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Zhou Y, Zhang A, van Klinken RD, Wang J. The effect of information provision on consumers' risk perceptions of, support for a ban, and behavioral intention towards the preventive use of antibiotics in food animals. BMC Public Health 2024; 24:1428. [PMID: 38807103 PMCID: PMC11134945 DOI: 10.1186/s12889-024-18859-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Antibiotics have been widely used in feed and drinking water for food animals to prevent them from getting sick. Such preventive use of antibiotics has become a contributor to increasing antibiotic resistance and thus poses threats to human health. However, consumers have little knowledge about this practice and the associated health risks of increasing transmission of antibiotic residues and antibiotic resistant bacteria. This study aimed to examine the effect of information provision on consumers' risk perceptions, support for a ban, and behavioral intention regarding the preventive use of antibiotics in food animals. Especially, the study sought to test two competing hypotheses which were informed by two theoretical perspectives of fear appeal theory - the linear model and the plateau effect model. The former suggested that providing information on the health risks of both antibiotic residues and antibiotic resistant bacteria would have a stronger effect compared to providing information on only one of them, while the latter posited that providing information on both risks might not have additional influence, as the effect of information on either risk could reach the plateau. METHODS An experimental study with four conditions was conducted where participants read different information on the health risks associated with the preventive use first and then answered questions regarding consumers' risk perceptions, support for a ban, and behavioral intention regarding the preventive use. Condition 1 was the control condition, where basic information about antibiotics, antibiotic resistance, and the preventive use was provided. Condition 2 and Condition 3 further added information on the health risk of antibiotic residues (Condition 2) and antibiotic resistant bacteria (Condition 3) due to the preventive use, respectively. Condition 4 provided all information contained in the first three conditions. RESULTS The results showed that compared to participants in the control condition, participants in Conditions 2-4 reported higher risk perceptions, stronger support for a ban on the preventive use, and a higher intention to buy meat produced without the preventive use of antibiotics. However, there were no significant differences in these factors between Conditions 2-4, indicating that providing information on the health risk of either antibiotic residues, or antibiotic resistant bacteria, or both, has similar effect on these variables. That is, the hypothesis based on the plateau effect model was supported. CONCLUSIONS The findings suggested that informing the public with the health risk of either antibiotic residues or antibiotic resistant bacteria associated with the preventive use is effective enough to reach plateau effect in increasing risk perceptions, support for a ban, and behavioral intention, which has important implications for policymakers and livestock industries to develop effective communication strategies to promote responsible antibiotic use in food animals.
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Affiliation(s)
- Yingnan Zhou
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD, 4102, Australia
- School of Sociology and Ethnology, University of Chinese Academy of Social Sciences, Beijing, 102488, China
| | - Airong Zhang
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD, 4102, Australia
| | - Rieks Dekker van Klinken
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD, 4102, Australia
| | - Junxiu Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325007, China.
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Musoke D, Lubega GB, Gbadesire MS, Boateng S, Twesigye B, Gheer J, Nakachwa B, Brown MO, Brandish C, Winter J, Ng BY, Russell-Hobbs K, Gibson L. Antimicrobial stewardship in private pharmacies in Wakiso district, Uganda: a qualitative study. J Pharm Policy Pract 2023; 16:147. [PMID: 37978569 PMCID: PMC10655315 DOI: 10.1186/s40545-023-00659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Private pharmacies are the first point of contact for the public regarding acquisition of medicines and other pharmaceuticals in many low- and middle-income countries including Uganda. Most antimicrobial stewardship (AMS) programmes in Uganda have targeted pharmacies in public health facilities, with little known about private pharmacies. This study explored knowledge and practices related to AMS in private pharmacies in Wakiso district, central Uganda. METHODS This was a qualitative study that involved 31 in-depth interviews to explore AMS among retail private pharmacy staff including pharmacists, pharmacy technicians/dispensers, and nurses. Participants were asked about antimicrobial resistance (AMR) and AMS practices at their pharmacy. The audio-recorded interviews were transcribed verbatim and imported to NVivo 2020 (QSR International) for thematic analysis. RESULTS Five major themes emerged from the study: commonly sold antimicrobials; knowledge on AMR and AMS; potential contributors to AMR; practices related to AMS; and challenges to AMS. The commonly sold antimicrobials in the pharmacies with or without prescriptions were oral azithromycin, Ampiclox® (ampicillin and cloxacillin), amoxicillin, ciprofloxacin, Septrin® (co-trimoxazole), metronidazole, Flucamox® (amoxicillin and flucloxacillin), Augmentin® (amoxicillin and clavulanic acid), cephalexin, doxycycline, and chloramphenicol. Participants had heard about AMR but not AMS, although only a few correctly defined AMR. Lack of knowledge among health workers and local communities; the overuse, misuse, and abuse of antimicrobials such as non-adherence to dosage; self-medication; and purchase of drugs without prescription were identified as potential accelerators to the emergence of AMR. Current practices related to AMS in private pharmacies were limited to meetings, antimicrobial dispensing, providing client advice, record keeping, and monitoring of drugs. Cost of healthcare, client satisfaction and retention, outdated guidelines, and the business orientation of pharmacies were the main challenges related to AMS. CONCLUSION There was poor knowledge of AMR and AMS, and limited AMS practices in private pharmacies. Private pharmacies have the potential to contribute to Uganda's fight against AMR if motivated and equipped with adequate knowledge to enhance their practices related to AMS.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.
| | - Grace Biyinzika Lubega
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Mimi Salome Gbadesire
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Stephanie Boateng
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Belinda Twesigye
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Jagdeep Gheer
- Medicines Optimisation Team, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board Trust Offices, Amersham Hospital, Amersham, HP7 0JD, UK
| | - Betty Nakachwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Michael Obeng Brown
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Claire Brandish
- Pharmacy Department, Buckinghamshire Healthcare NHS Trust, Aylesbury, HP21 8AL, UK
| | - Jody Winter
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Bee Yean Ng
- Department of Pharmacy, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Kate Russell-Hobbs
- Pharmacy Department, Buckinghamshire Healthcare NHS Trust, Aylesbury, HP21 8AL, UK
| | - Linda Gibson
- Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK
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Hibbard R, Chapot L, Yusuf H, Ariyanto KB, Maulana KY, Febriyani W, Cameron A, Vergne T, Faverjon C, Paul MC. "It's a habit. They've been doing it for decades and they feel good and safe.": A qualitative study of barriers and opportunities to changing antimicrobial use in the Indonesian poultry sector. PLoS One 2023; 18:e0291556. [PMID: 37747889 PMCID: PMC10519599 DOI: 10.1371/journal.pone.0291556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/01/2023] [Indexed: 09/27/2023] Open
Abstract
Interventions to change antimicrobial use (AMU) practices can help mitigate the risk of antimicrobial resistance (AMR) development. However, changing AMU practices can be challenging due to the complex nature of the factors influencing AMU-related behaviours. This study used a qualitative approach to explore the factors that influenced decision-making on AMU by farmers and other actors in the Indonesian poultry sector. Thirty-five semi-structured interviews were conducted with farmers, technical services staff from the private sector, and representatives of associations, universities, and international organisations in Central Java, West Java, and East Java. Thematic analysis identified three patterns of influence on AMU: how farmers used information to make AMU-related decisions, the importance of farmers' social and advisory networks, and the motivations driving changes in AMU behaviours. Key barriers identified included a lack of shared understanding around when to use antibiotics, financial pressures in the poultry sector, and a lack of engagement with government veterinary services. Potential opportunities identified included high farmer awareness of AMU, identification of private sector actors and peer networks as the stakeholders with established relationships of trust with farmers, and the importance of farmers' conceptions of good farming practices, which could be engaged with to improve AMU practices.
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Affiliation(s)
- Rebecca Hibbard
- Ausvet Europe, Lyon, France
- INRAE, IHAP, ENVT, Université de Toulouse, Toulouse, France
| | - Lorraine Chapot
- Ausvet Europe, Lyon, France
- INRAE, IHAP, ENVT, Université de Toulouse, Toulouse, France
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Al Sattar A, Chisty NN, Irin N, Uddin MH, Hasib FMY, Hoque MA. Knowledge and practice of antimicrobial usage and resistance among poultry farmers: A systematic review, meta-analysis, and meta-regression. Vet Res Commun 2023; 47:1047-1066. [PMID: 36823483 DOI: 10.1007/s11259-023-10082-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
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.
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Affiliation(s)
- Abdullah Al Sattar
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram, 4225, Bangladesh
| | - Nurun Nahar Chisty
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram, 4225, Bangladesh
| | - Nusrat Irin
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram, 4225, Bangladesh
| | - Md Helal Uddin
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram, 4225, Bangladesh
| | - F M Yasir Hasib
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Md Ahasanul Hoque
- Department of Medicine and Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Zakir Hossain Road, Khulshi, Chattogram, 4225, Bangladesh.
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Sanni AO, Onyango J, Rota AF, Mikecz O, Usman A, PicaCiamarra U, Fasina FO. Underestimated economic and social burdens of non-Typhoidal Salmonella infections: The One Health perspective from Nigeria. One Health 2023; 16:100546. [PMID: 37363243 PMCID: PMC10288087 DOI: 10.1016/j.onehlt.2023.100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 06/28/2023] Open
Abstract
Background The non-typhoidal salmonellosis (NTS) is a pathogenic bacterial zoonosis with substantial but often under-appreciated public health impacts. The NTS is prevalent in poultry and humans in Nigeria, yet its economic and social burden have not been determined through any empirical study. To bridge the gap, we evaluated the impact of NTS in social and economic terms. Methods Relevant population, economic and epidemiological data were retrieved from peer-reviewed publications, open sources and relevant authorities. Additional data were obtained through experts' opinions and field surveys. Using a customized and validated Microsoft Excel® tool, economic analysis was conducted. Results Using the year 2020 reference point, the burden of NTS was 325,731 cases and a total of 1043 human deaths, at a disability-adjusted life year (DALYs) of 37,321. The cost associated with infection in humans was US$ 473,982,068. A total loss of US$ 456,905,311 was estimated in poultry including the direct value of animal loss, US$ 224,236,769, loss from salvage slaughter and culling, US$ 220,386,556, and value of foregone production, US$ 12,281,987. Interpretation The outcomes of this important work provide empirical evidence to support informed decisions and investments in the control and eradication of human and poultry salmonellosis (NTS) in Nigeria.
