Exploring the epidemiology of mcr genes, genetic context and plasmids in Enterobacteriaceae originating from pigs and humans on farms in Thailand.

OBJECTIVES: In veterinary medicine, colistin has been widely used as therapeutic and prophylactic agent, and for growth promotion. However, colistin has been re-introduced into treatment of human MDR bacterial infections. We assessed the characteristics and spread of plasmid-borne colistin resistance among healthy pigs, workers with animal-contact and their household members in Thailand. METHODS: WGS and MIC data of 146 mcr-positive isolates from a cross-sectional One Health study were analysed. Long-read sequencing and conjugation were performed for selected isolates. RESULTS: mcr-carrying isolates were detected in 38% of pooled-pig samples and 16% of human faecal samples. Of 143 Escherichia coli and three Escherichia fergusonii, mcr-1, mcr-3, and mcr-9 variants were identified in 96 (65.8%), 61 (41.8%) and one (0.7%) isolate, respectively. Twelve E. coli co-harboured two mcr variants (mcr-1 and mcr-3). Clonal transmission was detected in five out of 164 farms. mcr-1 was mostly harboured by epidemic IncX4 and IncHI1 plasmids (89.9%). Conversely, mcr-3 was harboured by a range of different plasmids. Comparative plasmid studies suggested IncP and IncFII plasmids as possible endemic mcr-3 plasmids in Asian countries. Moreover, mcr-3 was associated with different mobile genetic elements including TnAs2, ISKpn40 and IS26/15DI. Detected genetic signatures (DRs) indicated recent mcr-3 transpositions, underlining the mobilizable nature of the mcr-3 cassette. CONCLUSIONS: The epidemiology of mcr and the possible evolution of successful plasmids and transposition modules should be carefully monitored. Of special concern is the growing number of different horizontal gene transferring pathways encompassing various transposable modules the mcr genes can be shared between bacteria.

Herd health and reproductive management associated with lamb weight gain and mortality in sub-Saharan drylands-a case from Ethiopia.

Sheep are important for food and livelihood security in sub-Saharan Africa, and maximizing lamb weight gain while minimizing mortality is essential to improve production. Using the Menz sheep breeding villages of Amhara region in Ethiopia as a case study, the weight gain and mortality rate of 208 lambs were monitored during their first 5 months of life. The study was conducted in intervention and control villages, where the intervention villages were part of community-based breeding programmes and had participated in various projects aiming to improve sheep production and management. Multivariable linear regression analysis was conducted to detect associations between weight gain from birth to 1 month, and birth to 5 months, and different lamb and ewe characteristics, farmer education, application of management routines, and presence of village level sheep management interventions. In general, lambs from intervention villages, without certain signs of diseases, whose mothers were 2 years or older, had a body condition score of more than 2 on a 5-point scale, and who originated from flocks where disease prevention strategies had been implemented, had gained more weight. Overall lamb mortality was 6.8% with most deaths occurring before 1 month of age. This study highlights that health interventions in ewes improve lamb survival and weight gain and that the care of lambs during the first month of life is crucial for overall herd productivity.

Genome-associations of extended-spectrum ß-lactamase producing (ESBL) or AmpC producing E. coli in small and medium pig farms from Khon Kaen province, Thailand.

Thailand is undergoing rapid intensification of livestock production where small subsistence farms and medium sized commercial farms coexist. In medium farms, antimicrobials are prescribed by a veterinarian, whereas in small farms antimicrobial use remains largely unsupervised. The impact of these differences as well as other farming practices on the emergence and composition of antimicrobial resistance genes (ARGs) remains largely unknown. We analyzed 363 genomes of extended-spectrum ß-lactamase producing (ESBL) and/or AmpC producing Escherichia coli recovered from humans and pigs at small and medium farms from the Khon Kaen province, Thailand. We tested for genome-wide associations to identify links between ARGs, host, and farm size. Pig isolates from small farms were associated with mcr and qnr genes conferring resistance to colistin and fluoroquinolones, respectively. In contrast, pig isolates from medium farms were associated with ARGs conferring resistance to drugs commonly used on medium farms (i.e., streptomycin). ESBL plasmids from small farms co-carried ARGs conferring resistance to critically important antimicrobials more frequently compared to plasmid from medium farms. Frequent ARG combinations included blaCTX-M-55 + qnrS1 (29.8% vs 17.5% in small and medium farms, respectively), blaCTX-M-55 + qnrS1 + mcr-3.19 (5% vs 0%), blaCTX-M-14 + qnrS1 (9.3% vs 6.2%), and blaCTX-M-14 + qnrS1 + mcr-1.1 (3.1% vs 0%). The co-location on plasmids of ARGs conferring resistance to critically important antimicrobials as defined by the World Health Organization is concerning, and actions to curb their spread are urgently needed. Legislation on limiting antimicrobial sales and initiatives to better inform farmers and veterinarians on appropriate antimicrobial usage and farm biosecurity could help reduce antimicrobial use on farms.

