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. 2023 Sep;16(9):1821-1828.
doi: 10.14202/vetworld.2023.1821-1828. Epub 2023 Sep 14.

Effect of knowledge of informal poultry drug prescribers on their attitude and practice toward antimicrobial use, residues, and resistance in Bangladesh

Aminatu Abubakar Sani  1   2 , Kazi Rafiq  1 , Fatema Akter  1 , Purba Islam  1 , Sabbya Sachi  1 , Nasrin Sultana  3 , Sajedul Hayat  1 , Usman Bashir Usman  4 , Md Shafiqul Islam  1 , Md Zahorul Islam  1 , Muhammad Tofazzal Hossain  5
Affiliations

Effect of knowledge of informal poultry drug prescribers on their attitude and practice toward antimicrobial use, residues, and resistance in Bangladesh

Aminatu Abubakar Sani et al. Vet World. 2023 Sep.

Abstract

Background and aim: Informal prescribers (IPs) significantly contribute to the development of antimicrobial resistance and in disseminating pathogens from poultry to humans and other animals through the food chain, posing a serious global health threat. Therefore, this study aimed to assess whether the knowledge of IPs has an impact on their attitude and practice toward antimicrobial use, antibiotic residues, and antimicrobial resistance.

Materials and methods: In this cross-sectional study, we conducted a pre-tested and questionnaire-based survey to investigate the knowledge, attitude, and practice of IPs in selected parts of the Mymensingh division, Bangladesh. Then, we used the linear regression model test with R-squared (R2) to measure the association between the study variables.

Results: Our investigation revealed that 70% of the IPs knew about antibiotics and 75% had good knowledge about antibiotic resistance, whereas only 50% were aware of withdrawal periods. Informal prescribers also displayed good attitudes toward the use and sale of antibiotics with withdrawal periods and completion of medication (50%). Analysis of their practice on the sale and prescription of antibiotics showed that 70% and 30% of IPs use antibiotics against bacterial infections and other conditions, respectively. Most of them do not consult a veterinarian before selling or prescribing antibiotics, although 80% claim to do so. This is because 75% of IPs gave other options regarding their consultations. However, 95% of IPs uses antibiotics only for therapeutic purposes. Furthermore, only 10% sell antibiotics based on a veterinarian's recommendation. Approximately 45% of IPs use single antibiotics at a time, while the rest use multiple antibiotics, individually or combined. Approximately 15% use antibiotics monthly, while 85% use them whenever the need arises. The knowledge and attitude of IPs are significantly affected by their age (p ≤ 0.025). The district of domicile also impacted their knowledge. Surprisingly, IPs from Jamalpur had significantly better knowledge compared to those from Mymensingh and Sherpur (p ≤ 0.01). The attitude of IPs from Jamalpur and Netrokona also differed significantly (p ≤ 0.001) from that of Mymensingh and Sherpur. The knowledge of IPs influenced their attitude up to 80.5% (r2 = 0.628) and their practice up to 75.4% (r2 = 0.545).

Conclusion: The knowledge of IPs greatly influenced their attitude and practice, while sociodemographics also influenced their knowledge and attitude toward antimicrobial use, antibiotic residues, and antimicrobial resistance.

Keywords: and practices; antimicrobial residue; antimicrobial resistance; antimicrobial use; attitude; informal poultry drug prescriber; knowledge; survey.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure-1
Figure-1
Response on knowledge of IPs on AMU and AMR. Question 1: Do you have knowledge about antibiotics? (Q1a) Antibiotics act against bacteria? (Q1b) Antibiotics act against virus? (Q1c) Others? (Q1d) Don’t know? (1Qe) Antibiotics act against bacteria and virus? (Q1f) Antibiotics act against bacteria, virus, and others? (Yes/No). Question 2: Do you know about withdrawal period of antibiotics? (Yes/No). Question 3: Heard about antibiotic resistance? (Yes/No). Question 4: What are the causes of resistance? (Q4a) Incomplete antibiotic course? (Q4b) Using the same antibiotic frequently? (Q4c) Overdose? (Q4d) Low dose? (Q4e) Skipping dose? (Q4f) Taking different antibiotics same time? (Q4g) Taking antibiotics that have been kept long time? (Q4h) Adulterated antibiotics? (Q4i) Others? (Yes/No). Question 5: Have knowledge about antibiotic resistance? (Yes/No). Question 6: What do you know about antibiotic resistance? (Q6a) It causes treatment failure? (Q6b) It causes poor response to treatment? (Q6c) Do not know? (Q6d); Others? (Yes/No). Question 7: Have knowledge about antibiotic residues? (Yes/No). IPs=Informal prescribers, AMU=Antimicrobial use, AMR=Antimicrobial resistance.
Figure-2
Figure-2
Response on attitude of IPs on AMU and AMR. Question 1: Do you suggest for completion of antibiotic course? Yes/No. Question 2: Do you advise farmers to follow withdrawal period? (Yes/No). Question 3: Sell of antibiotic recommended by? (3a) veterinarian; (3b) other farmers; (3c) pharmaceutical company representative; (3d) village doctor; (3e) quack; (3f) all of the above? (Yes/No). IPs=Informal prescribers, AMU=Antimicrobial use, AMR=Antimicrobial resistance.
Figure-3
Figure-3
Response on practice of IPs on AMU and AMR. Question 1 (Q1) Do you follow exact prescription to sell drugs? Yes/No. Question 2 (Q2) Do you sell antibiotics without prescription? Yes/No. Question 3 (Q3) How do you store drugs? Yes/No (room, refrigerator, others/room, others/room refrigerator/others/refrigerator/room). Question 4 (Q4) Route of administration in poultry? Yes/No (others/oral/injection). Question 5 (Q 5) Frequency of antibiotic use in poultry? Yes/No (when needed/monthly/daily, weekly). Question 6 (Q6) Number of antibiotics used at a time? Yes/No (single, combined &multiple/combined, multiple/single). Question 7 (Q7) Purpose of antibiotic use? Yes/No (growth promoter/both/prophylaxis/therapeutic). Question 8 (Q8) Have any record of antibiotic sell? Yes/No. Question 9 (Q9) How do you select antimicrobials and the dose? Yes/No (others/consult with other prescribers/consult with company representative/consult with drug seller/consult with veterinarian/personal experience). Question 10 (Q10) Conditions for using antibiotics? Yes/No (others/parasitic/Protozoa/mycoplasmosis/viral/bacterial). IPs=Informal prescribers, AMU=Antimicrobial use, AMR=Antimicrobial resistance.
Figure-4
Figure-4
Most frequently used antibiotics by IPs. Percentages of different antibiotic classes used by IPs in the experimental areas. IPs=Informal prescribers.
See this image and copyright information in PMC

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