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Affiliation(s)
- Abdullahi O. Sanni
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort 0110, South Africa
- Agro-Processing, Productivity Enhancement and Livelihood Improvement Support (APPEALS) Project, Lokoja, 260101, Kogi State, Nigeria
| | - Joshua Onyango
- Harper and Keele Veterinary School, Harper Adams University, Shropshire TF10 8NB, UK
| | - Ana Felis Rota
- Food and Agriculture Organization of the United Nations, Rome I-00100, Italy
| | - Orsolya Mikecz
- Food and Agriculture Organization of the United Nations, Rome I-00100, Italy
| | - Abdulkadir Usman
- Department of Animal Production, Federal University of Technology, Minna 920101, Nigeria
| | - Ugo PicaCiamarra
- Food and Agriculture Organization of the United Nations, Rome I-00100, Italy
| | - Folorunso O. Fasina
- Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort 0110, South Africa
- ECTAD Food and Agriculture Organization of the United Nations, Nairobi 00100, Kenya
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Hyder S, Sievers BL, Flamand C, TagoPacheco D, Chan M, Claes F, Karlsson EA. Influx of Backyard Farming with Limited Biosecurity Due to the COVID-19 Pandemic Carries an Increased Risk of Zoonotic Spillover in Cambodia. Microbiol Spectr 2023; 11:e0420722. [PMID: 36515551 PMCID: PMC9927512 DOI: 10.1128/spectrum.04207-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Backyard farming with limited biosecurity creates a massive potential for zoonotic spillover. Cambodia, a developing nation in Southeast Asia, is a hub for emerging and endemic infectious diseases. Due to pandemic-induced job losses in the tourism sector, rumors suggest that many former Cambodian tour guides have turned to backyard farming as a source of income and food security. A cross-sectional study including 331 tour guides and 69 poultry farmers in Cambodia before and during the novel coronavirus disease 2019 (COVID-19) pandemic was conducted. Participants were administered a survey to assess food security, income, and general farming practices. Survey data were collected to evaluate the risk perceptions for avian influenza virus (AIV), antimicrobial resistance (AMR), and general biosecurity management implemented on these poultry farms. Overall, food security decreased for 80.1% of the tour guides during the COVID-19 pandemic. Approximately 21% of the tour guides interviewed used backyard poultry farming to supplement losses of income and food insecurity during the COVID-19 pandemic, with a significantly higher risk than for traditional poultry farmers. Agricultural intensification in Cambodia due to the COVID-19 pandemic has caused an influx of makeshift farms with limited biosecurity. Inadequate biosecurity measures in animal farms can facilitate spillover and contribute to future pandemics. Improved biosecurity and robust viral surveillance systems are critical for reducing the risk of spillover from backyard farms. IMPORTANCE While this study highlights COVID-19-associated changes in poultry production at a small scale in Cambodia, poultry production is expected to expand due to an increase in the global demand for poultry protein during the pandemic, changes in urbanization, and the reduction of the global pork supply caused by African swine fever (ASF). The global demand and surge in poultry products, combined with inadequate biosecurity methods, can lead to an increased risk of domestic animal and human spillovers of zoonotic pathogens such as avian influenza. Countries in regions of endemicity are often plagued by complex emergency situations (i.e., food insecurity and economic fallouts) that hinder efforts to effectively address the emergence (or reemergence) of zoonotic diseases. Thus, novel surveillance strategies for endemic and emerging infectious diseases require robust surveillance systems and biosecurity training programs to prevent future global pandemics.
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Affiliation(s)
- Sudipta Hyder
- Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | - Claude Flamand
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Damian TagoPacheco
- Emergency Center for Transboundary Animal Diseases (ECTAD) of the Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
| | - Malen Chan
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Filip Claes
- Emergency Center for Transboundary Animal Diseases (ECTAD) of the Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
- CANARIES, Consortium of Animal Networks To Assess Risk of Emerging Infectious Diseases through Enhanced Surveillance, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Erik A. Karlsson
- Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- CANARIES, Consortium of Animal Networks To Assess Risk of Emerging Infectious Diseases through Enhanced Surveillance, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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Sawadogo A, Kagambèga A, Moodley A, Ouedraogo AA, Barro N, Dione M. Knowledge, Attitudes, and Practices Related to Antibiotic Use and Antibiotic Resistance among Poultry Farmers in Urban and Peri-Urban Areas of Ouagadougou, Burkina Faso. Antibiotics (Basel) 2023; 12:antibiotics12010133. [PMID: 36671334 PMCID: PMC9854744 DOI: 10.3390/antibiotics12010133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 01/12/2023] Open
Abstract
Increased use of antibiotics in livestock is a public health concern, as it poses risks of antibiotic residues and antibiotic-resistant pathogens entering the food chains and infecting humans. A cross-sectional survey was conducted on 216 poultry farms to study knowledge, attitudes and practices of poultry farmers on the use of antibiotics in urban and peri-urban areas of Ouagadougou. Results show that only 17.13% (37/216) of farmers attended training on poultry production. Majority of farmers-85.65% (185/216) were not knowledgeable about the rational use of antibiotics. When there was a disease outbreak, 31.98% (63/197) of farmers used veterinary drugs without a prescription and 22.34% (44/197) consulted a community animal health worker. It should also be noted that 79.19% (156/197) of farmers reported using chicken meat as per normal if the bird died during or right after treatment with an antibiotic. Knowledge of rational use of antibiotics was positively influenced by a good attitude adopted by the farmer during the illness of birds and negatively influenced by disease treatment success and high level of education of the farmer. Lack of knowledge about the rational use of antibiotics including their use without a prescription are serious risk factors for the emergence of antimicrobial resistance. Awareness of farmers and other veterinary drug supply chain actors such as drug stockists and animal health workers on best practices in antimicrobial use and promotion of good biosecurity on farms are important to reduce the misuse of antibiotics.
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Affiliation(s)
- Abdallah Sawadogo
- Laboratory of Molecular Biology, Epidemiology and Surveillance of Foodborne Bacteria and Viruses, Department of Biochemistry-Microbiology, Doctoral School of Science and Technology, Joseph KI-ZERBO University, Ouagadougou 03 BP 7021, Burkina Faso
- Correspondence: authors: (A.S.); (M.D.)
| | - Assèta Kagambèga
- Laboratory of Molecular Biology, Epidemiology and Surveillance of Foodborne Bacteria and Viruses, Department of Biochemistry-Microbiology, Doctoral School of Science and Technology, Joseph KI-ZERBO University, Ouagadougou 03 BP 7021, Burkina Faso
| | - Arshnee Moodley
- International Livestock Research Institute, Nairobi 00100, Kenya
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1817 Frederiksberg, Denmark
| | - Abdoul Aziz Ouedraogo
- National Institute of Statistics and Demography, Ouagadougou 01 BP 374, Burkina Faso
| | - Nicolas Barro
- Laboratory of Molecular Biology, Epidemiology and Surveillance of Foodborne Bacteria and Viruses, Department of Biochemistry-Microbiology, Doctoral School of Science and Technology, Joseph KI-ZERBO University, Ouagadougou 03 BP 7021, Burkina Faso
| | - Michel Dione
- International Livestock Research Institute, Dakar BP 24265, Senegal
- Correspondence: authors: (A.S.); (M.D.)
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Kariuki JW, Jacobs J, Ngogang MP, Howland O. Antibiotic use by poultry farmers in Kiambu County, Kenya: exploring practices and drivers of potential overuse. Antimicrob Resist Infect Control 2023; 12:3. [PMID: 36604700 PMCID: PMC9817392 DOI: 10.1186/s13756-022-01202-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 12/11/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Antibiotic resistance is a global concern threatening achievements in health care since the discovery of antibiotics. In Kenya, this topic remains understudied in a context of rising demand for livestock products, intensification and the concomitant increase in antibiotic use. Our study investigates drivers and practices of antibiotic use in poultry farming. The study was conducted in Kiambu County, Kenya. METHODS A qualitative research methodology was employed: fourteen key informant interviews, twenty in-depth interviews, and four focus group discussions were undertaken. The interviews were semi-structured. Themes and subthemes from the interviews were generated through inductive analysis. FINDINGS Of the farmers interviewed, sixty eight percent were female, thirty three percent of the sampled farmers could not read, and the majority (eight five percent) of farmers had reared poultry for at least ten years. Research findings showed that farmers extensively used antibiotics. Antibiotic use was influenced by factors such as high disease burden, access to medicines and economic pressure. Common practices included prophylactic use, use of antibiotics to enhance production, self-prescription use, use of combination antibiotics (A combination antibiotic is one in which two or more antibiotics are added together for additional therapeutic effect.), and antibiotics classified as critically important in human medicine. Key information sources for the farmers were agro- veterinary dispensers, sellers of day-old chicks, and peer-learning. External factors driving the inappropriate use of antibiotics included access to the antibiotics, influence by marketers such as sellers of day-old chicks, and branding. Use of antibiotics was also driven by economic factors among the farmers, sellers of day-old chicks and agro-veterinary dispensers. CONCLUSIONS Our findings indicate widespread use of antibiotics among poultry farmers in our study site. The use of antibiotics is influenced by an interplay of issues at the farmers' level as well as broader social, economic and structural level factors. A multifaceted One Health approach focusing on regulatory frameworks, knowledge transfer, and research is required to promote stewardship and judicious use of antibiotics.
