Knowledge, attitudes and practices towards antibiotic use and resistance in Kyegegwa district, Uganda - a questionnaire study

BackgroundAntimicrobials are widely used to protect human and animal health. Wide scale misuse can lead to the development and spread of antimicrobial resistance (AMR). In low and middle-income countries, knowledge, attitudes and practices are assumed to contribute to AMR. ObjectiveTo provide empirical data on knowledge and attitudes towards antibiotic use and resistance in livestock farmers, human and animal health professionals in Kyegegwa district, Uganda. To assess which factors (farming, education, affiliation with health-related ministries, gender, keeping cattle, goats, pigs, poultry or sheep) are associated with poor knowledge. MethodsA questionnaire related to antibiotic usage (AMU) and AMR, as well as demographic data was developed and administered to health practitioners of both the humanmedical and the livestock sector, and (semi)-intensive livestock farmers. Polytomous latent class analysis was used to cluster respondents - based on their responses - in different classes of knowledge and attitudes. The association between the probability of belonging to latent classes and demographic data was assessed by multinomial regression models and conditional inference trees. ResultsIn total 1022 responses were available (response rate 68.1%). More than 50% of the cattle received antibiotics at least three times during the last six months and in 39.1% members of the respondents households of this study were on antibiotics. Three latent classes related to attitude towards antibiotic access, usage and disposal; and two classes regarding resistance have been revealed. Class membership was associated with a number of socio-demographic factors. ConclusionInadequate knowledge and inappropriate practices as evidenced in this study should support further policy formulations and strategies to regulate AMU. It will also be useful in refining the implementation of local and national action plans and efforts to control AMR. A key component of this will require promotion of One Health approach and effective communication to tackle prevailing misconceptions.