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Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria.

ABSTRACT: Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of the respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner's inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest strategies focusing on the following areas may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and newly graduated veterinarians, increased dissemination of regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity and vaccination practices in disease prevention, and increased provision of laboratory services and AST at affordable costs.

SUBMITTER: Adekanye UO

PROVIDER: S-EPMC7460309 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria.

Adekanye Usman O UO Ekiri Abel B AB Galipó Erika E Muhammad Abubakar Bala AB Mateus Ana A La Ragione Roberto M RM Wakawa Aliyu A Armson Bryony B Mijten Erik E Alafiatayo Ruth R Varga Gabriel G Cook Alasdair J C AJC

Antibiotics (Basel, Switzerland) 20200728 8

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided ...[more]

PMID: 32731420

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Project description:ObjectivesThis study aimed to identify barriers to the proper use of antibiotics by healthcare professionals and to help the hospital Antimicrobial Stewardship develop suitable actions for the staff.MethodsIn a Belgian teaching hospital, a survey was conducted among physicians, pharmacists, and nurses involved in antibiotherapy. Questions from the 2019 European Center for Disease Prevention and Control (ECDC) survey were analyzed based on components of the COM-B model (capabilities, opportunities, and motivations). First, collected data were reviewed with the Ethnos software to analyze the different COM-B model components. For statistical analyses, responses were grouped into three clear-cut answers in a Fisher's exact test.ResultsOverall, 400 staff members were included. We found that our professions, combined, have a good perception of antibiotic resistance (97.8%). For capabilities, however, only 77.2% state that they have sufficient knowledge, with 91.3%, 71.5%, and 63.0% for physicians, nurses, and pharmacists, respectively. For opportunities (access to resources, information, and training), it is observed that 72.2% report having easy access to the guidelines they need to manage infections. In comparison, for 64.2% of the respondents, this information changed their opinion on the useless or inappropriate prescription, administration, and delivery of antibiotics. For 55.0%, this information has enabled them to change their practices. Finally, for motivations, 92.8% of respondents state that they know about the link between their practices and the emergence and spread of antibiotic resistance. However, only 65.0% of participants say they have a role in managing antibiotic resistance. We found that 5 out of 8 questions are significantly dependent on the profession: 2 inquiries related to capability, 1 to opportunity, and 2 to motivation.ConclusionWe found that responses to the ECDC questionnaire are related to the profession. While some topics are universal/cross-functional, others must be explicitly tailored to each professional category. Information is useless if not accessible. Communication and provision of documents are thus paramount.

Project description:In African countries, antimicrobial resistance (AMR) issue remains pertinent. Despite this, little efforts have been made to assess the future veterinary prescribers on their knowledge, attitudes and practices (KAP) related to antimicrobial usage. This multi-country survey attempts to explore the KAP of future veterinarians on stewardship of antimicrobial and identify knowledge gaps. Eight veterinary schools participated from Nigeria, Sudan and South Africa. Data regarding perceptions and knowledge were analyzed using Chi-square χ2 test, Spearman's (Rho) Rank order correlation and factor analysis using principal component factoring extraction method. Fifty-two percent of the study participants were final year veterinary students, respectively, and majority (77.2%) had no previous knowledge of biomedical sciences. Majority age were 22-27 years (24.7 ± 2.8) 79% and multiple career fields post-graduation were preferred. Overall, poor perceptions and knowledge of antimicrobial stewardship were observed with variations among countries and only 36.3% (n = 123) of the students were confident in their ability to choose the ideal antimicrobial agents for a specific patient/group of animals. The majority of the final year students were confident of their knowledge regarding AMR (68%), making of Gram staining (69.2%) and in choosing the most ideal route for administering a specific antimicrobial (74.7%). The final year students had significantly (p < 0.05) higher confidence level for knowledge compared with the pre-final year students. Tetracyclines, penicillins, and sulphonamides represent the three most abused veterinary antimicrobials with similar ranking across countries. South African (69.7 ± 20.5) and Sudanese (68.1 ± 15.4) had significantly (p < 0.0001) higher mean scores compared to the Nigerian students (44.3 ± 6.8) in the student's ability to correctly match some specific antimicrobials against their classes but Nigerian students performed better in ranking antimicrobials. This survey revealed poor to average knowledge of antimicrobial stewardship among veterinary students with significant knowledge gaps across the countries. It is recommended that the relevant regulatory and standardization authorities should make concerted efforts and interventions to regularly review curricula to ensure the delivery of targeted formative and normative training, and improved lectures on antimicrobial usage and stewardship in order to improve the awareness and behaviors of future prescribers. The identified knowledge gaps of veterinary medical students on antimicrobial stewardship must be bridge to safeguard the future.

Project description:Canine vector-borne pathogens (CVBP) have a worldwide distribution and show a high prevalence in tropical countries such as Sri Lanka. Some CVBP are zoonotic, with dogs identified as reservoir hosts for human subcutaneous dirofilariasis and potentially for spotted fever rickettsioses and re-emergent brugian filariasis in Sri Lanka, making these pathogens emerging public health issues in the country. Veterinarians are crucial in monitoring, preventing, and controlling these pathogens in dogs. Therefore, it is imperative to understand veterinarians' knowledge, attitude, and practices (KAP) regarding CVBP to mitigate their impact. A survey was designed and administered electronically to veterinarians residing and practising in Sri Lanka. Responses were evaluated using descriptive, univariable, and multivariable analyses to investigate associations between demographic factors, knowledge, attitude, and practices related to CVBP. Out of the 170 participating veterinarians, nearly 70% had moderate or high knowledge. However, the awareness of zoonotic pathogens, Brugia spp. (16%) and Rickettsia conorii (18%), was low, and a considerable number of veterinarians were unaware of the zoonotic nature of Dirofilaria repens. Based on multivariable analysis adjusting for experience and self-rated knowledge, new graduates had higher odds of knowledge compared to experienced veterinarians (OR 5.7, 95% CI 1.7-23, p = 0.028). Questions assessing the attitude towards CVBP indicated that most participating veterinarians comprehend and agree with their importance. Nearly all participants agreed that ectoparasite control is the best option to prevent CVBP infections (91%, 153/167) and that for effective treatment of CVBP, a definitive diagnosis is required (81%, 135/167). However, veterinarians recommended suboptimal treatments for some CVBP, like Babesia gibsoni. Better practices were associated with being a companion animal practitioner (OR 2.4, 95% CI 1.1-5.7, p = 0.032) and having a low to moderate canine caseload (OR 3.6, 95% CI 1.3-10.4, p = 0.038). Limited knowledge of zoonotic CVBP among veterinarians, along with suboptimal treatment, might contribute to dogs acting as reservoirs and high prevalence of these pathogens in Sri Lanka. Therefore, continued veterinary education is recommended to improve knowledge and practices, which in turn will help to improve the diagnosis, treatment, and control of these infections in Sri Lanka to ensure the well-being of dogs and humans.

Dataset Information

Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria.

Publications

Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria.

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