowledge, attitudes, and risk perception of antimicrobial use and resistance among broiler grow-out farmers include marital status, farm category, education, educational specialization, sales target, growth duration/cycle, broiler stocking batch, and feed source. Identified gaps exist in AMR awareness among Nigerian broiler farmers and should be targeted through stakeholders’ participation in combatting AMR threats.

An assessment of knowledge and attitude toward antibiotic misuse by small-scale broiler farmers in Bogor, West Java, Indonesia

Background and Aim:

Antibiotics are often overused and misused by broiler farmers. Moreover, this practice may lead to antibiotic resistance. Antibiotics may be used for various purposes such as therapy, prophylaxis, flushing, and growth promoters. The study aimed to examine the association of knowledge and attitudes with antibiotics used by broiler farmers.

Materials and Methods:

The study design was cross-sectional. The data were obtained from interviewing 132 farmers’ households in Bogor District, West Java, Indonesia. The outcome variable was antibiotic use, whereas the independent variables included knowledge and attitude toward antibiotic resistance. The statistical analysis used a t-test and correlation test.

Results:

A total of 78% of broilers farmers use antibiotics, and most of the farmers used antibiotics for flushing and prophylaxis. Furthermore, antibiotic use was associated with broiler farmers’ knowledge and attitudes toward antibiotic resistance. However, there is no significant correlation between the duration of antibiotics use and their knowledge and attitude.

Conclusion:

The use of antibiotics in broilers is still high in Bogor, and most of the used antibiotics belong to the Medically Important Antimicrobial category. In general, the use of antibiotics in broilers is influenced by knowledge.

A Survey on Knowledge, Attitude, and Practices of Large-Animal Farmers towards Antimicrobial Use, Resistance, and Residues in Mymensingh Division of Bangladesh

The widespread and indiscriminate use of antimicrobials in food animals is a key contributor to antimicrobial resistance and antimicrobial residue, which have become a growing public and animal health concern in developing countries such as Bangladesh. This study was aimed to assess the knowledge, attitude, and practices (KAP) of large-animal farmers towards antimicrobial use (AMU), antimicrobial resistance (AMR), and antimicrobial residue (AR) with their correlation. A cross-sectional survey was conducted with a structured and pretested questionnaire in the Mymensingh division of Bangladesh. A total of 212 large-animal farmers (dairy, beef fattening, buffalo, sheep, and goat farmers) were surveyed. Results showed that most of the farmers are male (85.8%) and belong to the 18–30 age group (37.3%). About 20.3% had no formal education, and nearly half of the participants (48.1%) received training regarding antibiotic use and resistance. Penicillin is the most common class of antibiotic used (61.8%) in the study area, followed by other antimicrobials. Only 37.7% of the farmers used antimicrobials on the recommendation of their veterinarian. Overall, 41.5%, 42.5%, and 21.7% of farmers possess adequate knowledge and a satisfactory attitude and perform desirable practices, respectively. Farmers in the 31–40 age group have adequate knowledge, attitude, and ability to implement desired practices compared to farmers in the 18–30 age group. Farmers having a graduate or post-graduate degree scored better in relation to knowledge, attitude, and practice than other farmers. Analysis revealed that farmers who received training on AMU and AMR had 10.014 times (OR = 10.014, 95% CIs: 5.252–19.094), 9.409 times (OR = 9.409, 95% CIs: 4.972–17.806), and 25.994 times (OR = 25.994, 95% CIs: 7.73–87.414) better knowledge, attitude, and performance, respectively, compared to their counterparts. A significant proportion of farmers (97.2%) dispose of leftover antibiotics inappropriately. The findings of the present study will be used to intervene in the education and training of the farmers, which will help to limit the indiscriminate and irrational use of antimicrobials, leading to reducing the chances of developing AMR.

Awareness of Antimicrobial Resistance and Associated Factors among Layer Poultry Farmers in Zambia: Implications for Surveillance and Antimicrobial Stewardship Programs

Antimicrobial resistance (AMR) is a global public health problem affecting animal and human medicine. Poultry production is among the primary sources of income for many Zambians. However, the increased demand for poultry products has led to a subsequent increase in antimicrobial use. This study assessed the awareness of AMR and associated factors among layer poultry farmers in Zambia. A cross-sectional study was conducted among 77 participants from September 2020 to April 2021. Data was analysed using Stata version 16.1. The overall awareness of AMR among the farmers was 47% (n = 36). The usage of antibiotics in layer poultry production was high at 86% (n = 66). Most antibiotics were accessed from agrovets (31%, n = 24) and pharmacies (21%, n = 16) without prescriptions. Commercial farmers were more likely to be aware of AMR compared to medium-scale farmers (OR = 14.07, 95% CI: 2.09–94.70), as were farmers who used prescriptions to access antibiotics compared to those who did not (OR = 99.66, 95% CI: 7.14–1391.65), and farmers who did not treat market-ready birds with antibiotics compared to those who did (OR = 41.92, 95% CI: 1.26–1396.36). The awareness of AMR among some layer farmers was low. Therefore, policies that promote the rational use of antibiotics need to be implemented together with heightened surveillance activities aimed at curbing AMR.