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Affiliation(s)
| | - Jan Jacobs
- grid.11505.300000 0001 2153 5088Institute of Tropical Medicine, Antwerp, Belgium ,Department of Microbiology, Immunology and Transplantation, Leuven, Louvain, Belgium
| | - Marie Paule Ngogang
- grid.412661.60000 0001 2173 8504Faculty of Medicine, University of Yaoundé, Yaoundé, Cameroon
| | - Olivia Howland
- grid.419369.00000 0000 9378 4481International Livestock Research Institute, Nairobi, Kenya ,grid.10025.360000 0004 1936 8470University of Liverpool, Liverpool, UK
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Hennessey M, Ebata A, Samanta I, Mateus A, Arnold JC, Day D, Gautham M, Alarcon P. Pharma-cartography: Navigating the complexities of antibiotic supply to rural livestock in West Bengal, India, through value chain and power dynamic analysis. PLoS One 2023; 18:e0281188. [PMID: 36730354 PMCID: PMC9894437 DOI: 10.1371/journal.pone.0281188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
Antibiotic resistance threatens provision of healthcare and livestock production worldwide with predicted negative socioeconomic impact. Antibiotic stewardship can be considered of importance to people living in rural communities, many of which depend on agriculture as a source of food and income and rely on antibiotics to control infectious diseases in livestock. Consequently, there is a need for clarity of the structure of antibiotic value chains to understand the complexity of antibiotic production and distribution in community settings as this will facilitate the development of effective policies and interventions. We used a value chain approach to investigate how relationships, behaviours, and influences are established during antibiotic distribution. Interviews were conducted with key informants (n = 17), value chain stakeholders (n = 22), and livestock keeping households (n = 36) in Kolkata, and two rural sites in West Bengal, India. Value chain mapping and an assessment of power dynamics, using manifest content analysis, were conducted to investigate antibiotic distribution and identify entry points for antibiotic stewardship. The flow of antibiotics from manufacturer to stockists is described and mapped and two local level maps showing distribution to final consumers presented. The maps illustrate that antibiotic distribution occurred through numerous formal and informal routes, many of which circumvent antibiotic use legislation. This was partly due to limited institutional power of the public sector to govern value chain activities. A 'veterinary service lacuna' existed resulting in livestock keepers having higher reliance on private and informal providers, who often lacked legal mandates to prescribe and dispense antibiotics. The illegitimacy of many antibiotic prescribers blocked access to formal training who instead relied on mimicking the behaviour of more experienced prescribers-who also lacked access to stewardship guidelines. We argue that limited institutional power to enforce existing antibiotic legislation and guide antibiotic usage and major gaps in livestock healthcare services make attempts to curb informal prescribing unsustainable. Alternative options could include addressing public sector deficits, with respect to both healthcare services and antibiotic provision, and by providing resources such as locally relevant antibiotic guidelines to all antibiotic prescribers. In addition, legitimacy of informal prescribers could be revised, which may allow formation of associations or groups to incentivise good antibiotic practices.
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Affiliation(s)
- Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
- * E-mail:
| | - Ayako Ebata
- Institute of Development Studies, Brighton, United Kingdom
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Dominic Day
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Meenakshi Gautham
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pablo Alarcon
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
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10
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Myers J, Hennessey M, Arnold JC, McCubbin KD, Lembo T, Mateus A, Kitutu FE, Samanta I, Hutchinson E, Davis A, Mmbaga BT, Nasuwa F, Gautham M, Clarke SE. Crossover-Use of Human Antibiotics in Livestock in Agricultural Communities: A Qualitative Cross-Country Comparison between Uganda, Tanzania and India. Antibiotics (Basel) 2022; 11:1342. [PMID: 36290000 PMCID: PMC9598773 DOI: 10.3390/antibiotics11101342] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/02/2022] [Accepted: 09/28/2022] [Indexed: 12/24/2022] Open
Abstract
Antibiotic use in animal agriculture contributes significantly to antibiotic use globally and is a key driver of the rising threat of antibiotic resistance. It is becoming increasingly important to better understand antibiotic use in livestock in low-and-middle income countries where antibiotic use is predicted to increase considerably as a consequence of the growing demand for animal-derived products. Antibiotic crossover-use refers to the practice of using antibiotic formulations licensed for humans in animals and vice versa. This practice has the potential to cause adverse drug reactions and contribute to the development and spread of antibiotic resistance between humans and animals. We performed secondary data analysis of in-depth interview and focus-group discussion transcripts from independent studies investigating antibiotic use in agricultural communities in Uganda, Tanzania and India to understand the practice of antibiotic crossover-use by medicine-providers and livestock-keepers in these settings. Thematic analysis was conducted to explore driving factors of reported antibiotic crossover-use in the three countries. Similarities were found between countries regarding both the accounts of antibiotic crossover-use and its drivers. In all three countries, chickens and goats were treated with human antibiotics, and among the total range of human antibiotics reported, amoxicillin, tetracycline and penicillin were stated as used in animals in all three countries. The key themes identified to be driving crossover-use were: (1) medicine-providers' and livestock-keepers' perceptions of the effectiveness and safety of antibiotics, (2) livestock-keepers' sources of information, (3) differences in availability of human and veterinary services and antibiotics, (4) economic incentives and pressures. Antibiotic crossover-use occurs in low-intensity production agricultural settings in geographically distinct low-and-middle income countries, influenced by a similar set of interconnected contextual drivers. Improving accessibility and affordability of veterinary medicines to both livestock-keepers and medicine-providers is required alongside interventions to address understanding of the differences between human and animal antibiotics, and potential dangers of antibiotic crossover-use in order to reduce the practice. A One Health approach to studying antibiotic use is necessary to understand the implications of antibiotic accessibility and use in one sector upon antibiotic use in other sectors.
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Affiliation(s)
- Jessica Myers
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London WC1E 7HT, UK
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Kayley D McCubbin
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Tiziana Lembo
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | - Ana Mateus
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK
| | - Freddy Eric Kitutu
- School of Public Health, Makerere University, New Mulago Hill Road, Kampala P.O. Box 7072, Uganda
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata 700037, India
| | - Eleanor Hutchinson
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Alicia Davis
- School of Social and Political Sciences, University of Glasgow, Glasgow G12 8RT, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi P.O. Box 2236, Tanzania
- Department of Paediatric and Child Health, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
| | - Fortunata Nasuwa
- Kilimanjaro Clinical Research Institute, Moshi P.O. Box 2236, Tanzania
| | - Meenakshi Gautham
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Siân E Clarke
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London WC1E 7HT, UK
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11
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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. Antibiotics (Basel) 2022; 11:antibiotics11091210. [PMID: 36139990 PMCID: PMC9495135 DOI: 10.3390/antibiotics11091210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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12
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Bradford H, McKernan C, Elliott C, Dean M. Factors Influencing Pig Farmers’ Perceptions and Attitudes Towards Antimicrobial Use and Resistance. Prev Vet Med 2022; 208:105769. [DOI: 10.1016/j.prevetmed.2022.105769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 08/02/2022] [Accepted: 09/21/2022] [Indexed: 11/15/2022]
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13
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Khun PA, Riley TV. Epidemiology of Clostridium (Clostridioides) difficile Infection in Southeast Asia. Am J Trop Med Hyg 2022; 107:tpmd211167. [PMID: 35940201 PMCID: PMC9490644 DOI: 10.4269/ajtmh.21-1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/27/2022] [Indexed: 11/07/2022] Open
Abstract
This review describes the current understanding of Clostridium (Clostridioides) difficile infection (CDI) in southeast Asia regarding the prevalence of CDI, C. difficile detection methods, antimicrobial susceptibility profiles, and the potential significance of a One Health approach to prevention and control. Our initial focus had been the Indochina region, however, due to limited studies/surveillance of CDI in Indochina, other studies in southeast Asian countries and neighboring Chinese provinces are presented here for comparison. Clostridium (Clostridioides) difficile infection is one of the most common causes of hospital-acquired gastroenteritis worldwide. Since its discovery as a cause of pseudomembranous colitis in 1978, C. difficile-related disease has been more prevalent in high-income rather than low-income countries. This may be because of a lack of knowledge and awareness about the significance of C. difficile and CDI, resulting in underreporting of true rates. Moreover, the abuse of antimicrobials and paucity of education regarding appropriate usage remain important driving factors in the evolution of CDI worldwide. The combination of underreporting of true CDI rates, along with continued misuse of antimicrobial agents, poses an alarming threat for regions like Indochina. C. difficile ribotype (RT) 027 has caused outbreaks in North America and European countries, however, C. difficile RT 017 commonly occurs in Asia. Toxin A-negative/toxin B-positive (A-B+) strains of RT 017 have circulated widely and caused outbreaks throughout the world and, in southeast Asia, this strain is endemic.
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Affiliation(s)
- Peng An Khun
- School of Biomedical Sciences, The University of Western Australia, Western Australia, Australia
| | - Thomas V. Riley
- School of Biomedical Sciences, The University of Western Australia, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, Western Australia, Australia
- Department of Microbiology, PathWest Laboratory Medicine, Nedlands, Western Australia, Australia
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14
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Characterisation of chicken farms in Vietnam: a typology of antimicrobial use among different production systems. Prev Vet Med 2022; 208:105731. [DOI: 10.1016/j.prevetmed.2022.105731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/08/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022]
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15
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Lovern SB, Van Hart R. Impact of oxytetracycline exposure on the digestive system microbiota of Daphnia magna. PLoS One 2022; 17:e0265944. [PMID: 35476627 PMCID: PMC9045634 DOI: 10.1371/journal.pone.0265944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
Antibiotics are used to treat serious illness, but may also be used extraneously or as a preventative measure in many farm animals. This usage increases the potential for unintentional exposure to a variety of organisms. When antibiotics enter aquatic environments, Daphnia magna are especially vulnerable as they filter-feed in freshwater environments. Oxytetracycline (OTC) is a commonly-used broad-spectrum antibiotic used to treat a variety of mammalian diseases. In this study, the impact of OTC on D. magna mortality and gut biota were studied using both cultivation and sequencing-based approaches. Mortality rates were extremely low with the LD50 >2,000ppm. However, OTC impacted abundance and species diversity of intestinal microorganisms in the gut of the D. magna in abundance as well as species diversity. In control organisms, Pseudomonas putida and Aeromonas hydrophila were both present while only P. putida was found in OTC-exposed organisms. Disruption of the intestinal biota in D. magna could have implications on long-term survival, energy expenditure, and reproduction.