Antimicrobial use and resistance in food-producing animals-How can we protect the efficacy of antibiotics for reproductive diseases?

The ongoing emergence of antibiotic resistance jeopardizes efficacy of antibiotics in curing animals from bacterial infections that threaten their health, welfare and productivity. This review gives an overview of antimicrobial use data in food-producing animals, a discussion on how antimicrobials are used for some infections in the reproductive system in cattle, the horse and pig in Europe where there are differences in treatment practices including options to refine the use of antibiotics, and finally, a presentation of the antibiotic resistance for some bacteria collected from the reproductive system. It is shown that there are differences in applied treatment regimens for, as well as prevention of, several reproductive diseases in Europe. Some of the treatments are not evidence-based, which should be considered by clinicians and other stakeholders. It is concluded that a more refined and restrictive use of antibiotics could be achieved by adhering to evidence-based guidelines by national and international expertise including the scientific literature when available. This may call for a re-think among the animal health stakeholders regarding the use of antibiotics and may demand new skill-sets in the animal health sphere.

Characterization of Klebsiella pneumoniae complex isolates from pigs and humans in farms in Thailand: population genomic structure, antibiotic resistance and virulence genes.

OBJECTIVES: To define characteristics of Klebsiella pneumoniae complex (hereafter KP) isolates from healthy pigs, farm workers and their household members in Thailand. METHODS: A total of 839 individual rectal swabs from pigs on 164 farms and 271 faecal samples of humans working on pig farms and persons living in the same household in Khon Kaen, Thailand were screened for gut colonization by KP. Genomic sequences were investigated for antibiotic resistance and virulence genes. Phylogenetic analyses were performed in addition to comparison with isolates from previous studies from Thailand. RESULTS: KP was detected in approximately 50% of pig and human samples. In total, 253 KP isolates were obtained: 39% from pigs, 34% from farmers and 26% from individuals living on the same farm but without animal contact. MLST revealed high genetic diversity with 196 different STs distributed over four phylogroups (Kp1 to Kp4). Low prevalence of ESBL-KP (7.5%) and colistin-resistant KP (3.2%) was observed among pigs and humans. Remarkably, four convergent MDR and hypervirulent strains were observed: one from pigs (ST290) and three from humans [ST35, ST3415 (strain 90CP1), ST17 (strain 90CM2)]. Sharing of KP clones among pigs and humans was identified for some STs including ST4788, ST661, ST3541 and ST29. CONCLUSIONS: The study indicated a low prevalence of ESBL and mcr genes among KP isolated from pigs and healthy humans in Thailand and suggested the possibility of zoonotic transmission for a subset of circulating KP clones.

Age and seasonal variation in testis and baculum morphology in East Greenland polar bears (Ursus maritimus) in relation to high concentrations of persistent organic pollutants.

Persistent organic pollutants (POPs) are found in high concentrations in the Artic. Polar bears (Ursus maritimus) are one of the most exposed mammals in the Arctic and are thereby vulnerable to reproductive disruption. The aim of this study was to investigate male polar bear reproduction based on a detailed evaluation of testis histology and to assess possible effects of environmental chemicals on male polar bear reproduction. Reproductive groups that were identified based on histology were as follows: actively reproductive (REP), non-reproductive either with degenerated testes (DEG), undeveloped seminiferous tubules (UND), or morphology in-transition (INT). Categorization into these groups was supported by significant differences in testis and baculum measurements among REP, DEG, and UND, as well as differences in the area and diameter of seminiferous tubules among REP, DEG, and UND. These results show that it is possible to identify the reproductive stage in polar bears even if capture date and or age is lacking. Based on testis morphology we suggest that adult male polar bears from East Greenland have active spermatogenesis in February to June, and inactive degenerated testes in August to January. January to February was the main period of reproductive transition, characterised by a shift between inactive and active spermatogenesis. Baculum and testis size measurements decreased significantly with increasing concentrations of the chlordane metabolite oxychlordane, suggesting a potential impact on male reproductive success. Half of the investigated polar bears in REP group displayed signs of disorganization of the spermatogenesis which might be a sign of disrupted reproduction. However, no correlations with levels of the investigated POPs were detected. Reproductive organ measurements in polar bears differed significantly between REP and DEG groups, which cannot be explained by age, and therefore should be considered when investigating the effect of POPs on male reproduction.

