Determinants of Knowledge, Attitude, and Practices of Veterinary Drug Dispensers toward Antimicrobial Use and Resistance in Main Cities of Malawi: A Concern on Antibiotic Stewardship

Abstract

Antimicrobial resistance (AMR) is an emerging challenge to global public health. The use of antibiotics in the veterinary field is one of the contributing factors to AMR mostly due to poor knowledge, attitudes, and practices (KAP) of dispensers. Veterinary drug dispensers are expected to guide clients on indications, contraindications, and withdrawal periods of veterinary drugs. This study assessed veterinary drug dispensers’ KAP toward AMR and associated potential contributing factors. A cross-sectional study, using a structured questionnaire, was conducted in three main cities of Malawi, namely Mzuzu, Lilongwe, and Blantyre. A total of 68 agrovet shops were selected using a simple random sampling technique. The KAP level was presented descriptively. Bivariate and multivariable analyses were run to investigate the relationships between the independent and outcome variable. Overall, the KAP score for knowledge, attitude, and practices was 46.7%, 49.2%, and 41.6%, respectively. The significant determinants of the knowledge were the practice of asking for a written prescription (OR: 16.291, 95% CI: 11.6–24.2) (p = 0.024), female (OR: 0.609, 95% CI: 0.3–0.9) (p = 0.001), and old age (≥35) (OR: 0.227, 95% CI: 0.1–0.5) (p = 0.04). Poor knowledge, negative attitude, and poor practices were observed among most of the participants. Sensitization and training on AMR and antimicrobial stewardship are recommended to address the KAP score gaps and the observed determinants among veterinary drug dispensers.

Prescribing Patterns of Antibiotics According to the WHO AWaRe Classification during the COVID-19 Pandemic at a Teaching Hospital in Lusaka, Zambia: Implications for Strengthening of Antimicrobial Stewardship Programmes

“…The inappropriate prescribing of antibiotics can lead to an increase in antimicrobialresistant infections, leading to increased morbidity, mortality, and healthcare costs [9][10][11][12]. The impact of AMR is arguably greatest in low-income countries, which face the double burden of fewer antibiotic choices and higher rates of infectious diseases [13][14][15][16][17][18][19][20][21][22][23][24]. Further, antibiotic-resistant infections commonly occur in hospitals because of the nature of the activities, such as large numbers of susceptible patients and invasive procedures taking place in the hospital environment [25].…”

Antibacterial activities of honey against Escherichia coli and Staphylococcus aureus: A potential treatment for bacterial infections and alternative to antibiotics

“…Given the escalating issue of antimicrobial resistance (AMR), there is an urgent need to promote drug discovery from natural products [6][7][8][9][10] . The inappropriate use of conventional antibiotics in humans, animals, and the environment have all contributed to the development and spread of AMR [11][12][13][14][15][16][17] . Antimicrobial resistance is a global public health problem that should be addressed using various strategies that include promoting drug discovery [7,9,[18][19][20][21][22][23][24] and implementing antimicrobial stewardship programmes [25][26][27][28][29][30][31][32][33][34][35] .…”

Expiry of veterinary medicines in supply outlets in Central Uganda: prevalence, management and associated factors

“…In Bhutan, for fear of future shortages, it is not uncommon to find veterinarians and para-veterinarians keeping expired drugs for sale and use in times of deficiency [ 18 ]. In Malawi, the practice of selling products that were about to expire or had expired at a low price to avoid losses is a common occurrence [ 19 ]. Likewise, in Ethiopia, some private veterinary drug shop owners and public veterinary pharmacy attendants do not dispose of expired drugs for the same reasons.…”