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Affiliation(s)
- Sarah B. Lovern
- Department of Life and Earth Science, Concordia University Wisconsin, Mequon, WI, United States of America
- * E-mail:
| | - Rochelle Van Hart
- Department of Life and Earth Science, Concordia University Wisconsin, Mequon, WI, United States of America
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16
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Khan X, Rymer C, Lim R, Ray P. Factors Associated with Antimicrobial Use in Fijian Livestock Farms. Antibiotics (Basel) 2022; 11:antibiotics11050587. [PMID: 35625231 PMCID: PMC9137839 DOI: 10.3390/antibiotics11050587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship (AMS) programmes in human health and livestock production are vital to tackling antimicrobial resistance (AMR). Data on antimicrobial use (AMU), resistance, and drivers for AMU in livestock are needed to inform AMS efforts. However, such data are limited in Fiji. Therefore, this study aimed to evaluate the association between farmer (socio-economic, demographic) and livestock production and management factors with AMU. Information was collected using purposive and snowball sampling from 236 livestock farmers and managers located in Central and Western divisions, Viti Levu, Fiji. Multinomial logistic regression was used to determine the factors associated with AMU in farms using an aggregated livestock farm model. Farms that raised cattle only for dairy (farm factor) were more likely to use antibiotics and anthelmintics (p = 0.018, OR = 22.97, CI 1.713, 308.075) compared to mixed cattle and poultry farms. Farms that maintained AMU records were more likely to use antibiotics (p = 0.045, OR = 2.65, CI 1.024, 6.877) compared to farms that did not. Other livestock production and management factors had no influence on AMU on the livestock farms. AMU in livestock farms was not influenced by the socio-economic and demographic characteristics of the farmer. There were differences between livestock enterprises regarding their management. The lack of association between management system and AMU could be because there was so much variation in management system, levels of farmer knowledge and awareness of AMU, and in management of farm biosecurity. Future studies exploring farmers’ knowledge and awareness of AMU and livestock management are required to design AMS programmes promoting prudent AMU in all livestock farms locally.
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Affiliation(s)
- Xavier Khan
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading RG6 6EU, UK; (C.R.); (P.R.)
- Correspondence:
| | - Caroline Rymer
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading RG6 6EU, UK; (C.R.); (P.R.)
| | - Rosemary Lim
- Reading School of Pharmacy, School of Chemistry, Food & Pharmacy, University of Reading, Reading RG6 6DZ, UK;
| | - Partha Ray
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, Reading RG6 6EU, UK; (C.R.); (P.R.)
- The Nature Conservancy, 4245 North Fairfax Drive, Suite 100, Arlington, VA 22203, USA
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17
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Ting S, Pereira A, Davis S, Vong da Silva PG, Alves A, Dos Santos C, Toribio JALML, Morais O, da Costa Jong JB, Barnes TS. Knowledge and Practices on Antibiotic Use and Antibiotic Resistance Among Smallholder Pig Farmers in Timor-Leste. Front Vet Sci 2022; 8:819643. [PMID: 35071400 PMCID: PMC8770917 DOI: 10.3389/fvets.2021.819643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Shawn Ting
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Abrao Pereira
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Steven Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Paulo Gabriel Vong da Silva
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Amalia Alves
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Cristibela Dos Santos
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jenny-Ann L M L Toribio
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, NSW, Australia
| | - Olavio Morais
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, NSW, Australia.,Ministry of Agriculture and Fisheries, Government of Timor-Leste, Dili, Timor-Leste
| | | | - Tamsin S Barnes
- Epivet Pty. Ltd., Withcott, QLD, Australia.,The University of Queensland, School of Veterinary Science, Gatton, QLD, Australia
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18
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McKernan C, Benson T, Farrell S, Dean M. Antimicrobial use in agriculture: critical review of the factors influencing behaviour. JAC Antimicrob Resist 2021; 3:dlab178. [PMID: 34859222 PMCID: PMC8634307 DOI: 10.1093/jacamr/dlab178] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- C McKernan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL,UK
| | - T Benson
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL,UK
| | - S Farrell
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL,UK
| | - M Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL,UK
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19
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Arnold JC, Day D, Hennessey M, Alarcon P, Gautham M, Samanta I, Mateus A. "If It Works in People, Why Not Animals?": A Qualitative Investigation of Antibiotic Use in Smallholder Livestock Settings in Rural West Bengal, India. Antibiotics (Basel) 2021; 10:antibiotics10121433. [PMID: 34943645 PMCID: PMC8698124 DOI: 10.3390/antibiotics10121433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Smallholder farms are the predominant livestock system in India. Animals are often kept in close contact with household members, and access to veterinary services is limited. However, limited research exists on how antibiotics are used in smallholder livestock in India. We investigated antibiotic supply, usage, and their drivers in smallholder livestock production systems, including crossover-use of human and veterinary antibiotics in two rural sites in West Bengal. Qualitative interviews were conducted with key informants (n = 9), livestock keepers (n = 37), and formal and informal antibiotic providers from veterinary and human health sectors (n = 26). Data were analysed thematically and interpreted following a One Health approach. Livestock keepers and providers used antibiotics predominantly for treating individual animals, and for disease prevention in poultry but not for growth promotion. All providers used (highest priority) critically important antimicrobials for human health and engaged in crossover-use of human antibiotic formulations in livestock. Inadequate access to veterinary drugs and services, and a perceived efficacy and ease of dosing of human antibiotics in animals drove crossover-use. Veterinary antibiotics were not used for human health due to their perceived adverse effects. Given the extent of usage of protected antibiotics and crossover-use, interventions at the community level should adopt a One Health approach that considers all antibiotic providers and livestock keepers and prioritizes the development of evidence-based guidelines to promote responsible use of antibiotics in animals.
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Affiliation(s)
- Jean-Christophe Arnold
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
- Correspondence: (J.-C.A.); (D.D.)
| | - Dominic Day
- South Wales Farm Vets, Tynewydd Farm, Cardiff CF72 8NE, UK
- Correspondence: (J.-C.A.); (D.D.)
| | - Mathew Hennessey
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
| | - Pablo Alarcon
- Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK; (M.H.); (P.A.)
| | - Meenakshi Gautham
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17, Tavistock Place, London WC1H 9SH, UK;
| | - Indranil Samanta
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata 700037, India;
| | - Ana Mateus
- World Organisation of Animal Health (OIE), 12 Rue de Prony, 75017 Paris, France;
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20
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Olasoju MI, Olasoju TI, Adebowale OO, Adetunji VO. Knowledge and practice of cattle handlers on antibiotic residues in meat and milk in Kwara State, Northcentral Nigeria. PLoS One 2021; 16:e0257249. [PMID: 34648524 PMCID: PMC8516246 DOI: 10.1371/journal.pone.0257249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/26/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Antibiotics are important for improving animal health and production. However, the deposition of its residues in food of animal origin intended for human consumption at non-permissible levels has generated global health concern and the need to tackle this using the "One Health Approach". This study assessed the knowledge and practice of 286 cattle handlers in Kwara State, Nigeria. METHODS A web-based cross sectional online survey using a semi-structured questionnaire was conducted from November to December, 2019. Univariate, bivariate and multivariate analyses were performed at 95% confidence interval to determine predictors of good knowledge and practices towards Antibiotic Residues in Meat and Milk among cattle handlers. RESULTS This study revealed that majority (52.7% n = 165/286) of the cattle handlers were not aware of antibiotic residues. Knowledge and practices regarding antibiotic residues were generally poor among the study population; 36.7% and 35.5% had satisfactory knowledge and practice respectively. The age (p = 0.026), gender (p = 0.006) and business duration (p = 0.001) of participants were significantly associated with their knowledge of antimicrobial residues. The effect of education on knowledge was modified by age. The odds of having poor knowledge on antibiotic residues increased 4 times among participants who were ≤40 years old than those above 40 years (Stratum Specific OR = 3.65; CI = 1.2, 11.1; p = 0.026). Knowledge levels of participants were statistically associated with their practice levels p<0.05 (OR = 2.43; CI = 1.45. 4.06; p = 0.0006). CONCLUSION This implies that poor knowledge is a risk factor to having poor practice among cattle handlers. Deliberate efforts towards educating cattle farmers on best farm practices in antibiotic use would prevent antibiotic residues in meat and milk. Also, an effective surveillance system for monitoring the use of veterinary drugs in Kwara State, Nigeria is crucial.
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Affiliation(s)
- Mary Idowu Olasoju
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Taiwo Israel Olasoju
- Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, FCT, Nigeria
| | - Oluwawemimo Oluseun Adebowale
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Victoria Olusola Adetunji
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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21
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Ting S, Pereira A, Alves ADJ, Fernandes S, Soares CDC, Soares FJ, Henrique ODC, Davis S, Yan J, Francis JR, Barnes TS, Jong JBDC. Antimicrobial Use in Animals in Timor-Leste Based on Veterinary Antimicrobial Imports between 2016 and 2019. Antibiotics (Basel) 2021; 10:426. [PMID: 33921477 PMCID: PMC8070255 DOI: 10.3390/antibiotics10040426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 01/21/2023] Open
Abstract
Monitoring veterinary antimicrobial use is part of the global strategy to tackle antimicrobial resistance. The purpose of this study was to quantify veterinary antimicrobials imported into Timor-Leste between 2016 and 2019 and describe the antimicrobial import profile of importers. Data were obtained from import applications received by the Ministry of Agriculture and Fisheries (MAF) of Timor-Leste. Import quantities were analysed by antimicrobial class, importance for human medicine, recommended route of administration and type of importer. An average of 57.4 kg (s.d. 31.0 kg) and 0.55 mg/kg (s.d. 0.27 mg/kg) animal biomass of antimicrobials was imported per year. Tetracyclines (35.5%), penicillins (23.7%), and macrolides (15.9%) were the commonly imported antimicrobial classes. Antimicrobials imported for parenteral administration were most common (60.1%). MAF was the largest importer (52.4%). Most of the critically important antimicrobials for human medicine were imported by poultry farms for oral administration and use for growth promotion could not be ruled out. In conclusion, the use of antimicrobials in animals in Timor-Leste is very low, in keeping with its predominantly subsistence agriculture system. Farmer education, development of treatment guidelines, and strengthening of the veterinary service is important for addressing the potential future misuse of antimicrobials especially in the commercial poultry industry.
