Knowledge, Attitude and Practices of Veterinarians on Anti-Biotics Use and Resistance and its Containments in Central Gondar Zone, Ethiopia

Research Article

Austin J Microbiol. 2024; 9(1): 1047.

Knowledge, Attitude and Practices of Veterinarians on Anti-Biotics Use and Resistance and its Containments in Central Gondar Zone, Ethiopia

Biruk Eshetu¹; Haileyesus Dejene¹; Bamlak Kassahun³*; Bement Wondimagegn²

1University of Gondar, College of veterinary medicine and animal sciences, P.O Box 196 Gonder Ethiopia

2Haremaya University, College of Veterinary Medicine, P.O.Box 138 Dire Dawa, Ethiopia

3Addis Ababa University, Aklilu Lemma Institute of Pathobiology, P.O Box 1176 Addis Ababa Ethiopia

*Corresponding author: Bamlak Kassahun Ayalew Addis Ababa University, Aklilu Lemma Institute of Pathobiology, P.O Box 1176 Addis Ababa Ethiopia. Email: bamlak.kassahun@aau.edu.et

Received: December 15, 2023 Accepted: January 27, 2024 Published: February 03, 2024

Abstract

Inappropriate use of antibiotics in the veterinary sector has contributed to Antibiotic Resistance (ABR), which negatively impacts animal health and welfare. Understanding the Knowledge, Attitudes, and Practices (KAP) on antibiotic use, ABR, and its containment amongst veterinarians is critical to optimizing antibiotic use and containing resistance. Thus, this study aimed to assess the knowledge, attitude, and practices of veterinarian on antibiotic use and resistance and its containment in central Gondar zone, Ethiopia. A cross-sectional study was conducted from December 2022 to July 2023 on 36 purposively selected central Gondar zones using self-administered structured questionnaires. The descriptive and chi-square tests were used to analyze the data. The response rate was one hundred percent. Approximately 86.11% of respondents were men, Almost 77.78%, 80.56% and 41.67% of respondents were 0-10 years of experience, 20-40 years of old and educational level respectively. Furthermore, 88.88%, 94.44%, and 77.78% of respondents, respectively, had high knowledge, positive attitude, and good practice about antibiotic use, resistance, and its containment. The chi-square analysis revealed a significant (p<0.05) between knowledge and educational level, and sex with p-values of 0.022 and 0.027, respectively. The respondent’s attitude levels were also significantly associated (p<0.05) with their educational level with p value is 0.005. Respondents’ practice levels were not significantly associated (p<0.05) with their socio-demographic or independent variables. The study not found a significant relationship between respondents’ knowledge and practice (Χ2=0.0201, p=0.887), practice and attitude (Χ2=0.9454, p=0.331). And that of attitude and knowledge also had not significantly associated ((Χ2=0.2647, p=0.607). Therefore, this study found that study participants with educational level have a positive effect on the occurrence rate of antibiotic resistance level.

Keywords: Antibiotic use; Attitude; Knowledge; Practice; Resistance

Introduction

Antibiotics are widely used in the animal husbandry sector for therapeutics and non-therapeutic purposes In food animal production, treating individual animal is practically impossible, rather rendering treatment to the entire livestock by medicating them with low dose of antimicrobials through feed, water, or parenteral routes [1]. The therapeutic benefits of antibiotics to humans, livestock and companion animals are well recognized also in livestock, antibiotics are essential in the therapeutic treatment of bacterial diseases that impact livestock health, production and welfare. Antibiotics are also used for prophylaxis and meta phylaxis, to maintain animal health and increase productivity [2]. The antibiotic was coined from the word, antibiosis" which literally means, against life". In the past, antibiotics were considered to be organic compounds produced by one microorganism which are toxic to other microorganisms [3]. The veterinary use of antibiotics includes the use on pets, farm animals, and animals raised in aquaculture. In companion animals, antibiotic are essential for therapeutic treatment of skin, wound, respiratory and urinary tract infections, as well as for reducing the frequency of sepsis and surgical site infections for farm animals to increase growth and feed efficiencies it’s also play major role for main infectious diseases treated are enteric and pulmonary infections, skin and organ abscesses and mastitis. Antibiotics used in veterinary medicine are: penicillin, cephalosporin, tetracycline, chloramphenicol, aminoglycosides, spectinomycin, lincosamide, macrolides, sulphonamides and trimethoprim [4].