Access to Veterinary Drugs in Sub-Saharan Africa: Roadblocks and Current Solutions

Background

Access to veterinary drugs for livestock has become a major issue over the last decade. Analysis has tended to focus on the demand for these products, while studies looking at the drivers behind their use generally focus on farmer behavior and interactions between veterinarians and farmers. However, the use of drugs also depends on structural factors that determine the functioning of the drug supply chain and farmers' access to the drugs. This article presents an overview of the factors that limit access to veterinary drugs in sub-Saharan Africa (SSA) as well as the international policy tools and arrangements that claim to improve it.

Methods

We have conducted a scoping review of the scientific and grey literature as well as the publicly-available data from both the animal health industry and international organizations. We aimed to gather information on the veterinary drugs market in SSA as well as on the international norms, recommendations, guidelines, and initiatives that impact SSA farmers' access to these drugs.

Findings

We highlight numerous barriers to veterinary drug access in SSA. The SSA market is highly dependent on imports, yet the region attracts little attention from the international companies capable of exporting to it. It suffers from a high level of fragmentation and weak distribution infrastructures and services, and is driven by the multiplication of private non-professional actors playing a growing role in the veterinary drug supply chain. The distribution system is increasingly dualized, with on the one hand the public sector (supported by development organizations) supplying small scale farmers in rural areas, but with limited and irregular means; and on the other side a private sector largely unregulated which supplies commercial and industrial farming systems. Different innovations have been developed at the international and regional levels to try to reduce barriers, such as homogenizing national legislations, donations, and vaccine banks. Alongside decades-old inter-state cooperation, many new forms of public-private partnerships and other hybrid forums continue to emerge, signaling the private sector's increasing influence in global governance.

Conclusions

Policies on animal health would be bolstered by a better understanding of the drivers behind and the components of access to veterinary drugs in different regional and national contexts. Inequalities in drug access need to be addressed and a market-driven approach adopted in order to strengthen our understanding of what determines veterinary drug use at the farm level. Policies should balance the interests of the various stakeholders, being careful not to reinforce bias toward certain diseases deemed "interesting" and neglect others that could prove to be highly important for veterinary public health.

Knowledge and Practices on Antibiotic Use and Antibiotic Resistance Among Smallholder Pig Farmers in Timor-Leste

Antibiotic resistance is an emerging global health threat which is linked to the overuse and misuse of antibiotics. This study was conducted to understand the knowledge and practices of smallholder pig farmers on antibiotic use and resistance in Timor-Leste. A cross-sectional study using a structured face-to-face interview was conducted in three municipalities. The interview was piloted and implemented in the local Tetun language. This study found that knowledge of antibiotics was very poor as only 12.7% (95% CI: 6.3–23.9) of farmers reported knowing what antibiotics were, and of these only one was able to correctly explain how an antibiotic worked. None of the farmers knew about antibiotic resistance and were able to explain the concept correctly. After the definition of antibiotic was explained to the farmer, only 3.6% (95% CI: 0.8–14.9) reported that their pigs had ever received antibiotics, and the majority of farmers whose pigs had not received antibiotics reported the lack of access to veterinary services. When used, antibiotics were only used for treatment with no reported use for disease prevention or growth promotion. None of the commonly used antibiotics were critically important antimicrobials. Compliance with withdrawal periods was not routinely followed. There is a need to improve access to government veterinary services for farmers in Timor-Leste, while addressing identified knowledge gaps on antibiotics and promoting prudent use practices. The findings from this study serve as baseline information to inform future interventions.

Antimicrobial use in agriculture: critical review of the factors influencing behaviour

Antimicrobial resistance (AMR) is a global health emergency affecting humans and animals, diminishing the effectiveness of medication used to treat illness. The agri-food sector has attracted increased attention for imprudent antimicrobial use (AMU) and its contribution to AMR. Thus, ascertaining farmers' and veterinarians' behaviours surrounding AMU is essential to address imprudent AMU and generate behaviour change within the agri-food sector. Therefore, the aim of this critical review is to investigate, assess and collate the current body of evidence to identify psychosocial factors including knowledge, understanding, perceptions, attitudes and behaviours surrounding AMU. Database searches were limited to articles utilizing qualitative and quantitative methodologies, available in English with no restriction on publication year. Of the 1156 articles identified, 103 were retained for this review. Findings on the psychosocial aspects were thematically analysed. Five key themes emerged from the data: (i) knowledge and awareness of antimicrobials; (ii) attitudes towards antimicrobials; (iii) influential relationships; (iv) resources; and (v) factors influencing AMU. Results indicated that to overcome barriers experienced by key stakeholders, a carefully considered, evidence-based approach, incorporating behaviour change theory, is required when designing intricate interventions/strategies, in order to elicit successful and sustained AMU behaviour change.

