antibiotics usage by pastoralists in livestock in north-central...

Antimicrobial usage by traditional livestock farmers in lactating cows in North-central

Nigeria: Risk perceptions, drivers for misuse and public health implications

Nma Bida Alhaji1, Bello Nma Sani1, Mohammad Baba Aliyu1, Mohammed Katun Yakubu1, Ismail Ayoade Odetokun2, Ibrahim

Ghali Mohammed2

1Niger State Ministry of Livestock and Fisheries, Minna, Nigeria2Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Nigeria

2nd ICREID, March 13–15, 2019, Addis Ababa

Disclosure

❑ Nothing to disclose

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Background

• Milk is an important source of nutrients tohumans and animals

• Antimicrobials are used by pastoralists tomaintain good health and productivity of cowsfor higher milk yields

• Improper antimicrobial usage in food animalscontributes to development of antimicrobialresistance, now a global health threat

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Background Cont...

• Global antimicrobial usage in food animals wasestimated at 63 000 tons per year in 2015 andprojected to increase by almost 70% in 2030

• Exploration of pastoralists’ local knowledge andpractices regarding antimicrobial usage inlactating cows is crucial for development ofantimicrobial surveillance in local milkproduction

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Study Objectives

➢To assess pastoralists’ knowledge and practicesregarding antimicrobial usage in lactating cows

➢ To explore risk pathways for emergence andspread of antimicrobial resistant pathogens fromcow milk to humans

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Hypothesis

❑ Socio-economic activities of pastoralists thatcannot influence their misuse of antimicrobialagents in lactating cows

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Methods

• Study design: interview questionnaire-basedcross-sectional study in pastoral settlements ofNorth-central Nigeria in 2017

• Sampling: 384 pastoral households selected usingsystematic random sampling approach

• Data analysis: descriptive and analytical analysesat 95% confidence level

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8A pastoral settlement in North-central Nigeria

Results• All the 384 recruited (45.6% or n=175 agro and

54.4% or n=209 nomadic) pastoralistsparticipated in the survey

• Majority (65.2%) of them had no formaleducation

• About 11% of participants indicatedantimicrobials misuse to be when given under-dose, while 58.9% of them had no knowledge ofwhat antimicrobials misuse entailed

• Majority (51.6%) of them had no knowledgeabout the effects of improper antimicrobial usagein lactating cows 9

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Table 1. Pastoralists’ knowledge regarding antimicrobial usage in lactating cows in North-central Nigeria

Variable Frequency (n)

Proportion(%)

Antimicrobials misuse is when

Administered under-dose 42 10.9

Administered over-dose 39 10.2

Administered in normal dose 77 20.0Don’t know 226 58.9

Effects of improper antimicrobial usage in lactating cows

Non response to bacterial infection treatment 121 31.5

Extra costs on treatment of bacterial infection 65 16.9Don’t know 198 51.6

Antimicrobials misuse in lactating cows can predispose to resistant pathogens emergenceAgree 103 26.8Disagree 158 41.1Don’t know 123 32.1

Effects of antimicrobial resistance in humans

Non response to bacterial infection treatment 56 14.6

Extra costs on treatment of bacterial infection 41 10.7

Longer duration of illness and treatment 55 14.3

Don’t know 232 60.4

Results Cont…

• Most (61.7%) respondents reported self-prescription of antimicrobials used in cows

• About 35% of them patronized animal drughawkers for antimicrobials used in animals

• Regarding antimicrobials dosage determination,67.4% of respondents reported arbitraryapplications

• About 15% of them used antimicrobials toincrease milk yield in lactating cows

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Practice Frequency (n)

Proportion(%)

Prescription of antimicrobials used on animals

Animal health officials 108 28.1Self prescription 237 61.7Friends and relations 39 10.2Purchase of antimicrobials

Veterinary drug shops 209 54.4

Human drug shops 41 10.7

Animal drug hawkers 134 34.9

Dosage determined before use

From instructions on the label 125 32.6

Arbitrary 259 67.4

Purpose for antimicrobial usage

Treatment of udder infections 205 53.4

Prevention of udder infections 93 24.2Promotion of milk yield 59 15.4

Don’t know 27 7.012

Table 2. Practices regarding antimicrobial usage in lactating cows by pastoralists in North-central Nigeria

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Frequently used antimicrobials by pastoralists in lactating cows

98,7 96,6 95,8 95,3 94,386,2

51,843,8

Pro

po

rtio

ns

(%)

Antimicrobials

Results Cont…Risk pathways for emergence and spread ofantimicrobial resistant pathogens from cow milkto humans:

➢ Consumption of contaminated raw milk and milkproducts (p<0.001)

➢ Handling of contaminated udder and milk(p<0.001)

➢ Aerosols of discarded contaminated milk in theenvironment (p=0.010)

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A pastoralist milking a cow

Drinking milk directly from cow udder

Results Cont…

Socio-economic factors that influencedantimicrobials misuse in lactating cows:

• Improper antimicrobial usage (p<0.001)

• Non-enforcement of regulating laws (p<0.001)

• Weak financial status (p<0.001)

• Low education and expertise (p<0.001)

• Extensive husbandry system (p<0.001)16

Factors Poor

influence (%)

Satisfactory

influence (%)

OR 95% CI P-value

Improper antimicrobial usage

Agro-pastoralists 111 (63.4) 64 (36.6) 1.00

Nomadic pastoralists 13 (6.2) 196 (93.8) 26.2 13.79, 49.59 <0.001

Non-enforcement of regulatory laws

Agro-pastoralists 98 (56.0) 77 (44.0) 1.00

Nomadic pastoralists 44 (21.1) 165(78.9) 4.8 3.05, 7.46 <0.001

Weak financial status

Agro-pastoralists 93 (53.1) 82 (46.9) 1.00

Nomadic pastoralists 42 (20.1) 167 (79.9) 4.5 2.88, 7.07 <0.001

Low education and expertise

Agro-pastoralists 97 (55.4) 78 (44.6) 1.00

Nomadic pastoralists 39 (18.7) 170 (81.3) 5.4 3.43, 8.57 <0.001

Extensive husbandry system

Agro-pastoralists 130 (74.3) 45 (25.7) 1.00

Nomadic pastoralists 50 (23.9) 159 (76.1) 9.2 5.77, 14.62 <0.001

% - Row percentage; OR – Odds ratio; CI – Confidence interval; Statistically significant at p<0.05

Table 3. Socio-economic factors that influence pastoralists’ misuse of antimicrobials inlactating cows in North-central Nigeria

Conclusions

• This study identified low knowledge andpractices regarding proper antimicrobial usage inlactating cows among surveyed pastoralists

• Pastoralists’ socio-economic activitiessignificantly influenced their misuse ofantimicrobials in lactating cows

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Recommendations

• Sensitization of pastoralists on proper use ofantimicrobials and effects of misuse in foodanimals will mitigate menace of antimicrobialresistance in humans and animals

• Addressing these socio-economic activitiesthrough multi-disciplinary collaborations, in linewith ‘One Health’ approach, will assure foodsafety, public and environmental health

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Acknowledgements

• All pastoralists that participated in the survey

• Area Animal Health Officers in the Niger StateMinistry of Livestock and Fisheries, Nigeria

• Virology Education

• Africa CDC

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