Antibiotic Use by Small-Scale Farmers for Freshwater Aquaculture in the Upper Mekong Delta, Vietnam.

This study describes antibiotic use by small-scale freshwater aquaculture farmers in the upper Mekong Delta in southwestern Vietnam and the knowledge and practices surrounding the cause and prevention of aquaculture disease in that region. Forty five farmers were included in the study, of which 19 (42%) cultivated tilapia Oreochromis spp., 13 (29%) Striped Catfish Pangasianodon hypophthalmus and 13 (29%) giant river prawns Macrobrachium rosenbergii. Antibiotics were used by farmers of tilapia and Striped Catfish (84% and 69% of farmers, respectively), but not by any of the prawn farmers. Most farmers (72%) used antibiotics for around 3 d when treating diseases, depending on the farmers' economic means and whether the fish recovered, as judged by the farmer. If farmers perceived that the antibiotic treatment had failed, the most common response was to change to another type of antibiotic. Some farmers also used antibiotics in the absence of clinical symptoms as a preventive measure. In the absence of rapid, cost-effective diagnostics, the likelihood for the incorrect use of antibiotics is high, which has implications for antibiotic resistance. Moreover, the sequential use of different antibiotics following therapeutic failure is a risk factor for the emergence of resistance. All farmers that were surveyed were aware of the risks associated with antibiotic use. This may lead to successful intervention toward reduced antibiotic use in freshwater fish farming in Vietnam.

The milk delivery chain and presence of Brucella spp. antibodies in bulk milk in Uganda.

This study examined the influence of informal milk delivery chains on the risk of human exposure to Brucella spp. through milk consumption in two regions of Uganda (Gulu and Soroti Districts). The work involved describing milk delivery chains, investigating brucellosis awareness amongst milk deliverers and determining the presence of Brucella spp. antibodies in cattle milk on delivery to primary collection points (boiling points and dairies). Milk samples (n = 331) were collected from deliverers at primary collection points and from street vendors at point of sale and analysed using indirect enzyme-linked immunosorbent assay (I-ELISA). A written questionnaire was used to collect data from deliverers (n = 279) on their milk delivery chains and their brucellosis awareness. The most common delivery points in Gulu District were small dairies and in Soroti District boiling points. The presence of Brucella spp. antibodies in milk samples was higher in Soroti (40 %) than in Gulu (11 %) (P < 0.0001). There are possible public health risk consequences of this finding as 42 % of deliverers in Soroti District reported drinking raw milk, compared with 15 % in Gulu District (P < 0.0001). Awareness of brucellosis was low, with 70 % of all milk deliverers reporting not having heard of the disease or the bacterium. Application of quality controls for milk (colour and odour) along the delivery chain varied depending upon supply and demand. This study provides evidence of the diversity of informal milk markets in low-income countries and of the potential public health risks of consuming unpasteurised milk. These results can be useful to those planning interventions to reduce brucellosis.

Prevalence and risk factors for Brucella seropositivity among sheep and goats in a peri-urban region of Tajikistan.

This cross-sectional study aimed to estimate the seroprevalence of Brucella infection among sheep and goats on small-scale farms in a peri-urban area of Tajikistan and identify factors associated with seropositivity. The study population was 667 female sheep and goats >6 months of age from 21 villages in four districts surrounding the capital city, Dushanbe. Individual blood samples were collected during October and November 2012 and analysed with indirect enzyme linked immunosorbent assay (ELISA). Positive samples were confirmed with competitive ELISA. To identify factors associated with seropositivity at an individual level, a generalised linear mixed model was applied to account for clustering of individuals within villages and districts. The true individual seroprevalence was 6.7 % and ranged from 1.0 to 15.6 % between the four districts. Fourteen villages had at least one seropositive sheep or goat, resulting in apparent prevalence of 67 % at village level. The seroprevalence at individual level was significantly lower in Rudaki district (odds ratio (OR) = 0.1; 95 % confidence interval (CI) 0.03-0.4) and Varzob district (OR = 0.3; 95 % CI 0.09-0.8) than in Vahdat district. Sheep were more likely than goats to be seropositive (OR = 2.7; 95 % CI 1.3-5.5). Increasing age was significantly associated with seropositivity (OR = 1.4; 95 % CI 1.2-1.6). These results indicate high prevalence of Brucella infection among sheep and goats in the peri-urban area of the capital city in Tajikistan. Given the dense human population in such areas, this could constitute a threat to public health, besides causing significant production losses.

