How farm practices and antibiotic use drive disease incidence in smallholder livestock farms: Evidence from a survey in Uganda

Background: Antimicrobial resistance (AMR) is a growing threat to human and animal health, and the growth in AMR prevalence globally is thought to be partially driven by non-therapeutic antibiotic use in livestock production. However, livestock farms may depend on antibiotics as a prophylactic disease management tool, and reducing antibiotic use in isolation may harm farmers' economic security. In order to help farmers safely reduce their antibiotic use, we must first determine how necessary non-therapeutic antibiotic use is for disease management, and how other farm practices can guard against disease and make antibiotic use reduction safe and feasible. Methods: Using the Antimicrobial Use in Livestock Production Settings (AMUSE) tool, a standardised survey tool for investigating attitudes and practices relating to antibiotic use on farms, we investigated the farming practices and animal disease outcomes of smallholder livestock farms in Uganda. We used logistic regression to investigate the effect of prophylactic antibiotic use; as well as of prophylactic vaccination, non-antimicrobial medicines, and onfarm biosecurity measures; on the likelihood of disease outbreaks. Findings: We found that prophylactic antibiotic use did indeed seem to guard against disease outbreaks, underlining the rationality of non-therapeutic antibiotic use in smallholder livestock farms and the need to pair antibiotic use reduction with other interventions in order to mitigate risk. The most effective intervention pairing varied by species, with expanded access to animal health services and the use of prophylactic vaccination demonstrating the greatest potential overall. Implications: These findings echo earlier results generated using the AMUSE survey tool. They should be followed by participatory research in which farmers are consulted to explore intervention options, and subsequently by farm-level intervention trials of combined antimicrobial stewardship interventions to verify their effectiveness

Antimicrobial use and resistance in food-producing animals-How can we protect the efficacy of antibiotics for reproductive diseases?

The ongoing emergence of antibiotic resistance jeopardizes efficacy of antibiotics in curing animals from bacterial infections that threaten their health, welfare and productivity. This review gives an overview of antimicrobial use data in food-producing animals, a discussion on how antimicrobials are used for some infections in the reproductive system in cattle, the horse and pig in Europe where there are differences in treatment practices including options to refine the use of antibiotics, and finally, a presentation of the antibiotic resistance for some bacteria collected from the reproductive system. It is shown that there are differences in applied treatment regimens for, as well as prevention of, several reproductive diseases in Europe. Some of the treatments are not evidence-based, which should be considered by clinicians and other stakeholders. It is concluded that a more refined and restrictive use of antibiotics could be achieved by adhering to evidence-based guidelines by national and international expertise including the scientific literature when available. This may call for a re-think among the animal health stakeholders regarding the use of antibiotics and may demand new skill-sets in the animal health sphere

Understanding veterinary drug shop workers' knowledge and practices to identify drivers of antibiotic use in Vietnamese livestock farms

Background: Antimicrobial resistance (AMR) is a One Health issue and a major threat to animal and human health. Antibiotic use (ABU) drives AMR development, and several hotspots for ABU, and AMR, in livestock have been identified in Southeast Asia, including Vietnam. There are often multiple drivers of ABU at farms, and to identify all of them there is a need to look beyond farm level. Objectives: The overall aim of this study was to identify routines and/or competencies, related to antibiotic sales, among veterinary drug shop workers that may be improved in order to decrease the medically non-rational use of antibiotics in livestock production. Methods: A questionnaire-based survey was conducted at 50 veterinary drug shops in northern Vietnam. Results: Results showed high education and knowledge levels. According to the respondents, antibiotic treatment advice was almost always provided to the farmers, and the recommended treatment was most commonly based on recommendations for the specific disease. However, farmers had almost never had their animals properly diagnosed. Antibiotics were the most sold drug category, penicillins being the most common. Several broad-spectrum antibiotics were also quite frequently sold. Further, >50% of respondents recommended antibiotics for disease prevention. Conclusions: Even though education and knowledge levels might be high, several challenges can prevent drug shop workers from contributing to more prudent ABU at farms, for example, lack of proper diagnosis, commercial interests and individual farmer motives, often in combination with poor compliance to regulations

Geo-mapping of time trends in childhood caries risk - a method for assessment of preventive care

Background: Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time. The aim of this study was to develop the geo-map concept, addressing time trends in caries risk, and demonstrate the novel approach by analyzing epidemiological data from preschool residents in the region of Halland, Sweden. Methods: The study population consisted of 9,973 (2006) and 10,927 (2010) children between 3 to 6 years of age (similar to 77% of the eligible population) from whom caries data were obtained. Reported dmfs >0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region). Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI (R) ArcGIS system. Parish-level socioeconomic data were available. Results: The overall proportion of caries-free (dmfs = 0) children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level) smoothed relative risks (SmRRs) increased from 1.76/0.44 = 4.0 in 2006 to 2.37/0.33 = 7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period. Conclusion: Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive care in child populations

Bovine brucellosis: prevalence, risk factors, economic cost and control options with particular reference to India- a review

Background: Brucellosis is an economically important zoonotic disease with worldwide distribution, with low-income countries being more affected. The disease is endemic in India, a country that house the world’s largest cattle and buffalo population and produce the most milk in the world. Results: Prevalence of the disease in the country is reported as low as 1% to as high as 60% by different researchers but many of the published studies that reported higher prevalence were conducted in non-randomised samples. Based on this review, overall prevalence in the country is likely 12% or less. About 20 different risk factors are reported that contribute/ predispose to occurrence of bovine brucellosis. The risk factors could be classified in four groups: host factors, farmer’s factors, managemental factors, and agro-ecological factors. Various studies reported high economic burden of the diseases in dairy animals but there is dearth of comprehensive and rigorous economic studies. Conclusions: In the absence of highly effective vaccines and because of difficulties in executing a segregation and slaughter policy of infected animals in countries like India, control of bovine brucellosis remains a challenge