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

Henson Kainga; Marvin Collen Phonera; Ibrahim Chikowe; Elisha Chatanga; Hlupikire Nyirongo; Mike Luwe; James Mponela; Vincent Kachisi; Nathani Kamanga; Julius Chulu; Gilson Njunga; Daisy Nabadda; Alyce Fonchin; Simegnew Adugna Kallu; Steward Mudenda; Rabecca Tembo; Mildred Zulu; Florence Mwaba; Natalia Mbewe; Prudence Mpundu; Mulemba Tillika Samutela; Musso Munyeme; John Bwalya Muma; Edgar Simulundu

doi:10.3390/antibiotics12010149

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

Antibiotics (Basel). 2023 Jan 11;12(1):149. doi: 10.3390/antibiotics12010149.

Authors

Henson Kainga¹, Marvin Collen Phonera², Ibrahim Chikowe³, Elisha Chatanga⁴, Hlupikire Nyirongo¹, Mike Luwe², James Mponela², Vincent Kachisi⁵, Nathani Kamanga², Julius Chulu², Gilson Njunga², Daisy Nabadda⁶, Alyce Fonchin⁷, Simegnew Adugna Kallu⁸, Steward Mudenda⁹, Rabecca Tembo¹⁰, Mildred Zulu¹⁰, Florence Mwaba¹⁰, Natalia Mbewe¹¹, Prudence Mpundu¹², Mulemba Tillika Samutela¹³, Musso Munyeme¹⁴, John Bwalya Muma¹⁴, Edgar Simulundu^{14

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Affiliations

¹ Department of Veterinary Epidemiology and Public Health, Faculty of Veterinary Medicine, Lilongwe University of Agriculture and Natural Resources, Lilongwe 207203, Malawi.
² Department of Animal Health and Livestock Development, Ministry of Agriculture, Lilongwe 207203, Malawi.
³ Pharmacy Department, Kamuzu University of Health Sciences (KUHES), Blantyre P.O. Box 360, Malawi.
⁴ Department of Veterinary Pathobiology, Faculty of Veterinary Medicine, Lilongwe University of Agriculture and Natural Resources, Lilongwe 207203, Malawi.
⁵ Excel Private Secondary School, Blantyre 30758, Malawi.
⁶ Department of Biosecurity, Ecosystems and Public Health, College of Veterinary Medicine, Makerere University, Kampala P.O. Box 7062, Uganda.
⁷ Community Initiative for Sustainable Development, Manko-Bamenda P.O. Box 356, Cameroon.
⁸ College of Veterinary Medicine, Haramaya University, Dire Dawa P.O. Box 138, Ethiopia.
⁹ Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia.
¹⁰ Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka P.O. Box 50110, Zambia.
¹¹ Department of Basic and Clinical Nursing Sciences, School of Nursing Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia.
¹² Department of Environmental and Occupational Health, Levy Mwanawasa Medical University, Lusaka P.O. Box 33991, Zambia.
¹³ Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka P.O. Box 10101, Zambia.
¹⁴ Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 10101, Zambia.
¹⁵ Macha Research Trust, Choma P.O. Box 20100, Zambia.

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.

Keywords: Malawi; agrovet shops; antibacterials; antimicrobial resistance; antimicrobial stewardship; attitudes; knowledge; practices.

Grants and funding

This work was in part funded by the Department of Animal Health and Livestock Development (DAHLD) and Lilongwe University of Agriculture and Natural Resources through the Office of the Director of Programmes (LUANAR-DOP). The Article Processing Charge (APC) was paid by the Office of the Director of Programmes (LUANAR-DOP).