"Chicken dumping": Motivations and perceptions in shifting poultry production practices

Non-governmental organizations (NGOs) often implement overseas development aid through intensive small-scale animal agriculture to alleviate food insecurity in low- and middle-income countries. Intensive animal farming can pose unclear outcomes to households engaged in the practice because of the reliance on industrial animal breeds that are reared with antibiotics and raised in higher densities compared to traditional scavenging husbandry systems. As a result, intensive small-scale farming operations that lack proper infrastructure, training, and financial resources could facilitate the spread of antimicrobial resistance and infectious diseases. We applied a mixed-methods framework towards analyzing the effectiveness of small-scale broiler chicken farming in northern Ecuador. First, from May 2016 – May 2017, our observational surveys indicated that intensive small-scale poultry farming follows a boom-and-bust cycle that is extremely vulnerable to environmental stressors. Second, in May 2016, we followed a cohort of households enrolled in a poultry development project led by an NGO. We observed a substantial decline in chicken survivorship from Survey period 1 to 2 (mean chicken count decrease from 50 to 35 corresponding to a 70% survivorship) and from Survey period 2 to 3 (mean chicken count decrease from 35 to 20.3 corresponding to a 58% survivorship). Heads of households were self-reporting broiler chicken survivorship substantially higher than our recorded observations during survey period two (46 compared to 35 respectively) and three (44.3 compared to 20.3 respectively). We speculate that if households continue to inaccurately report poultry demographics, then it could perpetuate a negative feedback loop where NGOs continue to conduct the same intervention practices without receiving accurate outcome metrics. Third, we used semi-structured questionnaires to determine that access to financial resources was the major motivation for determining when to farm broiler chickens. Intensive small-scale poultry farming can be unreliable and disease-enhancing, yet also associated with dubious self-reports of success.

Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Commercial Poultry Farmers in Bangladesh

Antimicrobial resistance (AMR) has become an emerging health issue globally, posing a threat to zoonotic pathogens and foodborne diseases. In Bangladesh, the poultry sector supplies the majority of the demand for animal-source protein. The irrational and excessive use of antimicrobials (AMU) has been observed in the poultry sector. The development of AMR is associated with many factors, including the knowledge and attitudes of poultry farmers. Therefore, AMR reduction requires intervention from all the stockholders, including the farmers who are considered as end users of antimicrobials. This current research conducted a cross-sectional study to assess the knowledge, attitudes, and practices (KAP) of poultry farmers on AMU and AMR in Bangladesh. We determined the KAP of poultry farmers (broiler and layer farmers) of some selected districts of the country using a tested and paper-based questionnaire. The results demonstrated that most of the respondents have insufficient KAP regarding AMU and AMR. The respondents used a variety of antimicrobials primarily in the treatment of various diseases in poultry. One-third of the farmers did not seek antimicrobials from registered vets. Instead, they depended on others or themselves. The factor score analysis further revealed that the farmers’ demographic and socioeconomic variables were significant factors influencing the KAP. An adjusted logistic regression analysis showed that older farmers with 9–12 years of farming experience and graduate-level education, engaging in medium-sized layer farming, were more likely to have correct KAP on AMU and AMR. Further, farmers from the Cox’s Bazar region showed correct knowledge, whereas farmers of the Chattogram region showed a correct attitude towards AMU and AMR. A Spearman’s rank-order correlation revealed a positive association between knowledge–attitudes and knowledge–practices. The findings of the current investigation provide baseline evidence about the KAP of poultry farmers from low-income resources and offer insights into designing interventions and policies for the use of AMU and AMR in Bangladesh.

Poultry Litter Contamination by Escherichia coli Resistant to Critically Important Antimicrobials for Human and Animal Use and Risk for Public Health in Cameroon

Residues of antimicrobials used in farm can exert selective pressure and accelerate the occurrence of multidrug resistant bacteria in litter. This study aimed to investigate the resistance profile of Escherichia coli isolated from poultry litter. A total of 101 E. coli strains was isolated from 229 litter samples collected and stored for two months in the laboratory at room temperature. Antimicrobial susceptibility testing was performed using the disk diffusion method. An overall resistance prevalence of 58.4% (95% CI: 48.8-68.0) was obtained with 59 E. coli strains resistant to various antimicrobial agents. High levels of resistance were observed with ciprofloxacin (21/59: 36%), imipenem (27/59: 45%), norfloxacin (44/59: 74%), ceftriaxone (44/59: 74%), and levofloxacin (44/59: 75%). These antimicrobials classified under the Watch group by WHO are indicators of the high AMR risk to public health in Cameroon. Multivariable logistic regression analysis revealed that a greater probability of high level of E. coli multidrug resistance was associated with lack of training in poultry farming (OR = 0.13, p = 0.01), less experience in poultry farming (OR = 11.66 p = 0.04), and the high frequency of digestive tract disease (OR = 0.10; p = 0.001). This study revealed that poultry litter constitutes a potential source of dissemination of resistant germs from farm animals to the environment and humans.