Household practices related to disease transmission between animals and humans in rural Cambodia.

BACKGROUND: Zoonotic diseases are disproportionately affecting poor societies in low-income countries and pose a growing threat to public health and global food security. Rural Cambodian households may face an increased likelihood of exposure to zoonotic diseases as people there live in close association with livestock. The objectives of the study was to identify practices known to influence zoonosis transmission in rural Cambodian households and relate the practices to agro-ecological region, socio-economic position, demographics, livestock management and zoonosis awareness. METHODS: The study was conducted in three different agro-ecological regions of Cambodia; 10 villages each in the central lowlands, north-west wetlands and on the south coast, where information was obtained in questionnaires administered to 300 households, and 30 village heads and animal health workers. RESULTS: Descriptive analysis revealed a gender difference in responsibility for livestock and that the main purpose of raising livestock was for sale. Few respondents (6%) perceived a likelihood of disease transmission in their village between livestock, humans and wildlife, despite household practices related to zoonosis transmission being common. More than one-forth of households practised behaviours such as culling sick animals for consumption, eating animals found dead and allowing animals to enter sleeping and food preparation areas. Associations between household practices and possible explanatory factors were analysed with multivariable models using generalised estimation equations to account for clustering of practices within villages. Factors found to influence household practices were agro-ecological region, socio-economic position, number of people in the household, livestock species reared and awareness of zoonoses. CONCLUSIONS: Cambodia has experienced numerous fatal human cases of zoonotic influenza and extensive influenza information campaigns have been run, yet only a few of the households surveyed here reported the threat of zoonosis to be a concern in their village. Zoonosis awareness was positively related to hand washing behaviour, but other practices associated with an increased or decreased likelihood of exposure to zoonotic pathogens were unaffected by awareness. The findings indicate a knowledge-to-action gap among rural farmers and highlight the necessity for reconstructed interventions in zoonotic disease control.

Endocrine Disruptors in Domestic Animal Reproduction: A Clinical Issue?

The objective of this review was to discuss whether endocrine disruption is a clinical concern in domestic animal reproduction. To that end, we firstly summarize the phenomenon of endocrine disruption, giving examples of the agents of concern and their effects on the mammalian reproductive system. Then there is a brief overview of the literature on endocrine disruptors and domestic animal reproduction. Finally, the clinical implications of endocrine disruptors on the reproductive system of farm animals as well as in dogs and cats are discussed. It is concluded that the evidence for clinical cases of endocrine disruption by chemical pollutants is weak, whereas for phytooestrogens, it is well established. However, there is concern that particular dogs and cats may be exposed to man-made endocrine disruptors.

Seropositivity and risk factors for Brucella in dairy cows in urban and peri-urban small-scale farming in Tajikistan.

In this cross-sectional study, we assessed and mapped the seroprevalence of brucellosis in small-scale dairy farming in an urban and peri-urban area of Tajikistan and investigated factors associated with seropositivity. As urban and peri-urban farming is both an opportunity to improve the livelihood for small-scale farmers and a potential public health hazard, studies are warranted to reveal possible peculiarities in the epidemiology of brucellosis in this type of dairy farming. In total, 904 cows of breeding age belonging to 443 herds in 32 villages were serologically tested with indirect enzyme-linked immunosorbent assay (ELISA) and positive samples confirmed with competitive ELISA. Two logistic regression models were used to investigate an association between seropositivity and risk factors at herd and individual level. The herd and individual seroprevalences were 4.1 and 2.0 %, respectively. Herds with a history of abortions were found to be associated with seropositivity [odds ratio (OR) = 5.3; 95 % confidence interval (CI), 1.3-21.3]. Large herds with more than eight cattle were more likely to be seropositive compared to smaller herds with one to two cattle (OR = 13.9; 95 % CI, 1.6-119). The number of calves produced per cow (indicating age) was found to be associated with seropositivity. Younger cows with one to two produced calves were less likely to be seropositive compared to older cows with more than six produced calves (OR = 0.24; 95 % CI, 0.06-1.0). Neither introduction of new cattle to the herd nor communal grazing was associated with seropositivity. This study shows that infection with Brucella (1) is present in small-scale urban and peri-urban dairy farming in Tajikistan and (2) has significant negative effects on reproductive performance in this farming system and (3) that some previously known risk factors for seropositivity in rural farming system were absent here.