Antibiotic Resistance (AR) is a burning health-care issue influencing both humans and domestic animals across the globe. Antibiotic resistance is accelerated by the overuse and misuse of antibiotics (WHO 2008). The use of antibiotics exerts selection pressure on microbes, allowing resistant pathogens to proliferate and leading to the emergence of Antimicrobial Resistance (AMR). The emergence of AMR in humans has been linked with AMR in animals and the environment. Inappropriate antibiotic prescribing and increased antibiotic consumption in animals have contributed to Antibiotic Resistance (ABR) [5].

This anti-microbial have been widely used in animals for disease control, prevention and treatment and have played a vital role as growth promoters in animals. Use of antimicrobial drugs has become widespread over several decades, and these drugs have been extensively misused in both humans and food-producing animals in ways that favor the selection and spread of resistant microbes [6]. This widespread application of antibiotics in different food animal populations imposes strong selection pressure, which contributes to the emergence, spread, and persistence of resistant pathogens to other animals, humans, and the environment [7].

Misuse and overuse of various antimicrobial agents in the health care setting and the agricultural industry are regarded as major contributors to the emergence of antimicrobial resistance. Besides that, spontaneous evolution, pathogen mutation, and the transmission of resistant genes via horizontal gene transfer are significant contributors to antimicrobial resistance. More than half of all medicines are prescribed, dispensed, or sold improperly and do not follow the principle of rational drug use, and more than half of patients fail to take them correctly [8]. This inappropriate dose results in increasing antimicrobial résistance. Despite continuous efforts to improve antimicrobial prescribing and address issues such as self-prescribing, unnecessary use for viral infections, dosing errors, and excessive treatment durations, rates of antimicrobial resistant infections continue to rise globally [9].

Antimicrobial Resistance (AMR) in these present times has become a big challenge to public health worldwide, because of the emergence of superbugs “which are strains of bacteria that have become resistant to antibiotic drugs” hence resulting in higher mortality and economic hardships. Sub-Saharan African countries are also faced with the challenges arising from AMR. This global health problem is facing both medical and veterinary healthcare professionals, hence it requires a ‘One-Health’ approach to provide effective response. The Global Action Plan (GAP) on Antimicrobial Resistance (AMR) was adopted by the World Health Assembly in 2015 [10].

However, it has not been determined well to what extent knowledge, attitude, and practices of animal antibiotic usage and resistance in the central Gondar zone. Thus, the investigation of animal antibiotic usage and resistance in the study area contributes by identifying the factors that contribute to low levels of knowledge, attitude, and practices which allow veterinarians to be aware of the condition and apply possible intervention measures to decrease the risk. Therefore, this study was designed with the following objectives.

General Objective

To assess the knowledge, attitude, and practice of veterinarians on antibiotic use, resistance and its containment in central Gondar zone, Ethiopia.

Specific Objectives

• To assess veterinarians' knowledge, attitude, and practice toward usage of antibiotics

• To assess veterinarians' knowledge, attitude, and practice and toward antibiotic resistances

• To identify the antibiotic resistance containment in central Gondar

Materials and Methods

Study Area

A study was conducted among veterinarian professionals working in central Gondar zone from December 2022 to July 2023. Gondar is found in Northern Ethiopia in Amhara regional state, located at 725 km from Addis Ababa, the capital city of federal government of Ethiopia, 175 km from Bahir Dar, the capital city of Amhara National Regional State. Gondar is the historical capital of the Ethiopia and it is a famed tourist destination place that stands at an elevation of 2,133 meters above sea level. The city of Gondar is situated in North-western parts of Gondar and It is at 120 3’ N latitude and 370 28’E. In the area there were different organizations that providing services for animal health, which includes private, pharmacy, governmental clinics and governmental pharmacy [11].

Study Design and Sampling Technique

A cross sectional study design was carried out to assess knowledge, attitude and practices of veterinarians on antibiotics use, resistance and its containment in central Gondar zone, Ethiopia. The sampling method was a purposive sampling technique.