Antibiotics Use in Food Animal Production: Escalation of Antimicrobial Resistance: Where Are We Now in Combating AMR?

The use of antibiotics has been very beneficial to human health, animal wellbeing, and food production, however, there are no alternatives to antimicrobials in treating infectious diseases. Their use can contribute to the development of antimicrobial resistance, but the world has realized the need to combat antimicrobial resistance in recent decades due to the continued escalation of the problem jeopardizing human and veterinary medicine and food and environmental safety. Understanding the AMR and judicious use of antimicrobials are critical, and one health approach involving several sectors and multiple disciplines is important to tackle the problem. National, regional, and global action plans have been instigated to tackle the escalation of AMR. Antimicrobials are frequently used in food animal production. Therefore, food animal producers are important participants to prevent overuse and misuse of antimicrobials. Recent regulations to address the challenges have not been perceived well in animal farming communities. More awareness regarding these action plans and understanding the impact of AMR are needed. A nationwide survey of perceptions of food animal producers regarding AMR mitigation approaches should be conducted to evaluate the effectiveness of the current policies regarding antibiotics use and AMR. These outcomes should be incorporated in future policies and awareness campaigns targeting food animal producers.

Knowing Is Not Enough: A Mixed-Methods Study of Antimicrobial Resistance Knowledge, Attitudes, and Practises Among Maasai Pastoralists

Global, national, and local efforts to limit antimicrobial resistance (AMR) often stress the importance of raising awareness among users, sellers, and prescribers of antimicrobial drugs. This emphasis is founded upon two assumptions. First, awareness is limited, particularly concerning the links between antimicrobial use (AMU) and AMR. Second, "filling the awareness gaps" will motivate practises that will limit AMR. The first assumption is supported by knowledge, attitudes, and practises (KAP) surveys but these same studies provide mixed support for the second, with several studies finding that knowledge and attitudes are not correlated with related practises. This disconnect may arise as these surveys typically do not collect data on the cultural or historical contexts that pattern AMU. To explore how these contexts impact KAP related to AMU and AMR, we use a mixed-methods approach to examine veterinary practises among Maasai pastoralists in Tanzania. We combine a quantitative KAP survey (N = 195 households) with extensive qualitative data from focus group discussions (N = 55 participants). Results document limited awareness of AMR but also find that knowledge and attitudes are not correlated with practise. Thematic analysis of qualitative data pointed to three reasons behind this disconnect, including (1) Maasai self-perceptions as veterinary experts, (2) the central role of livestock in Maasai culture, and (3) the use of ethnoveterinary knowledge in animal health treatment. We argue that mixed-method approaches will be critical to developing the targeted awareness campaigns needed to limit the emergence and transmission of AMR.

Antimicrobial use and practices by animal health professionals in 20 sub-Saharan African countries

The use of antimicrobial (AM) in animal production is an important contributor to antimicrobial resistance (AMR) worldwide. Animal health professionals should play a key role in ensuring judicious use of AM. However, they are subjected to influence from clinical and non-clinical factors. The present study evaluates the perceptions and concerns of animal health practitioners regarding antimicrobial use (AMU) and prescription practices. A cross-sectional online questionnaire survey was conducted among animal health practitioners, predominantly veterinary doctors (88 %) in 20 African countries. Results showed that the most prescribed and administered AM were tetracycline (66 %) followed by β-lactams (32 %) and macrolides (25 %). Most respondents were very confident in deciding on the right dose of AM (77 %) and treatment plans (76 %) as compared to choosing the correct AM (52 %) and making an accurate diagnosis (46 %). Self-reported confidence in the implementation of antimicrobial stewardship was significantly influenced by the respondents' work environment, gender and access to information on AM. Lack of diagnostic facilities and susceptibility tests were major hindrances to adequate prescriptions and use of AM. Perceived drivers of AMR identified were excessive prescription by animal health professionals and the use of AM without proper diagnosis. Almost two thirds (62 %) of the respondents had sufficient information on AM when needed while the main source of information was professional training and drug labels. Thus, reinforcement of regional and country-level guidelines and tailored continuing education programs for veterinarians as well as the development of field-friendly disease diagnosis and management tools are essential to considerably improve AMU.