The social biography of antibiotic use in smallholder dairy farms in India

Background Antimicrobial resistance (AMR) has been identified as one of the major threats to global health, food security and development today. While there has been considerable attention about the use and misuse of antibiotics amongst human populations in both research and policy environments, there is no definitive estimate of the extent of misuse of antibiotics in the veterinary sector and its contribution to AMR in humans. In this study, we explored the drivers ofirrational usage of verterinary antibiotics in the dairy farming sector in peri-urban India. Methods and materials The study was conducted in the peri-urban belts of Ludhiana, Guwahati and Bangalore. A total of 54 interviews (formal and non-formal) were carried out across these three sites. Theme guides were developed to explore different drivers of veterinary antimicrobial use. Data was audio recorded and transcribed. Analysis of the coded data set was carried out using AtlasTi. Version 7. Themes emerged inductively from the set of codes. Results Findings were presented based on concept of ‘levels of analyses’. Emergent themes were categorised as individual, health systems, and policy level drivers. Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers and easily available antibiotics, dispensed without appropriate prescriptions contributed to easy access to antibiotics, and were identified to be the possible drivers contributing to the non-prescribed and self-administered use of antibiotics in the dairy farms. Conclusions Smallholding dairy farmers operated within very small margins of profits. The paucity of formal veterinary services at the community level, coupled with easy availability of antibiotics and the need to ensure profits and minimise losses, promoted non-prescribed antibiotic consumption. It is essential that these local drivers of irrational antibiotic use are understood in order to develop interventions and policies that seek to reduce antibiotic misuse

Noise-induced hearing loss in Asia

The aim of this manuscript is to summarize the current scenarios encompassing noise exposure in the workplace and the risk of noise-induced hearing loss (NIHL) in Asia. NIHL is the most prevalent and preventable occupational disease in most Asian countries. Sources of noise in these countries include manufacturing and agriculture industries, exploitation of natural resources, and urban traffic. The highest attributable fraction of adult-onset hearing loss resulting from noise exposure in the world comes from Asian countries. NIHL is a serious health problem in Asia, not only because of the number of affected labourers, but also because the majority of Asian countries are still developing economies where access to health services and preventive programmes are limited. Lack of awareness about NIHL among employers, employees, and health care professionals is one of the main barriers for the prevention of NIHL in Asia. In this paper, the sources of noise, NIHL prevalence in different industries, local legislation, and research publications on NIHL from Asia are discussed