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Affiliation(s)
- Shawn Ting
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
| | - Abrao Pereira
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
| | - Amalia de Jesus Alves
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
| | - Salvador Fernandes
- Ministry of Agriculture and Fisheries, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili 0332, Timor-Leste; (S.F.); (C.d.C.S.); (F.J.S.); (O.d.C.H.); (J.B.d.C.J.)
| | - Cristina da Costa Soares
- Ministry of Agriculture and Fisheries, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili 0332, Timor-Leste; (S.F.); (C.d.C.S.); (F.J.S.); (O.d.C.H.); (J.B.d.C.J.)
| | - Felix Joanico Soares
- Ministry of Agriculture and Fisheries, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili 0332, Timor-Leste; (S.F.); (C.d.C.S.); (F.J.S.); (O.d.C.H.); (J.B.d.C.J.)
| | - Onofre da Costa Henrique
- Ministry of Agriculture and Fisheries, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili 0332, Timor-Leste; (S.F.); (C.d.C.S.); (F.J.S.); (O.d.C.H.); (J.B.d.C.J.)
| | - Steven Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
| | - Jennifer Yan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
- Department of Paediatrics, Royal Darwin Hospital, Darwin, NT 0810, Australia
| | - Joshua R. Francis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia; (A.P.); (A.d.J.A.); (S.D.); (J.Y.); (J.R.F.)
- Department of Paediatrics, Royal Darwin Hospital, Darwin, NT 0810, Australia
| | | | - Joanita Bendita da Costa Jong
- Ministry of Agriculture and Fisheries, Government of Timor-Leste, Av. Nicolao Lobato, Comoro, Dili 0332, Timor-Leste; (S.F.); (C.d.C.S.); (F.J.S.); (O.d.C.H.); (J.B.d.C.J.)
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Anh HQ, Le TPQ, Da Le N, Lu XX, Duong TT, Garnier J, Rochelle-Newall E, Zhang S, Oh NH, Oeurng C, Ekkawatpanit C, Nguyen TD, Nguyen QT, Nguyen TD, Nguyen TN, Tran TL, Kunisue T, Tanoue R, Takahashi S, Minh TB, Le HT, Pham TNM, Nguyen TAH. Antibiotics in surface water of East and Southeast Asian countries: A focused review on contamination status, pollution sources, potential risks, and future perspectives. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 764:142865. [PMID: 33097262 DOI: 10.1016/j.scitotenv.2020.142865] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/26/2020] [Accepted: 10/03/2020] [Indexed: 05/11/2023]
Abstract
This review provides focused insights into the contamination status, sources, and ecological risks associated with multiple classes of antibiotics in surface water from the East and Southeast Asia based on publications over the period 2007 to 2020. Antibiotics are ubiquitous in surface water of these countries with concentrations ranging from <1 ng/L to hundreds μg/L and median values from 10 to 100 ng/L. Wider ranges and higher maximum concentrations of certain antibiotics were found in surface water of the East Asian countries like China and South Korea than in the Southeast Asian nations. Environmental behavior and fate of antibiotics in surface water is discussed. The reviewed occurrence of antibiotics in their sources suggests that effluent from wastewater treatment plants, wastewater from aquaculture and livestock production activities, and untreated urban sewage are principal sources of antibiotics in surface water. Ecological risks associated with antibiotic residues were estimated for aquatic organisms and the prevalence of antibiotic resistance genes and antibiotic-resistant bacteria were reviewed. Such findings underline the need for synergistic efforts from scientists, engineers, policy makers, government managers, entrepreneurs, and communities to manage and reduce the burden of antibiotics and antibiotic resistance in water bodies of East and Southeast Asian countries.
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Affiliation(s)
- Hoang Quoc Anh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam; Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan.
| | - Thi Phuong Quynh Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam.
| | - Nhu Da Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Xi Xi Lu
- Department of Geography, National University of Singapore, Arts Link 1, Singapore 117570, Singapore
| | - Thi Thuy Duong
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Josette Garnier
- Sorbonne University, UMR Metis 7619, 4th floor, Tour 56, 4 Place Jussieu, Paris 75005, France
| | - Emma Rochelle-Newall
- Institute of Ecology and Environmental Sciences of Paris (iEES-Paris), Sorbonne Université, Université Paris-Est Créteil, IRD, CNRS, INRA, Paris, France
| | - Shurong Zhang
- College of Water Sciences, Beijing Normal University, 19 Xinjiekouwai St., Beijing 100875, China
| | - Neung-Hwan Oh
- Graduate School of Environmental Studies, Seoul National University, Seoul 08826, Republic of Korea
| | - Chantha Oeurng
- Institute of Technology of Cambodia, Russian Conference Blvd., Phnom Penh, Cambodia
| | - Chaiwat Ekkawatpanit
- Civil Engineering Department, King Mongkut's University of Technology Thonburi (KMUTT), 126 Pracha Uthit Rd., Thon Buri, Bangkok 10140, Thailand
| | - Tien Dat Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Quang Trung Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Tran Dung Nguyen
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Trong Nghia Nguyen
- Faculty of Chemical Technology and Environment, Hung Yen University of Technology and Education, Khoai Chau, Hung Yen 17000, Viet Nam
| | - Thi Lieu Tran
- Viet Nam National Institute of Occupational Safety and Health (VNNIOSH), 99 Tran Quoc Toan, Hoan Kiem, Hanoi 10000, Viet Nam
| | - Tatsuya Kunisue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Rumi Tanoue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Shin Takahashi
- Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan; Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Tu Binh Minh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Huu Tuyen Le
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Ngoc Mai Pham
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Anh Huong Nguyen
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
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Albernaz-Gonçalves R, Olmos G, Hötzel MJ. Exploring Farmers' Reasons for Antibiotic Use and Misuse in Pig Farms in Brazil. Antibiotics (Basel) 2021; 10:331. [PMID: 33809885 PMCID: PMC8004152 DOI: 10.3390/antibiotics10030331] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 02/08/2023] Open
Abstract
Stressful management that makes farmed pigs susceptible to infections is associated with high antibiotic use (AMU) and resistance (AMR). Pig farmers are key stakeholders to support the international agenda pushing AMU restrictions. We interviewed 58 pig farmers on AMU/AMR, biosecurity, veterinary assistance, disease prevention and treatment, aiming to understand practices and attitudes towards the AMU/AMR problem. Farmers described a reliance on antibiotics to prevent and treat disease while neglecting biosecurity measures. We identified inappropriate AMU practices (high use of broad-spectrum antibiotics, incorrect dosage or treatment length) and unrestricted access to antibiotics, which encouraged imprudent AMU. Nevertheless, most farmers considered this AMU legitimate to guarantee herd productivity and showed unpreparedness and resistance to changing AMU practices, perceiving limitations (economic, sanitary and inspection) more easily than alternatives to reduce AMU. Agro-industries and foreign markets were mentioned, and internal consumers dismissed as potential motivators for behavioral changes. Importantly, farmers' economic, technical and social factors may limit their autonomy to change practices. We conclude that the observed distancing of pig farmers from the AMU/AMR problem limits the efficiency of policies aiming for a prudent AMU. Our study indicates a need for education, training and behavior change nudging that should include other stakeholders beyond farmers.
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Affiliation(s)
- Rita Albernaz-Gonçalves
- Instituto Federal Catarinense, Campus Santa Rosa do Sul, Santa Rosa do Sul, SC 88965-000, Brazil;
- Laboratório de Etologia Aplicada e Bem-Estar Animal, Departamento de Zootecnia e Desenvolvimento Rural, Universidade Federal de Santa Catarina, Florianópolis, SC 88034-001, Brazil
| | - Gabriela Olmos
- Veterinary Epidemiology Unit, Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, 75007 Uppsala, Sweden;
| | - Maria José Hötzel
- Laboratório de Etologia Aplicada e Bem-Estar Animal, Departamento de Zootecnia e Desenvolvimento Rural, Universidade Federal de Santa Catarina, Florianópolis, SC 88034-001, Brazil
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Servia-Dopazo M, Taracido-Trunk M, Figueiras A. Non-Clinical Factors Determining the Prescription of Antibiotics by Veterinarians: A Systematic Review. Antibiotics (Basel) 2021; 10:antibiotics10020133. [PMID: 33573109 PMCID: PMC7912449 DOI: 10.3390/antibiotics10020133] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
The misuse of antibiotics in humans, animals, and plants is related to the spread of resistant antibiotic strains among humans and animals. In this paper, we carry out a bibliographic search of Medline, Web of Knowledge, and Cab Abstracts with the main objective of ascertaining the available evidence on non-clinical factors and attitudes that could influence the prescription of antibiotics by veterinarians. A total of 34 studies fulfilled the inclusion criteria. Whereas, veterinary health professionals' prescribing habits did not appear to be influenced by their socio-demographic characteristics, they were influenced by different attitudes, such as fear (identified in 19 out of 34 studies), self-confidence (19/34), business factors (19/34), and by complacency (16/34). Certain owner-related factors, such as lack of awareness (16/34) and demand for antibiotics (12/34), were also important, as were concurrent factors, ranging from a lack of appropriate regulations (10/34) to the expense and delays involved in performing culture and sensitivity tests (10/34) and inadequate farm hygiene (8/34). Our results appear to indicate that the non-clinical factors are potentially modifiable. This may be useful for designing interventions targeted at improving antibiotic use in animals, as part of an overall strategy to reduce the global spread of multi-resistant strains.