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

Introduction: Antimicrobial resistance (AMR) poses a threat to animal and human health, as well as food security and nutrition. Development of AMR is accelerated by over- and misuse of antimicrobials as seen in many livestock systems, including poultry production. In Vietnam, high AMR levels have been reported previously within poultry production, a sector which is dominated by small-scale farming, even though it is intensifying. This study focuses on understanding small- and medium-scale chicken farmers' knowledge and practices related to AMR by applying an item response theory (IRT) approach, which has several advantages over simpler statistical methods. Methods: Farmers representing 305 farms in Thai Nguyen province were interviewed from November 2021 to January 2022, using a structured questionnaire. Results generated with IRT were used in regression models to find associations between farm characteristics, and knowledge and practice levels. Results: Descriptive results showed that almost all farmers could buy veterinary drugs without prescription in the local community, that only one third of the farmers received veterinary professional advice or services, and that the majority of farmers gave antibiotics as a disease preventive measure. Regression analysis showed that multiple farm characteristics were significantly associated to farmers' knowledge and practice scores. Conclusion: The study highlights the complexity when tailoring interventions to move towards more medically rational antibiotic use at farms in a setting with high access to over-the-counter veterinary drugs and low access to veterinary services, since many on-farm factors relevant for the specific context need to be considered.

Understanding veterinary drug shop workers' knowledge and practices to identify drivers of antibiotic use in Vietnamese livestock farms.

BACKGROUND: Antimicrobial resistance (AMR) is a One Health issue and a major threat to animal and human health. Antibiotic use (ABU) drives AMR development, and several hotspots for ABU, and AMR, in livestock have been identified in Southeast Asia, including Vietnam. There are often multiple drivers of ABU at farms, and to identify all of them there is a need to look beyond farm level. OBJECTIVES: The overall aim of this study was to identify routines and/or competencies, related to antibiotic sales, among veterinary drug shop workers that may be improved in order to decrease the medically non-rational use of antibiotics in livestock production. METHODS: A questionnaire-based survey was conducted at 50 veterinary drug shops in northern Vietnam. RESULTS: Results showed high education and knowledge levels. According to the respondents, antibiotic treatment advice was almost always provided to the farmers, and the recommended treatment was most commonly based on recommendations for the specific disease. However, farmers had almost never had their animals properly diagnosed. Antibiotics were the most sold drug category, penicillins being the most common. Several broad-spectrum antibiotics were also quite frequently sold. Further, >50% of respondents recommended antibiotics for disease prevention. CONCLUSIONS: Even though education and knowledge levels might be high, several challenges can prevent drug shop workers from contributing to more prudent ABU at farms, for example, lack of proper diagnosis, commercial interests and individual farmer motives, often in combination with poor compliance to regulations.

Scenario development as a basis for formulating a research program on future agriculture: a methodological approach.

To increase the awareness of society to the challenges of global food security, we developed five contrasting global and European scenarios for 2050 and used these to identify important issues for future agricultural research. Using a scenario development method known as morphological analysis, scenarios were constructed that took economic, political, technical, and environmental factors into account. With the scenarios as a starting point future challenges were discussed and research issues and questions were identified in an interactive process with stakeholders and researchers. Based on the outcome of this process, six socioeconomic and biophysical overarching challenges for future agricultural were formulated and related research issues identified. The outcome was compared with research priorities generated in five other research programs. In comparison, our research questions focus more on societal values and the role of consumers in influencing agricultural production, as well as on policy formulation and resolving conflicting goals, areas that are presently under-represented in agricultural research. The partly new and more interdisciplinary research priorities identified in Future Agriculture compared to other programs analyzed are likely a result of the methodological approach used, combining scenarios and interaction between stakeholders and researchers.

