Patterns of Antibiotic Sales by Drug Stores and Usage in Poultry Farms: A Questionnaire-Based Survey in Maiduguri, Northeastern Nigeria

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

Background

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

Methods

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

Results

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

Conclusions

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

Antimicrobial use in cattle and poultry production on occurrence of multidrug resistant Escherichia coli. A systematic review with focus on sub-Saharan Africa

Antimicrobial use in livestock production has been linked to antimicrobial resistance (AMR) worldwide; however, optimization of their use has been considered an important strategy in dealing with it. The aims of this study were as follows: (a) to assess the literature on antimicrobial usage (practices, frequency, class, type) in cattle and poultry production with regard to resistance in Escherichia coli (E. coli) including multidrug resistance (MDR) (b) summarize evidence for quantitative (volumes of active antimicrobial ingredients) and quality (identify and quantify active ingredient) and (c) to identify data gaps. Peer reviewed literature search was conducted by querying two online databases: PubMed and Google scholar from November 15, 2018 to February 2019. The inclusion criteria for eligibility were articles: published in English between 2008 and 2018, including poultry (chicken) or cattle or both, E. coli bacteria of choice, antimicrobial use on farms, quantitative data and quality of antimicrobial used. Microsoft Excel was used for data extraction and Rayyan software for eligibility studies. The search retrieved 1,446 probable articles including those from the reference list of significant papers, of which twenty-four articles remained on full text review with more than a third of the studies being conducted in Nigeria. Farm surveys and antimicrobial sales were identified as the main sources of data and the mean quantities of antimicrobials based on sales data were 23,234, 41,280.87, and 1,538,443 kg of the active ingredient in Nigeria, Zambia and South Africa, respectively. One study from Cameroon determined the quantities of active ingredients based on dose metrics while another study still from Cameroon mentioned the quality of antimicrobials. Tetracyclines, beta-lactams/aminoglycosides and fluoroquinolones were the most common classes of antimicrobials (antibiotics) used. Our review reveals a dearth of information in Sub- Saharan Africa on the quantity and quality of veterinary drugs and yet they play a role in the overall picture of antimicrobial resistance. This finding gives an opportunity in the area of focus for future research as far as resistance and multidrug resistance are concerned in food producing animals.

Multi-Drug Resistant Escherichia coli, Biosecurity and Anti-Microbial Use in Live Bird Markets, Abeokuta, Nigeria

Live bird markets (LBM) remain a critical link from farm to fork in the poultry value chain, which oftentimes promotes indiscriminate antimicrobial use (AMU) and resistance (AMR). In this study, we assessed biosecurity practices, AMU, and associated these with multidrug resistant (MDR) E. coli in LBMs in Abeokuta, Ogun State. A cross-sectional survey among live bird sellers (LBS) in eight LBMs was conducted using a semi-structured questionnaire. Also, cloacal samples (n = 200) were randomly collected and pooled for bacteriological detection of MDR E. coli in live chickens of consenting LBS. Susceptibility to 14 antimicrobials belonging to 6 different classes was determined using the disk diffusion method. Biosecurity level and AMU were generally low. LBS less than 46 years were 6.8- fold more likely to fall within the poor biosecurity level (Crudes odds ratio = 6.8; 95% CI; 1.20-38.56; p = 0.03) than others. An informal or primary school education increased the odds of having a poor practice of AMU by 15.1 folds (Crudes odds ratio = 15.1; 95% CI; 2.73-84.18; p = 0.002) than those with secondary or tertiary. The prevalence of E. coli and MDR E. coli at the LBM level were 80% and 56.3%, respectively. Extremely high resistance rates were observed for ceftazidime (96.9%) and imipenem (90.6%). The odds of MDR E. coli increased eight-fold in poultry kept by LBS who use AMs as prophylaxis. This current data could be useful for the development of targeted behavioral risk communication and mitigation strategies for AMR to impede the potential horizontal transfer of AMR genes to humans through animal-sourced food.

A survey of the usage (frequency and pattern) of antibiotics at the University of Maiduguri Veterinary Teaching Hospital, Maiduguri, Borno State, Nigeria

Background and Aim:

Veterinary antibiotics are widely used to treat bacterial diseases in various species of animals. However, despite the importance of these chemotherapeutic agents, their indiscriminate or extensive use can pose dangers to the animals or humans that consume edible tissues from animals contaminated with antibiotic residues. Therefore, concerns regarding their appropriate and judicious use in animals are of public health significance. This is because of the tendencies of developing resistance to targeted microbes and the ability of the parent compound or its metabolites to persist as residues in the animal tissues. This study aimed to determine the frequency and pattern of antibiotic usage and ascertain the level of awareness of clinicians on the judicious use of antibiotics at the University of Maiduguri Veterinary Teaching Hospital, Maiduguri, Borno State, Nigeria.