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Affiliation(s)
- Miguel Servia-Dopazo
- Department of Preventive Medicine and Public Health, Salnés Clinical Hospital, 36619 Vilagarcía de Arousa, Spain
- Correspondence:
| | - Margarita Taracido-Trunk
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (M.T.-T.); (A.F.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 15706 Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (M.T.-T.); (A.F.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 15706 Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Lekagul A, Tangcharoensathien V, Liverani M, Mills A, Rushton J, Yeung S. Understanding antibiotic use for pig farming in Thailand: a qualitative study. Antimicrob Resist Infect Control 2021; 10:3. [PMID: 33407887 PMCID: PMC7789695 DOI: 10.1186/s13756-020-00865-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is promoted by multiple drivers, including antibiotic use in the livestock sector. Thus, understanding factors influencing antibiotic use in livestock production is essential to the design and implementation of effective interventions to reduce AMR. This qualitative study aimed to explore the experiences and views of the key actors associated with the use of antibiotics for pig farming in Thailand, from local farmers to officers in central government institutions. METHODS A total of 31 in-depth interviews were conducted with different categories of actors: pig farmers (n = 13), drug retailers (n = 5), veterinarians (n = 7), government officers (n = 3) and representatives of animal and human health associations (n = 2). Themes emerging from the interviews were identified and explored using thematic analysis. In addition, direct observations were conducted in the pig farms. RESULTS The findings highlight the multi-faceted nature of the views and practices that may contribute to misuse or overuse of antibiotics in the study locations, including misconceptions about the nature of antibiotics and AMR (particularly among smallholders), lack of facilities and financial means to establish an antibiotic-free farm, lack of sufficient training on AMR and antibiotic prescribing for veterinarians, the profit motive of pharmaceutical companies and their ties to farm consultants, and lack of sufficient regulatory oversight. CONCLUSIONS Our study indicates a clear need to improve antibiotic use for pig production in Thailand. Farmers need better access to veterinary services and reliable information about animal health needs and antibiotics. Innovative investments in biosecurity could improve farm management and decrease reliance on antibiotics, although the cost of these interventions should be low to ensure wide uptake in the livestock sector. Lastly, further development of professional training and clinical guidelines, and the establishment of a code of conduct, would help improve antibiotic dispensing practices.
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Affiliation(s)
- Angkana Lekagul
- London School of Hygiene and Tropical Medicine, London, UK.
- International Health Policy Programme, Ministry of Public Health, Nonthaburi, Thailand.
| | | | - Marco Liverani
- London School of Hygiene and Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Anne Mills
- London School of Hygiene and Tropical Medicine, London, UK
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Shunmay Yeung
- London School of Hygiene and Tropical Medicine, London, UK
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Gozdzielewska L, King C, Flowers P, Mellor D, Dunlop P, Price L. Scoping review of approaches for improving antimicrobial stewardship in livestock farmers and veterinarians. Prev Vet Med 2020; 180:105025. [DOI: 10.1016/j.prevetmed.2020.105025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/26/2022]
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Iskandar K, Molinier L, Hallit S, Sartelli M, Catena F, Coccolini F, Craig Hardcastle T, Roques C, Salameh P. Drivers of Antibiotic Resistance Transmissionin Low- and Middle-Income Countriesfrom a "One Health" Perspective-A Review. Antibiotics (Basel) 2020; 9:E372. [PMID: 32630353 PMCID: PMC7400606 DOI: 10.3390/antibiotics9070372] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Antibiotic resistance is an ecosystem problem threatening the interrelated human-animalenvironmenthealth under the "One Health" framework. Resistant bacteria arising in onegeographical area can spread via cross-reservoir transmission to other areas worldwide either bydirect exposure or through the food chain and the environment. Drivers of antibiotic resistance arecomplex and multi-sectoral particularly in Lower- and Middle-income countries. These includeinappropriate socio-ecological behaviors; poverty; overcrowding; lack of surveillance systems; foodsupply chain safety issues; highly contaminated waste effluents; and loose rules and regulations. Inorder to examine the drivers of antibiotic resistance from a "one health" perspective, a literaturereview was conducted on three databases including PubMed, Medline and Google Scholar. A totalof 485 studies of potential relevance were selected, out of which 182 were included in this review.Results have shown that the aforementioned market failures are the leading cause for the negativeexternality of antibiotic resistance that extends in scope from the individual to the global ecosystem.Incremental and sustainable global actions can make the change, however, the problem willcontinue to prevail if governments do not prioritize the "One health" approach and if individual'saccountability is still denied in a world struggling with profound socio-economic problems.
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Affiliation(s)
- Katia Iskandar
- Department of Mathématiques Informatique et Télécommunications, Université Toulouse III, Paul Sabatier, INSERM, UMR 1027, F-31000 Toulouse, France
- INSPECT-LB: Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban, Beirut 6573-14, Lebanon; (S.H.); (P.S.)
- Faculty of Pharmacy, Lebanese University, Beirut 1106, Lebanon
| | - Laurent Molinier
- Department of Medical Information, Centre Hospitalier Universitaire, INSERM, UMR 1027, Université Paul Sabatier Toulouse III, F-31000 Toulouse, France;
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban, Beirut 6573-14, Lebanon; (S.H.); (P.S.)
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh P.O. Box 446, Lebanon
| | - Massimo Sartelli
- Department of surgery, University of Macerata, 62100 Macerata, Italy;
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, 43126 Parma, Italy;
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Cisanello University Hospital, 56100 Pisa, Italy;
| | - Timothy Craig Hardcastle
- Department of Trauma service, Inkosi Albert Luthuli Central Hospital, Durban 4091, South Africa;
- Department of Surgery, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Congela, Durban 4041, South Africa
| | - Christine Roques
- Departement of Bioprocédés et Systèmes Microbiens, Laboratoire de Génie Chimique, Université Paul Sabatier Toulouse III, UMR 5503, 31330 Toulouse, France;
- Department of Bactériologie-Hygiène, Centre Hospitalier Universitaire, Hôpital Purpan, 31330 Toulouse, France
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban, Beirut 6573-14, Lebanon; (S.H.); (P.S.)
- Faculty of Pharmacy, Lebanese University, Beirut 1106, Lebanon
- Faculty of Public Health, Lebanese University, Beirut 1103, Lebanon
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High performance of Mn2(BDC)2(DMF)2-derived MnO@C nanocomposite as superior remediator for a series of emergent antibiotics. J Mol Liq 2020. [DOI: 10.1016/j.molliq.2020.113038] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Nadimpalli M, Fabre L, Yith V, Sem N, Gouali M, Delarocque-Astagneau E, Sreng N, Le Hello S. CTX-M-55-type ESBL-producing Salmonella enterica are emerging among retail meats in Phnom Penh, Cambodia. J Antimicrob Chemother 2020; 74:342-348. [PMID: 30376113 DOI: 10.1093/jac/dky451] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background Salmonella enterica is a leading cause of human gastroenteritis. S. enterica strains that produce ESBLs (ESBL-Salm) remain rare in Europe and North America, but less is known about their prevalence among animal-derived foods in countries with weaker food safety practices and unregulated veterinary antibiotic use. Objectives To examine the prevalence and characteristics of ESBL-Salm from retail meats in Phnom Penh, Cambodia. Methods We tested fish, pork and chicken from two markets for ESBL- and carbapenemase-producing Salmonella from September-December 2016, using cefotaxime- and ertapenem-supplemented media, respectively. ESBL-Salm were sequenced and their genomes characterized. We performed plasmid conjugation experiments to assess the co-transferability of ESBL-encoding genes and MDR phenotypes. Results Twenty-six of 150 fish and meat samples (17%) were positive for ESBL-Salm, including 10/60 fish (17%), 15/60 pork (25%) and 1/30 chicken (3%). Carbapenemase-producing Salmonella strains were not detected. Pork-origin ESBL-Salm were primarily serotypes Rissen (10/15) or a monophasic variant of Typhimurium 4,5,12:i:- (3/15), whereas Saintpaul (3/10) and Newport (4/10) were more common among fish. Most ESBL enzymes were encoded by blaCTX-M-55 genes (24/26) harboured on conjugative IncA/C2 (n = 14) or IncHI2 (n = 10) plasmids. Resistance to up to six additional drug classes was co-transferred by each plasmid type. ESBL-Salm were resistant to almost every antibiotic recommended for severe salmonellosis treatment. Conclusions CTX-M-55-type S. enterica are highly prevalent among pork and fish from Phnom Penh markets and their spread appears to be mediated by MDR IncA/C2 and IncHI2 plasmids. Food safety must be improved and veterinary antibiotic use should be regulated to protect public health.
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Affiliation(s)
- Maya Nadimpalli
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases Unit (B2PHI), Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Université Paris-Saclay, 25 rue du Docteur Roux, Paris, France
| | - Laetitia Fabre
- Enteric Bacterial Pathogens Unit, Institut Pasteur, 25 rue du Docteur Roux, Paris, France
| | - Vuthy Yith
- Laboratory of Environment and Food Safety, Institut Pasteur du Cambodge, 5 Preah Monivong Blvd, Phnom Penh, Cambodia
| | - Nita Sem
- Laboratory of Environment and Food Safety, Institut Pasteur du Cambodge, 5 Preah Monivong Blvd, Phnom Penh, Cambodia
| | - Malika Gouali
- Laboratory of Environment and Food Safety, Institut Pasteur du Cambodge, 5 Preah Monivong Blvd, Phnom Penh, Cambodia
| | - Elisabeth Delarocque-Astagneau
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases Unit (B2PHI), Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Université Paris-Saclay, 25 rue du Docteur Roux, Paris, France.,Assistance Publique/Hôpitaux de Paris, Raymond-Poincaré Hospital, 104 Boulevard Raymond Poincaré, Garches, France
| | - Navin Sreng
- Laboratory of Environment and Food Safety, Institut Pasteur du Cambodge, 5 Preah Monivong Blvd, Phnom Penh, Cambodia
| | - Simon Le Hello
- Enteric Bacterial Pathogens Unit, Institut Pasteur, 25 rue du Docteur Roux, Paris, France
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Coyne L, Patrick I, Arief R, Benigno C, Kalpravidh W, McGrane J, Schoonman L, Harja Sukarno A, Rushton J. The Costs, Benefits and Human Behaviours for Antimicrobial Use in Small Commercial Broiler Chicken Systems in Indonesia. Antibiotics (Basel) 2020; 9:antibiotics9040154. [PMID: 32244693 PMCID: PMC7235826 DOI: 10.3390/antibiotics9040154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 01/20/2023] Open
Abstract
There are growing concerns over the threat to human health from the unregulated use of antimicrobials in livestock. Broiler production is of great economic and social importance in Indonesia. This study used a structured questionnaire approach to explore the human behaviours and economic drivers associated with antimicrobial use in small commercial broiler systems in Indonesia (n = 509). The study showed that antimicrobial use was high with farmers easily able to access antimicrobials through local animal medicine, however, it was difficult for farmers to access veterinary advice on responsible antimicrobial use. The most significant finding was that the relative cost of antimicrobials was low, and farmers observed improvements in productivity rates from routine antimicrobial administration. However, farmers seldom kept detailed records on farm productivity or economic costs; this is a hurdle to undertaking a more detailed economic analysis of antimicrobial use. There is a need for further research on the cost-effectiveness of alternative methods of preventing disease and ensuring that feasible alternatives are easily available. Farm-level economics and securing the food supply chain need to be central to any future policy interventions to reduce antimicrobial use in broiler systems in Indonesia and this observation is relevant at a regional and global level.