Study Population

The sources of population were all veterinary professionals working in central Gondar zone. The study population was veterinary professionals working in five selected areas of the population, such as Azezo, Maksegnite, the University of Gondar veterinary clinic and academic, chohit, and aberjah.

Inclusion and Exclusion Criteria

Inclusion criteria: the study included all veterinarians who was working in central Gondar zone at different position such us private pharmacy, academic/lectures/, government clinics and others had basic knowledge regarding veterinary information. Veterinarians who was voluntary during data collection was includes in the study.

Exclusion Criteria: The professional who was not willing to participate during data collection was excluding in the study.

Variables of the Study

Dependent variables: Knowledge, attitude and Practice of veterinarian respondents about antibiotics use, resistance and its containment.

Independent variables: Socio demographic profiles of respondents such us district sex, age, educational level, year of experience, field of practice.

Data Collection Methods

Data Collection

Data were collected through self-administered structured questionnaires, which were prepared in English. The questionnaire comprised four parts with most of the questions being close-ended. The questionnaire items were internally reviewed for content validity by two experts in the field of epidemiology and public health. Modifications of questionnaire items were made based on expert feedback and recommendations to suit the local population. Moreover, before data collection participants in this study was provided to inform by questionnaire them the purpose of the study, that participation is entirely voluntary, they were free to fill the questionnaire at any time and all data will be kept securely.

Measurement Tools

Socio-demographic data: There were six (6) questions in this part. The questions include district, sex, age, year of experience, educational level, and field of experience.

Knowledge on antibiotic usage and resistance: There were seven (7) questions which were asked to know the knowledge level of the veterinarians on antibiotics use and resistance and its containment. A correct answer for each close ended questions was given 3 score for correct answer, 2 disagree and 1 uncertain score for a wrong answer. The score varied from 6-21 points and was classified into 3 levels according to the Blooms' (1956) cut off point, 60-80% as follows:

High level (80-100%) 16-21 scores

Moderate level (60-79%) 13-16scores

Low level (less than 60%) 6-10 scores

Attitude on antibiotics usage and resistance: This part includes the attitude veterinarians who work in central Gondar zone towards antibiotics usage and its resistances and its containment. There was a total of eight questions, six positive and two negative statements with Likert scale options of choice ranging from agree to disagree. The rating scale was measured as knowledge scale. The scores varied from 8 to 24 and all individual answers were summed up for total and calculated for means. The scores were classified in to 3 levels (Positive Attitude, Neutral Attitude and Negative Attitude).

Positive Attitude 19-24 scores (80%-100%)

Neutral Attitude 15-18 scores (60%-79%)

Negative Attitude 8-14 scores (Less than 60%)

Practice on antibiotics usage and resistance: Seven (7) questions have been included in this part. Of which all seven questions were close ended the rating scale for the responses was measured as previous one. The scores in measuring the practice of antibiotics usage and resistance were varied from 8 to 21, and were classified into 3 levels according to the Bloom's cut off point, 60-80% (Bloom 1956). The levels of practice were:

Good (80-100%) 16-21 scores; Fair (60-79%) 13-16 scores; Poor (Less than 60%) 8-14 scores

Data Management and Analysis

The data obtained was classified and coded using Microsoft Excel® 2019. Then, the data was exported to STATA version 16 (Stata Corp. Texas, USA). Descriptive statistics such as mean ±standard deviation or percentage as appropriate was used to show socio-demographic characteristics of the study participants. The test for association on knowledge, attitude and practice was done by using Chi square (Χ2) to identify the most contributing demographic factor. The data was interpreted as significant when p-value is less than 0.05.

Result

Respondent Socio-Demographic Characteristics

There were a total of 36 participants in this study. Of these, 86.11% were male and 13.89%. The highest percentage of the study participants were 20-40 years (n=29), +40 years or age 19.44%, and regarding to educational level highest percent of 15 were DVM, 7 were DVM, Msc, 1 were BVSc, MSc, 6 were BVSc and respondents n=4 was diploma (Table 1). Relating to year of experience, most participants were 0-10 years of experiences that is 77.78%, 5.56% of 11-20 years of experience, and 16.67% of +20 year of experience were participated in the study (Table 1).