Use of antibiotics to treat humans and animals in Uganda: a cross-sectional survey of households and farmers in rural, urban and peri-urban settings

Abstract

Background Use of antibiotics to treat humans and animals is increasing worldwide, but evidence from low- and middle-income countries (LMICs) is limited. We conducted cross-sectional surveys in households and farms in Uganda to assess patterns of antibiotic use among humans and animals. Methods Between May and December 2018, a convenience sample of 100 households in Nagongera (rural), 174 households in Namuwongo (urban) and 115 poultry and piggery farms in Wakiso (peri-urban) were selected and enrolled. Using the ‘drug bag’ method, participants identified antibiotics they used frequently and the sources of these medicines. Prevalence outcomes were compared between different sites using prevalence ratios (PRs) and chi-squared tests. Results Nearly all respondents in Nagongera and Namuwongo reported using antibiotics to treat household members, most within the past month (74.7% Nagongera versus 68.8% Namuwongo, P = 0.33). Use of metronidazole was significantly more common in Namuwongo than in Nagongera (73.6% versus 40.0%, PR 0.54, 95% CI: 0.42–0.70, P < 0.001), while the opposite was true for amoxicillin (33.3% versus 58.0%, PR 1.74, 95% CI: 1.33–2.28, P < 0.001).Veterinary use of antibiotics within the past month was much higher in Wakiso than in Nagongera (71.3% versus 15.0%, P < 0.001). At both sites, oxytetracycline hydrochloride was the most frequently used veterinary antibiotic, but it was used more commonly in Wakiso than in Nagongera (76.5% versus 31.0%, PR 0.41, 95% CI: 0.30–0.55, P < 0.001). Conclusions Antibiotics are used differently across Uganda. Further research is needed to understand why antibiotics are relied upon in different ways in different contexts. Efforts to optimize antibiotic use should be tailored to specific settings.

Oxytetracycline residues in bovine muscles, liver and kidney tissues from selected slaughter facilities in South Western Uganda

“…Among the livestock diseases, tick-borne diseases are the most challenging to cattle production systems which accounts for 75.4% of losses in cattle (Byaruhanga et al 2015;Tayebwa et al 2018;Fuente et al 2019). In order to maintain health and productivity in animal production, antibiotics are used for treatment of livestock diseases, as animal feed additives and to promote growth in animals (Ndoboli et al 2019;Nayiga et al 2020).…”

The role of Escherichia coli in the etiology of piglet diarrhea in selected pig producing districts of central Uganda

“…Antimicrobial resistance profiles of E. coli isolates in the present study revealed high resistance to erythromycin and tetracycline. This is highly concerning considering that the tetracyclines are the most frequently used antibiotics for treatment of infections in animals and poultry in Uganda, compared to other antimicrobial agents (25). Therefore, the high resistance levels in our study might be the result of widespread and frequent use of tetracycline to treat colibacillosis in the field.…”

Validity of caregivers’ reports on prior use of antibacterials in children under five years presenting to health facilities in Gulu, northern Uganda

“…Studies in Uganda, report a high prevalence of veterinary use of antibacterials. The most commonly used antibacterials in veterinary medicine in Uganda include; procaine penicillin, trimethoprim/sulfadiazine, erythromycin sulphate, tylosin tartrate, oxytetracycline hydrochloride [ 24 , 25 ]. This high prevalence of antibacterial use can lead to increased risk of resistance within the community [ 26 ].…”

“…The caregivers could have been aware that self-medication is not a good practice, and therefore feared to tell the interviewers the truth. Another reason for the inconsistencies could have been due to consumption of these medicines from diffuse sources such as milk, water or food, studies in Uganda have reported veterinary use of antibacterials [ 24 , 25 ]. Another worrying explanation for the inconsistencies could be the quality of antibacterial medicines, some of these antibacterials may not contain the actual quantity of the active medicine the manufacturers claim they contain.…”