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Affiliation(s)
- Lucy Coyne
- Epidemiology and Population Health, University of Liverpool, Neston CH64 7TE, UK; (I.P.); (J.R.)
- Correspondence: ; Tel.: +44-1517946036
| | - Ian Patrick
- Epidemiology and Population Health, University of Liverpool, Neston CH64 7TE, UK; (I.P.); (J.R.)
- Agricultural and Resource Economic Consulting Services, Armidale, NSW 2350, Australia
| | - Riana Arief
- Center for Indonesian Veterinary Analytical Studies, Bogor 16310, Indonesia;
| | - Carolyn Benigno
- Regional Food and Agriculture Organization (FAO) Office for Asia and the Pacific, Bangkok 10200, Thailand; (C.B.); (W.K.)
| | - Wantanee Kalpravidh
- Regional Food and Agriculture Organization (FAO) Office for Asia and the Pacific, Bangkok 10200, Thailand; (C.B.); (W.K.)
| | - James McGrane
- Food and Agriculture Organization (FAO) Country Office for Indonesia, Jakarta 10250, Indonesia; (J.M.); (L.S.); (A.H.S.)
| | - Luuk Schoonman
- Food and Agriculture Organization (FAO) Country Office for Indonesia, Jakarta 10250, Indonesia; (J.M.); (L.S.); (A.H.S.)
| | - Ady Harja Sukarno
- Food and Agriculture Organization (FAO) Country Office for Indonesia, Jakarta 10250, Indonesia; (J.M.); (L.S.); (A.H.S.)
| | - Jonathan Rushton
- Epidemiology and Population Health, University of Liverpool, Neston CH64 7TE, UK; (I.P.); (J.R.)
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Masud AA, Rousham EK, Islam MA, Alam MU, Rahman M, Mamun AA, Sarker S, Asaduzzaman M, Unicomb L. Drivers of Antibiotic Use in Poultry Production in Bangladesh: Dependencies and Dynamics of a Patron-Client Relationship. Front Vet Sci 2020. [PMID: 32185184 DOI: 10.3389/fvets.2020.00078/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which provides the social and information network for small-scale farmers. Conclusion: Social capital theory can be applied to the patron-client relationship observed among poultry farmers and dealers in Bangladesh to identify influences on decision making and antibiotic use. Within unregulated food production systems, strategies to promote the prudent use of antibiotics should target commercial feed producers and livestock pharmaceutical manufacturers as a first step in developing a sustainable poultry value chain.
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Affiliation(s)
- Abdullah Al Masud
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Emily Kate Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Mohammad Aminul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States
| | - Mahbub-Ul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Supta Sarker
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Muhammad Asaduzzaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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32
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Masud AA, Rousham EK, Islam MA, Alam MU, Rahman M, Mamun AA, Sarker S, Asaduzzaman M, Unicomb L. Drivers of Antibiotic Use in Poultry Production in Bangladesh: Dependencies and Dynamics of a Patron-Client Relationship. Front Vet Sci 2020; 7:78. [PMID: 32185184 PMCID: PMC7058630 DOI: 10.3389/fvets.2020.00078] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/30/2020] [Indexed: 01/21/2023] Open
Abstract
Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which provides the social and information network for small-scale farmers. Conclusion: Social capital theory can be applied to the patron-client relationship observed among poultry farmers and dealers in Bangladesh to identify influences on decision making and antibiotic use. Within unregulated food production systems, strategies to promote the prudent use of antibiotics should target commercial feed producers and livestock pharmaceutical manufacturers as a first step in developing a sustainable poultry value chain.
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Affiliation(s)
- Abdullah Al Masud
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Emily Kate Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Mohammad Aminul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States
| | - Mahbub-Ul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Supta Sarker
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Muhammad Asaduzzaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Dyar OJ, Zhang T, Peng Y, Sun M, Sun C, Yin J, Ding L, Sun C, Wang Y, Sun Q, Greko C, Stålsby Lundborg C. Knowledge, attitudes and practices relating to antibiotic use and antibiotic resistance among backyard pig farmers in rural Shandong province, China. Prev Vet Med 2020; 175:104858. [PMID: 31835205 DOI: 10.1016/j.prevetmed.2019.104858] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 12/13/2022]
Abstract
China is among the world's largest consumers of antibiotics for livestock, and the demand for meat protein continues to rise. Pig production takes place at a range of facilities, including backyard pig farms. The aim of this study was to describe the knowledge, attitudes and practices of backyard pig farmers concerning antibiotic use and resistance, and to observe household storage of antibiotics for use in pigs. We conducted a cross-sectional questionnaire survey among 271 rural residents with backyard pig farms in 12 villages in one town in Shandong province. The median number of pigs per backyard farm was 14, and 82 % (222/271) of participants reported not having had any training about raising pigs. Eighteen percent of participants (48/271) reported always or often adding antibiotics to feed to keep pigs healthy and prevent diseases, and a third (88/271) of participants believed that pigs should be given antibiotics when they stop eating. Thirty percent (82/271) reported having bought antibiotics in the previous year without having first spoken with a veterinarian. Antibiotics accounted for over half of all medicines stored (55 %, 197/358), and were observed in 31 % of all households (83/271). Less than half of participants (45 %, 37/83) from households in which antibiotics for pig use were found knew that they were storing antibiotics. The most common class of antibiotics stored for use in pigs was (Q)J01C beta-lactam antibiotics, penicillins (19 %, 37/197), followed by (Q)J01F macrolides, lincosamides and streptogramins (14 %, 28/197), and (Q)J01M quinolones (12 %, 25/197). These results provide important insights into how backyard pig farmers are using antibiotics in rural China and suggest potential targets for interventions to reduce unnecessary and inappropriate use.
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Affiliation(s)
- Oliver J Dyar
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tianyang Zhang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yang Peng
- Zhucheng Center for Disease Prevention and Control, Zhucheng City, Shandong, China
| | - Mingli Sun
- Zhucheng Center for Disease Prevention and Control, Zhucheng City, Shandong, China
| | - Chengyun Sun
- Zhucheng Center for Disease Prevention and Control, Zhucheng City, Shandong, China
| | - Jia Yin
- School of Health Care Management, Shandong University, Jinan, Shandong, China; Key Laboratory of Health Economics and Policy Research, NHC, Shandong University, Jinan, Shandong, China; Center for Health Management and Policy Research, Shandong University, Jinan, Shandong, China
| | - Lilu Ding
- School of Health Care Management, Shandong University, Jinan, Shandong, China; Key Laboratory of Health Economics and Policy Research, NHC, Shandong University, Jinan, Shandong, China; Center for Health Management and Policy Research, Shandong University, Jinan, Shandong, China; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Chengtao Sun
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Yang Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Qiang Sun
- School of Health Care Management, Shandong University, Jinan, Shandong, China; Key Laboratory of Health Economics and Policy Research, NHC, Shandong University, Jinan, Shandong, China; Center for Health Management and Policy Research, Shandong University, Jinan, Shandong, China.
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34
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Xu J, Sangthong R, McNeil E, Tang R, Chongsuvivatwong V. Antibiotic use in chicken farms in northwestern China. Antimicrob Resist Infect Control 2020; 9:10. [PMID: 31921416 PMCID: PMC6947973 DOI: 10.1186/s13756-019-0672-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/23/2019] [Indexed: 01/21/2023] Open
Abstract
Background Misuse of antibiotics in food animals contributes to an increase of antibiotic resistant bacteria transmitting to humans. China is the largest producer and user of antibiotics in the world, of which animals share more than half of the total consumption. This study aimed to explore Chinese farmer’s practice of antibiotic use and the factors associated with their use. Methods In this cross-sectional survey, we interviewed farmers from 88 chicken farms in northwestern China. We defined two kinds of misuse: 1) using antibiotics in the Chinese prohibited list, and 2) using antibiotics within the recommended withdrawal period. Factor analysis was used to select farmers’ knowledge variables and multinomial logistic regression was used to determine factors associated with antibiotic misuse. Results All the participating farmers used antibiotics on their farms. Amoxicillin was the most common antibiotic used (76.5%), followed by norfloxacin, ofloxacin, ceftriaxone and oxytetracycline. 75% of farmers used antibiotics in the prohibited list while 14.8% continued to use antibiotics during the withdrawal period. Hierarchical cluster analysis revealed three patterns of antibiotic use: 1) excessive use of non-prohibited and prohibited antibiotics or an excessive user, 2) low use of a few types of non-prohibited and moderate use of prohibited antibiotics or a low user, 3) multiple use of a variety (≥ 7 types) of non-prohibited and prohibited antibiotics or a moderate user. Farmers from medium size, family-based farms, those with a low education level and low income were more likely to misuse antibiotics. Prior formal agricultural training was associated with reducing multiple types of antibiotic use. There was a huge gap between policy and reinforcement causing antibiotic misuse in the study community. Conclusion Antibiotics are commonly used on chicken farms; misuse of antibiotics is high; improvement in farm sanitation, education on antibiotic use for farmers and veterinarians/pharmacists and enforcement of the regulations may reduce antibiotic use on chicken farms in China.