Materials and Methods:

Data related to the administration of antibiotics in all species of animals presented for treatment from January 2009 to December 2018 were obtained from the hospital archives, with permission from the office of the hospital directorate. The diseases, hospital units, antibiotics used, and years were parameters that were recorded for each case. Furthermore, 47 questionnaires were administered to clinicians who render services to the hospital.

Results:

A total of 63.9% of all cases brought to the hospital within the 10 years under study were infectious, and as such, were treated with antibiotics. The highest recorded use of antibiotics was observed in the poultry unit (38.4%), followed by the large animal unit (24.1%), with the lowest used recorded in the ambulatory unit (9.3%). Furthermore, regarding the antibiotics used, oxytetracycline had the highest occurrence (55%), followed by penicillin-streptomycin combination (12.2%), with the lowest being metronidazole (0.30%). The highest number of cases treated with antibiotics was recorded in 2018 (22.5%), and the lowest was recorded in 2014 (1.3%). Regarding the questionnaire administered to the clinicians, 78.7% of the respondents preferred oxytetracycline as their drug of choice, whereas only 2.1%, 4.3%, 2.1%, and 4.3% preferred amoxicillin, penicillin, streptomycin, and penicillin-streptomycin, respectively. Moreover, 65.9% of the respondents used a particular antibiotic because of its availability at the hospital, 8.5% because of cost, and 27.7% because of clinician preference. Furthermore, 74.5% of the clinicians offered palliative intervention while awaiting laboratory reports, whereas 8.5% treated the animals without requesting laboratory analyses.

Conclusion:

In this study, oxytetracycline was found to be the most used antibiotic for treating infectious diseases at the hospital because of its availability. The observed pattern appeared in the following order of frequency: Oxytetracycline, penicillin-streptomycin combination, neomycin, erythromycin, amoxicillin, tylosin, streptomycin, and gentamicin with metronidazole being the least frequent. There might also be antibiotic resistance, which requires a change to another antibiotic because of the lack of response to the initial antibiotic. Non-judicious antibiotic use can also have a negative impact on public health because of the development of multidrug-resistant “superbugs” and the problem of drug residue.

Biosecurity and Antimicrobial Use Practices in Live Bird Markets within Abeokuta Metropolis, Southwest, Nigeria: A Preliminary Survey

The development of an antimicrobial stewardship plan (AMSP) for live bird sellers (LBS) requires an understanding of the current biosecurity status, antimicrobial use (AMU) and the practices involved in live bird selling (e.g., drivers, sellers, etc.) which is a direct source of poultry meat for human consumption. Seven Live Bird Markets (LBMs) within Abeokuta, Ogun State were surveyed using a semi-structured questionnaire. Data on LBMs characteristics, LBS demographics, biosecurity, and AMU practices, awareness on Antimicrobial Resistance (AMR), as well as preferred channels of information on antimicrobial stewardship were gathered. A total of 40 consenting LBS with 82.5% female and 17.5% male participants were included in the study. The participants’ mean age was 45.3 years (SD±11.9, range: 23-70 years). Laying hens, broilers, and cockerels were the main poultry types sold by LBS. Antimicrobials (AMs) were used for growth promotion (57.5%), therapeutic (40.0%), and prophylactic (2.5%) purposes. Tetracycline, metronidazole, and chloramphenicol were the most frequently used AMs. The majority of the participants (90.0%) have treated birds based on their empirical experience, with little or no inputs from veterinarians. Biosecurity and AMU practices were generally low (54.0% and 34.0%, respectively). The contact with veterinarians was associated with satisfactory biosecurity practices (p=0.049). No significant factors were found to be linked with AMU. This study has provided recent evidence-based data on practices in poultry management among LBS in Abeokuta, Ogun state. The findings would be useful for policy decisions and the development of AMSP on prudent AMU among LBS.

Risk Perceptions of Antibiotic Usage and Resistance: A Cross-Sectional Survey of Poultry Farmers in Kwara State, Nigeria

Overwhelming empirical evidence has highlighted the contribution of indiscriminate antibiotic usage (ABU) in food animals to the overall burden of antibiotic resistance (ABR) in humans, thus making antibiotic use the main selective pressure driving antibiotic resistance. The social and behavioral perspective on antibiotic use and resistance in poultry is limited. Our study therefore aimed at obtaining information on antibiotic usage, awareness of ABR, and the attitude and perceptions towards prudent antibiotic usage and ABR. A cross-sectional survey using a structured questionnaire was conducted in 125 poultry farms in Kwara state in December 2019. Most farmers (69.6%, n = 87/125) were aware of ABR and had satisfactory knowledge about ABR with a mean knowledge score of 3.2 ± 1.5. Age (older farmers; OR: 1.1, 95% CI: 1.0, 1.2) and gender (male respondents, OR: 8.5, 95% CI: 3.0, 23.9; p < 0.01) were more likely to have satisfactory knowledge of ABR. Tertiary education was significantly associated with ABR awareness (OR: 4.7; 95% CI: 0.1, 0.7; p = 0.007) and the ABR knowledge level (OR: 7.8; 95% CI: 3.3, 18.7; p < 0.01). Higher flock size was significantly associated with a satisfactory knowledge of ABR (OR: 9.5; 95% CI: 3.8, 23.6; p < 0.01). Most of the poultry farmers (68%) had positive attitudes towards prudent antibiotic use with a mean score of 2.7 ± 0.9. On the contrary, only 32.8% of poultry farmers had a desirable perception of ABR with a mean perception score of 4.9 ± 1.1. The ABR knowledge level was significantly associated with the perceptions of farmers (p < 0.05) but not their attitudes toward ABU and ABR (p = 0.083). There was evidence of unprescribed use of antibiotics in poultry and a failure to observe antibiotic withdrawal periods. These constitute a risk of exposure to unacceptable levels of drug residues from poultry products and an increased risk of ABR. Improving education and communication on antibiotic stewardship programs are crucial to prevent the looming antibiotic threat.