How farm practices and antibiotic use drive disease incidence in smallholder livestock farms: Evidence from a survey in Uganda.

Background: Antimicrobial resistance (AMR) is a growing threat to human and animal health, and the growth in AMR prevalence globally is thought to be partially driven by non-therapeutic antibiotic use in livestock production. However, livestock farms may depend on antibiotics as a prophylactic disease management tool, and reducing antibiotic use in isolation may harm farmers' economic security. In order to help farmers safely reduce their antibiotic use, we must first determine how necessary non-therapeutic antibiotic use is for disease management, and how other farm practices can guard against disease and make antibiotic use reduction safe and feasible. Methods: Using the Antimicrobial Use in Livestock Production Settings (AMUSE) tool, a standardised survey tool for investigating attitudes and practices relating to antibiotic use on farms, we investigated the farming practices and animal disease outcomes of smallholder livestock farms in Uganda. We used logistic regression to investigate the effect of prophylactic antibiotic use; as well as of prophylactic vaccination, non-antimicrobial medicines, and on-farm biosecurity measures; on the likelihood of disease outbreaks. Findings: We found that prophylactic antibiotic use did indeed seem to guard against disease outbreaks, underlining the rationality of non-therapeutic antibiotic use in smallholder livestock farms and the need to pair antibiotic use reduction with other interventions in order to mitigate risk. The most effective intervention pairing varied by species, with expanded access to animal health services and the use of prophylactic vaccination demonstrating the greatest potential overall. Implications: These findings echo earlier results generated using the AMUSE survey tool. They should be followed by participatory research in which farmers are consulted to explore intervention options, and subsequently by farm-level intervention trials of combined antimicrobial stewardship interventions to verify their effectiveness.

Reproductive performance in sows in relation to Japanese Encephalitis Virus seropositivity in an endemic area.

Japanese Encephalitis Virus (JEV) is considered an important reproductive pathogen in pigs. Most studies of the reproductive impact of JEV have been conducted in areas where the disease occurs in seasonal epidemics. In this study, the associations between seropositivity for JEV, measured with an IgG ELISA, and the number of piglets born alive and stillborn were investigated in a tropical area endemic for JEV in Vietnam. Sixty percent of sows from four farms in the Mekong delta of Vietnam were seropositive to JEV and the Odds Ratio for a sow being infected was highest (6.4) in sows above 3.5 years (95% confidence interval 2.2-18.3). There was an association between increasing Optical Density (OD) values from the ELISA and the number of stillborn piglets in sows less than 1.5 years, but no effect of seropositivity could be shown when all sows were studied. OD values had an effect (p = 0.04) on the number of piglets born alive in the statistical analysis only when interacting with the effect of the breeds. An increase in mean OD value of the herd was correlated (p < 0.0001) with an increase in the number of piglets born alive. In this study, there was evidence of a negative association between seropositivity for JEV and the reproductive performance only in sows less than 1.5 years in endemic areas. This could be explained by a year-round infection with the virus, which would lead to immunity in many gilts before their first pregnancy. This, in turn, may imply that JEV infection in pigs is of minor importance for the reproductive performance in endemic areas.

Geographic and Socioeconomic Influence on Knowledge and Practices Related to Antimicrobial Resistance among Smallholder Pig Farmers in Uganda.

To mitigate the development of antimicrobial resistance (AMR), antibiotic use (ABU) in the livestock sector needs to be reduced. In low- and middle-income countries, regulations have shown to be less successful in reducing ABU. Here, a bottom-up approach can complement legal frameworks, which requires an understanding of the drivers for ABU. In this study, we investigated the influence of geographic and socioeconomic settings on determinants for ABU among pig farmers in Uganda. The data were collected through a questionnaire in two districts, Lira and Mukono, and comparative statistical analyses were performed. Farmers in Lira had less access to animal health services, applied disease prevention measures less and used antibiotics more. In Mukono, it was more common to consult a veterinarian in response to disease, while in Lira it was more common to consult an animal health worker. There was no difference in how many farmers followed treatment instructions from a veterinarian, but it was more common in Lira to follow instructions from pharmacies. The findings support the need for locally tailored AMR-reducing interventions to complement regulations. To accomplish this tailoring, systematic collection of knowledge of farm structures, farm practices and access to animal health services and veterinary drugs is necessary.