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Affiliation(s)
- Jingyi Xu
- 1Public Health and Management Faculty, Ningxia Medical University, Yinchuan, Ningxia China.,2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Rassamee Sangthong
- 2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Edward McNeil
- 2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Rong Tang
- 1Public Health and Management Faculty, Ningxia Medical University, Yinchuan, Ningxia China
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35
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Abstract
While the description of resistance to quinolones is almost as old as these antimicrobial agents themselves, transferable mechanisms of quinolone resistance (TMQR) remained absent from the scenario for more than 36 years, appearing first as sporadic events and afterward as epidemics. In 1998, the first TMQR was soundly described, that is, QnrA. The presence of QnrA was almost anecdotal for years, but in the middle of the first decade of the 21st century, there was an explosion of TMQR descriptions, which definitively changed the epidemiology of quinolone resistance. Currently, 3 different clinically relevant mechanisms of quinolone resistance are encoded within mobile elements: (i) target protection, which is mediated by 7 different families of Qnr (QnrA, QnrB, QnrC, QnrD, QnrE, QnrS, and QnrVC), which overall account for more than 100 recognized alleles; (ii) antibiotic efflux, which is mediated by 2 main transferable efflux pumps (QepA and OqxAB), which together account for more than 30 alleles, and a series of other efflux pumps (e.g., QacBIII), which at present have been sporadically described; and (iii) antibiotic modification, which is mediated by the enzymes AAC(6')Ib-cr, from which different alleles have been claimed, as well as CrpP, a newly described phosphorylase.
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36
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Atterby C, Osbjer K, Tepper V, Rajala E, Hernandez J, Seng S, Holl D, Bonnedahl J, Börjesson S, Magnusson U, Järhult JD. Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of bla OXA-48 in humans. Zoonoses Public Health 2019; 66:603-617. [PMID: 31264805 PMCID: PMC6852310 DOI: 10.1111/zph.12612] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 01/19/2023]
Abstract
Objectives This study investigates the frequency and characteristics of carbapenemase‐producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended‐spectrum cephalosporinase‐producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified. Methods Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes. Results CPE/K isolates harbouring blaOXA‐48 were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: blaCTX‐M‐15, blaCTX‐M‐14, blaCTX‐M‐27, blaCTX‐M‐55, blaSHV‐2, blaSHV‐12, blaSHV‐28; AmpC genes: blaCMY‐2, blaCMY‐42,blaDHA‐1; and colistin resistance genes: mcr‐1‐like and mcr‐3‐like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K. Conclusions Faecal carriage of E. coli and K. pneumoniae harbouring extended‐spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.
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Affiliation(s)
- Clara Atterby
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Kristina Osbjer
- Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden.,Food and Agriculture Organization of the United Nations, Phnom Penh, Cambodia
| | - Viktoria Tepper
- Institute of Environmental Engineering, ETH Zürich, Switzerland
| | - Elisabeth Rajala
- Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | - Jorge Hernandez
- Center for Ecology and Evolution in Microbial Model Systems Linnaeus University, Kalmar, Sweden.,Department of Infectious Diseases, Kalmar County Council, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Diagnostic Centrum, Clinic Microbiologic Laboratory, Kalmar County Hospital, Kalmar, Sweden
| | - Sokerya Seng
- Food and Agriculture Organization of the United Nations, Phnom Penh, Cambodia
| | - Davun Holl
- General Directorate of Animal Health and Production, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | - Jonas Bonnedahl
- Center for Ecology and Evolution in Microbial Model Systems Linnaeus University, Kalmar, Sweden.,Department of Infectious Diseases, Kalmar County Council, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Stefan Börjesson
- Department of Animal Health and Antimicrobial strategies, National Veterinary Institute (SVA), Uppsala, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Ulf Magnusson
- Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | - Josef D Järhult
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Rousham EK, Unicomb L, Islam MA. Human, animal and environmental contributors to antibiotic resistance in low-resource settings: integrating behavioural, epidemiological and One Health approaches. Proc Biol Sci 2019; 285:rspb.2018.0332. [PMID: 29643217 DOI: 10.1098/rspb.2018.0332] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/20/2018] [Indexed: 01/04/2023] Open
Abstract
Antibiotic resistance (ABR) is recognized as a One Health challenge because of the rapid emergence and dissemination of resistant bacteria and genes among humans, animals and the environment on a global scale. However, there is a paucity of research assessing ABR contemporaneously in humans, animals and the environment in low-resource settings. This critical review seeks to identify the extent of One Health research on ABR in low- and middle-income countries (LMICs). Existing research has highlighted hotspots for environmental contamination; food-animal production systems that are likely to harbour reservoirs or promote transmission of ABR as well as high and increasing human rates of colonization with ABR commensal bacteria such as Escherichia coli However, very few studies have integrated all three components of the One Health spectrum to understand the dynamics of transmission and the prevalence of community-acquired resistance in humans and animals. Microbiological, epidemiological and social science research is needed at community and population levels across the One Health spectrum in order to fill the large gaps in knowledge of ABR in low-resource settings.
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Affiliation(s)
- Emily K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Leanne Unicomb
- Environmental Intervention Unit, Infectious Disease Division, International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Mohammad Aminul Islam
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
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Patterns of antibiotic use in global pig production: A systematic review. Vet Anim Sci 2019; 7:100058. [PMID: 32734079 PMCID: PMC7386699 DOI: 10.1016/j.vas.2019.100058] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/31/2019] [Accepted: 04/05/2019] [Indexed: 11/23/2022] Open
Abstract
Many classes of antibiotic used for humans are also used in food animals, including the highest priority of the critically important antimicrobials for human medicine in the World Health Organisation's list. Penicillins and Tetracyclines classes were the most commonly used antibiotics in many countries. Improve understanding of the use of antibiotics and factors influencing antibiotic use will help promoting prudent use of antimicrobials in livestock.
This review assesses the evidence for patterns of antibiotic use in pig on the basis of papers published in peer-reviewed journals in English between 2000 and 2017. Thirty-six articles were identified and reviewed, of which more than 85% of studies were conducted in Europe and North America. Penicillins and Tetracyclines groups were the most commonly used antibiotics in many countries. Oral medication in suckling and post-weaning periods were the most common applications of antibiotic administration in pig production. Antibiotic use is driven by age-specific diseases and the common pathogens causing these conditions where epidemiological profiles varied greatly across countries. In addition, the type and size of farm were associated with antibiotic use with finisher and larger farms using more antibiotics than farrow-to-finish and smaller farms. There is variation in the use of the highest priority critically important antimicrobials in humans across studies. However, this review indicates that they are still commonly used in pig production, for treatment and prevention of infection. This evidence calls for global efforts on the prudent use of antibiotics in response to the emergence of antimicrobial resistance (AMR) in the agricultural sector.
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39
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Detection of mcr-Mediated Colistin Resistance in Escherichia coli Isolates from Pigs in Small-Scale Farms in Cambodia. Antimicrob Agents Chemother 2019; 63:AAC.02241-18. [PMID: 30642933 DOI: 10.1128/aac.02241-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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40
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Ström G, Boqvist S, Albihn A, Fernström LL, Andersson Djurfeldt A, Sokerya S, Sothyra T, Magnusson U. Antimicrobials in small-scale urban pig farming in a lower middle-income country - arbitrary use and high resistance levels. Antimicrob Resist Infect Control 2018. [PMID: 29541447 PMCID: PMC5842516 DOI: 10.1186/s13756-018-0328-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background Administration of antimicrobials to food-producing animals is regarded as a major contributor to the overall emergence of resistance in bacteria worldwide. However, few data are available on global antimicrobial use and resistance (AMR) in livestock, especially from low- and middle-income countries. Methods We conducted a structured survey of 91 small-scale pig farms in the urban and peri-urban areas of Phnom Penh, Cambodia, to assess the farmers' knowledge, attitudes and practices related to antimicrobial use in their pig production. Commensal Escherichia coli was isolated from three healthy pigs from each farm (n = 261) and susceptibility testing was performed against 14 antimicrobials, using broth microdilution. Univariable logistic regression and generalized linear mixed models were used to investigate potential associations between farm characteristics, management factors and resistance to different types of antimicrobials. Results We found a widespread and arbitrary use of antimicrobials, often based on the farmer's own judgment. Around 66% of the farmers reported frequently self-adjusting treatment duration and dosage, and 45% had not heard about the term 'antimicrobial resistance'. The antimicrobials most commonly mentioned or kept by the farmers were amoxicillin, tylosin, gentamicin and colistin. Around 37% used a feed concentrate that contained antimicrobials, while antimicrobials for humans were used as a last-line treatment by 10% of the farmers. Commensal E. coli exhibited high prevalence of resistance to several antimicrobials considered to be of critical importance for human medicine, including ampicillin, ciprofloxacin and colistin, and multidrug-resistance was found in 79% of the samples. Higher prevalence of resistance was observed on farms that administered prophylactic antimicrobials and on farms that treated the entire group or herd in the event of disease. Conclusion The widespread and arbitrary use of antimicrobials in pig farming in Cambodia is highly worrisome. Overall, farmers had a low awareness of the risks and consequences related to antimicrobial use and AMR. The results presented in this study confirm the hypothesis that non-rational use of antimicrobials results in higher prevalence of AMR and highlight the need for professional animal health systems that involve medically rational use of antimicrobials in emerging economies such as Cambodia.
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Affiliation(s)
- G Ström
- 1Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S Boqvist
- 2Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A Albihn
- 2Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden.,3Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden
| | - L-L Fernström
- 2Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - S Sokerya
- Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia
| | - T Sothyra
- National Animal Health and Production Research Institute, Phnom Penh, Cambodia
| | - U Magnusson
- 1Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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41
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Tangcharoensathien V, Chanvatik S, Sommanustweechai A. Complex determinants of inappropriate use of antibiotics. Bull World Health Organ 2018; 96:141-144. [PMID: 29403119 PMCID: PMC5791781 DOI: 10.2471/blt.17.199687] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/22/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Sunicha Chanvatik
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
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