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.

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.

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.