Antimicrobial Usage in Animal Production: A Review of the Literature with a Focus on Low- and Middle-Income Countries

Antimicrobial use (AMU) in animal production is a key contributor to antimicrobial resistance (AMR) worldwide. As consumption of animal protein and associated animal production is forecast to increase markedly over coming years in low- and middle-income countries (LMICs), accurate monitoring of AMU has become imperative. We summarized data from 89 scientific studies reporting AMU data in animal production published in English since 1998, identified through the 'ISI Web of Knowledge' search engine. The aims were as follows: (a) to describe methodologies and metrics used to quantify AMU; (b) to summarize qualitative (on-farm prevalence of use) and quantitative (amounts of antimicrobial active principle) data, in order to identify food animal species at the highest risk of AMU; and (c) to highlight data gaps from LMICs. Only 17/89 (19.1%) studies were conducted in LMICs. Sixty (67.3%) reported quantitative data use, with 'daily doses per animal-time' being the most common metric. AMU was greatest in chickens (138 doses/1000 animal-days [inter quartile range (IQR) 91.1⁻438.3]), followed by swine (40.2 [IQR 8.5⁻120.4]), and dairy cattle (10.0 [IQR 5.5⁻13.6]). However, per kg of meat produced, AMU was highest in swine, followed by chickens and cattle. Our review highlights a large deficit of data from LMICs, and provides a reference for comparison with further surveillance and research initiatives aiming to reduce AMU in animal production globally.

Antimicrobials usage assessments in commercial poultry and local birds in North-central Nigeria: Associated pathways and factors for resistance emergence and spread

The World Health Organization's Global Action Plan on antimicrobial resistance (AMR) recommended monitoring of antimicrobial use (AMU) through surveillance and research to help mitigate AMR. This survey was aimed at assessing poultry owners' knowledge/awareness and practices regarding AMU, identified pathways for AMR emergence and spread in small-scale commercial poultry farms and free-range local bird flocks in North-central Nigeria. An interview questionnaire-based cross-sectional study was conducted on commercial poultry farmers and local bird flock keepers in 2017. Also, a Traffic Light system model was used assess risk status of AMU in farms and flocks. All the 384 recruited poultry farmers/keepers participated in the survey. Female respondents were the majority (67.2%). Low proportion of poultry farmers (46.4%, 89/192) and very low proportion of bird keepers (6.8%, 13/192) knew antimicrobials misuse to be when administered under dose. About 48% (93/192) of farmers and 93% (179/192) of keepers arbitrary determined antimicrobial dosage before administration. Respondents used antimicrobials for therapeutic, prophylactic, and growth promotion in birds. Also, participants significantly identified contaminated poultry products, infected poultry or contaminated formites, and discharged contaminated faeces into environment as pathways for transmission of antimicrobial resistant pathogens to humans. Traffic Light system model revealed 88.5% of small-scale commercial poultry farms to frequently used antimicrobials without veterinarians' consultations thereby attaining Class 1 (Red risk) status. The model showed that 92.1% of free-range local bird flocks rarely used antimicrobials thereby attaining Class 3 (Green risk) status. Improper antimicrobial dosage in poultry (OR: 7.23; 95% CI: 2.74, 19.21), non-enforcement of AMU regulating laws in poultry (OR: 4.12; 95% CI: 2.39, 7.10), weak financial status of poultry owners (OR: 3.00; 95% CI: 2.39, 7.10), and management system (OR: 8.94; 95% CI: 5.62, 14.24) were more likely to satisfactorily influenced antimicrobials misuse in poultry farms and local bird flocks. The survey revealed low knowledge level regarding AMU in the poultry. Antimicrobials were rarely used in local bird flocks, making them likely organic and safe from AMR. It is imperative to educate farmers on judicious AMU, enforce existing veterinary legislation on antimicrobials, establish antimicrobials surveillance system, and sensitize farmers on adequate biosecurity measures and routine vaccination of farms, so as to assure food safety, food security, and public health.