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Determinants influencing antibiotic use in Singapore's small-scale aquaculture sectors: A qualitative study.

ABSTRACT: Singapore's Antimicrobial Resistance (AMR) national strategic action plan includes inappropriate use of antimicrobials in food-producing animals as a specific priority. Although the use of antibiotics and other drugs are monitored by regulatory bodies, food fish farmers are allowed to buy and administer antimicrobials without a veterinary prescription. We conducted a qualitative study of Singaporean food fish farmers to understand patterns and determinants of antibiotic use, their knowledge of antibiotic resistance, as well as perceptions of on-farm infection prevention and control measures. During the interview, participants were asked about their farming processes, farm infrastructure, antibiotic use and any disease prevention measures. Thematic analysis of participants' interviews showed that antibiotic for growth promotion and infection prevention was uncommon among local food fish farmers. The following three main themes influenced participants' decisions to use antibiotics in their practice: 1) individual factors, 2) local regulatory factors as well as 3) market-related factors. Individual factors included their personal experience and knowledge both with antibiotics as well as with alternate options. In terms of local regulatory factors, we found that regular oversight was a strong deterrent in antibiotic use. Last, at the market level, the relatively high price of antibiotics in Singapore coupled with stiff competition was a strong disincentive for participants to use antibiotics in their farming practice. These factors were also influential in their relationships with local regulatory bodies as well as their counterparts. Although industries differ significantly across countries, lessons learnt from Singapore's food fish farming demonstrate the importance of an environment where multi-dimensional factors come together to discourage the irrational use of antibiotics in food animal production. In addition, our results allow greater insight into food fish farmers' perspectives on infection control and form a basis from which further research work can be undertaken.

SUBMITTER: Lim JM

PROVIDER: S-EPMC7041790 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Determinants influencing antibiotic use in Singapore's small-scale aquaculture sectors: A qualitative study.

Lim Jane Mingjie JM Duong Minh Cam MC Hsu Li Yang LY Tam Clarence C CC

PloS one 20200225 2

Singapore's Antimicrobial Resistance (AMR) national strategic action plan includes inappropriate use of antimicrobials in food-producing animals as a specific priority. Although the use of antibiotics and other drugs are monitored by regulatory bodies, food fish farmers are allowed to buy and administer antimicrobials without a veterinary prescription. We conducted a qualitative study of Singaporean food fish farmers to understand patterns and determinants of antibiotic use, their knowledge of a ...[more]

PMID: 32097422

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Project description:BACKGROUND:Mental illnesses pose a significant burden worldwide. Furthermore, the treatment gap for mental disorders is large. A contributor to this treatment gap is the perceived stigma towards mental illness. Besides impeding one's help-seeking intentions, stigma also impairs persons with mental illness (PMI) in other aspects of their life. Studies have found that stigma may manifest differentially under different cultural contexts. Thus, this study seeks to elucidate the determinants of stigma towards PMI among lay public in Singapore using a qualitative approach. METHODS:A total of 9 focus group discussions (FGD) were conducted with 63 participants consisting of lay public Singaporeans who were neither students or professionals in the mental health field, nor had they ever been diagnosed with a mental illness. Topics discussed during the FGD were related to the stigma of mental illness. Data collected were analyzed with inductive thematic analysis method. A codebook was derived through an iterative process, and data was coded by 4 different coders. Both coding and inter-rater analysis were performed with NVivo V.11. RESULTS:In total, 11 themes for the determinants of stigma were identified and conceptualized into a socioecological model. The socioecological model comprised 4 levels of themes: 1) Individual level beliefs (fear towards PMI, perceiving PMI to be burdensome, dismissing mental illness as not a real condition), 2) Interpersonal influences (upbringing that instills stigma, intergroup bias, perceived inability to handle interactions with PMI), 3) Local cultural values (elitist mindset among Singaporeans, Chinese culture of "face", Islamic beliefs about spiritual possession and reaction towards PMI), and 4) Shared societal culture (negative portrayal by media, Asian values). CONCLUSIONS:The findings of this study improved our understanding of the various reasons why stigma exists in Singapore. The themes identified in this study concur with that of studies conducted overseas, as some determinants of stigma such as fear towards PMI are quite ubiquitous. Specifically, the themes elitist mindset among Singaporeans and perceived inability to handle interactions with PMI were unique to this study. It is highly recommended that future anti-stigma campaigns in Singapore should incorporate the findings of this study to ensure cultural misgivings and beliefs are addressed adequately.

Project description:Piscivorous avian species are the main source of catfish depredation at aquaculture facilities in Mississippi, resulting in the economic loss of millions of dollars every year. Most notable of these avian species are the double-crested cormorant (Phalacrocorax auritus), great blue heron (Ardea herodias), and great egret (A. alba). Understanding why these species select specific ponds can increase management efficiency directed at avian dispersal and provide insight into their decision making with respect to foraging behavior. We collected species presence data on catfish ponds by flying 35 surveys from October through April of 2015-2017, during which an average of 973 catfish ponds were observed each year. We collected data associated with each pond's physical surroundings and contents and used occupancy modeling to determine their influence on avian occupancy probability. We also collected data associated with stocking practices and catfish health on a subset of ponds, and constructed resource selection functions to model their influence on avian presence. Pond area was positively related to occupancy probability of each species. Cormorant occupancy increased as pond distance from forest cover and activity centers, such as workshops and offices, increased. Distance to nearest activity center was positively related to egret occupancy, while distance to nearest forested area was negative. Ponds containing diseased catfish had an increased probability of use by both herons and egrets. In general, cormorants and egrets showed greater probability of use on the periphery of pond clusters. The abundance of catfish was positively related to cormorant and heron presence. Specific pond contents and characteristics influenced presence of each avian species in different ways, including fish species cultured, production methods, pond systems, and fish types. Many pond selection relationships were species-specific, illustrating inherent differences in their foraging ecology. Consequently, specific management actions aimed to reduce avian presence will depend on the targeted species.

Project description:BACKGROUND:Digital health innovations can improve health system performance, yet previous experience has shown that many innovations do not advance beyond the pilot stage to achieve scale. Vietnam's National Immunization Information System (NIIS) began as a series of digital health pilots, first initiated in 2010, and was officially launched nationwide in 2017. The NIIS is one of the few examples of an electronic immunization registry (EIR) at national scale in low- and middle-income countries. OBJECTIVE:The aim of this study was to understand the determinants of scale-up of the national EIR in Vietnam. METHODS:This qualitative study explored the facilitators and barriers to national scale-up of the EIR in Vietnam. Qualitative data were collected from October to December 2019 through in-depth key informant interviews and desk review. The mHealth Assessment and Planning for Scale (MAPS) Toolkit guided the development of the study design, interview guides, and analytic framework. MAPS defines the key determinants of success, or the "axes of scale," to be groundwork, partnerships, financial health, technology and architecture, operations, and monitoring and evaluation. RESULTS:The partnership and operations axes were critical to the successful scale-up of the EIR in Vietnam, while the groundwork and monitoring and the evaluation axes were considered to be strong contributors in the success of all the other axes. The partnership model leveraged complementary strengths of the technical working group partners: the Ministry of Health General Department of Preventive Medicine, the National Expanded Program on Immunization, Viettel (the mobile network operator), and PATH. The operational approach to introducing the NIIS with lean, iterative, and integrated training and supervision was also a key facilitator to successful scale-up. The financial health, technology and architecture, and operations axes were identified as barriers to successful deployment and scale-up. Key barriers to scale-up included insufficient estimates of operational costs, unanticipated volume of data storage and transmission, lack of a national ID to support interoperability, and operational challenges among end users. Overall, the multiple phases of EIR deployment and scale-up from 2010 to 2017 allowed for continuous learning and improvement that strengthened all the axes and contributed to successful scale-up. CONCLUSIONS:The results highlight the importance of the measured, iterative approach that was taken to gradually expand a series of small pilots to nationwide scale. The findings from this study can be used to inform other countries considering, introducing, or in the process of scaling an EIR or other digital health innovations.

Project description:BackgroundInsight into factors that influence antibiotic prescribing is crucial when developing interventions aimed at a more rational use of antibiotics. We examined factors that influence antibiotic prescribing in long-term care facilities, and present a conceptual model that integrates these factors.MethodsSemi-structured qualitative interviews were conducted with physicians (n?=?13) and nursing staff (n?=?13) in five nursing homes and two residential care homes in the central-west region of the Netherlands. An iterative analysis was applied to interviews with physicians to identify and categorize factors that influence antibiotic prescribing, and to integrate these into a conceptual model. This conceptual model was triangulated with the perspectives of nursing staff.ResultsThe analysis resulted in the identification of six categories of factors that can influence the antibiotic prescribing decision: the clinical situation, advance care plans, utilization of diagnostic resources, physicians' perceived risks, influence of others, and influence of the environment. Each category comprises several factors that may influence the decision to prescribe or not prescribe antibiotics directly (e.g. pressure of patients' family leading to antibiotic prescribing) or indirectly via influence on other factors (e.g. unfamiliarity with patients resulting in a higher physician perceived risk of non-treatment, in turn resulting in a higher tendency to prescribe antibiotics).ConclusionsOur interview study shows that several non-rational factors may affect antibiotic prescribing decision making in long-term care facilities, suggesting opportunities to reduce inappropriate antibiotic use. We developed a conceptual model that integrates the identified categories of influencing factors and shows the relationships between those categories. This model may be used as a practical tool in long-term care facilities to identify local factors potentially leading to inappropriate prescribing, and to subsequently intervene at the level of those factors to promote appropriate antibiotic prescribing.

Project description:Small-scale carp polyculture plays a key role in food supply in Bangladesh. However, factors including water pollution, limited infrastructure, and inadequate disease management hinder its sustainability. This paper reports on a survey of 231 farmers across the six major carp producing regions in Bangladesh, analyzing factors including farmers' social aspects, farm characteristics, information on disease and approaches adopted to combat them, and biosecurity practices. Almost half (46.8%) of the farms surveyed experienced disease in carp species, with clear regional variations. Eighty-four percent of farms reported carp mortalities during disease outbreaks, with an average mortality level of 10.23 ± 11.81%. Clinical signs during outbreaks lasted between a week and a month, with a peak in disease outbreaks occurring in two seasonal periods between June and July and October and December. Disease incidence was related to a range of factors including the farmer's experience, ponds/farm type, stocked species, and biosecurity practice. A combination of disinfecting measures during pond preparation and measures during stocking, including discarding fingerling transport water away from the farm, fingerling disinfection, and checking the health of fingerlings before stocking, significantly reduced disease occurrence. Treatments involving antibiotics, ciprofloxacin, erythromycin, and azithromycin were reported as ineffective, raising concerns about their non-prudent use, inadequate dosing (perhaps without appropriate veterinary guidance), and the potential for driving antimicrobial resistance in the environment. The research unveils a concerning pattern of high disease incidence across small-scale carp farms in Bangladesh, and the significant potential for disease spread highlights the need for responsible disposal practices. The study emphasizes the need for improving training and awareness programs for addressing biosecurity and disease management challenges, ensuring sustainable aquaculture and community well-being.

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Determinants influencing antibiotic use in Singapore's small-scale aquaculture sectors: A qualitative study.

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Determinants influencing antibiotic use in Singapore's small-scale aquaculture sectors: A qualitative study.

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