Abstract
In African countries, antimicrobial resistance (AMR) issue remains pertinent. Despite this, little efforts have been made to assess the future veterinary prescribers on their knowledge, attitudes and practices (KAP) related to antimicrobial usage. This multi-country survey attempts to explore the KAP of future veterinarians on stewardship of antimicrobial and identify knowledge gaps. Eight veterinary schools participated from Nigeria, Sudan and South Africa. Data regarding perceptions and knowledge were analyzed using Chi-square χ2 test, Spearman's (Rho) Rank order correlation and factor analysis using principal component factoring extraction method. Fifty-two percent of the study participants were final year veterinary students, respectively, and majority (77.2%) had no previous knowledge of biomedical sciences. Majority age were 22–27 years (24.7 ± 2.8) 79% and multiple career fields post-graduation were preferred. Overall, poor perceptions and knowledge of antimicrobial stewardship were observed with variations among countries and only 36.3% (n = 123) of the students were confident in their ability to choose the ideal antimicrobial agents for a specific patient/group of animals. The majority of the final year students were confident of their knowledge regarding AMR (68%), making of Gram staining (69.2%) and in choosing the most ideal route for administering a specific antimicrobial (74.7%). The final year students had significantly (p < 0.05) higher confidence level for knowledge compared with the pre-final year students. Tetracyclines, penicillins, and sulphonamides represent the three most abused veterinary antimicrobials with similar ranking across countries. South African (69.7 ± 20.5) and Sudanese (68.1 ± 15.4) had significantly (p < 0.0001) higher mean scores compared to the Nigerian students (44.3 ± 6.8) in the student's ability to correctly match some specific antimicrobials against their classes but Nigerian students performed better in ranking antimicrobials. This survey revealed poor to average knowledge of antimicrobial stewardship among veterinary students with significant knowledge gaps across the countries. It is recommended that the relevant regulatory and standardization authorities should make concerted efforts and interventions to regularly review curricula to ensure the delivery of targeted formative and normative training, and improved lectures on antimicrobial usage and stewardship in order to improve the awareness and behaviors of future prescribers. The identified knowledge gaps of veterinary medical students on antimicrobial stewardship must be bridge to safeguard the future.
Highlights
Antimicrobial-resistant organisms are emerging and spreading rapidly in humans, animals and the environment
Only 8 veterinary schools responded to the survey including 3 from Nigeria, 4 from Sudan and 1 from South Africa
A total of 105 (29.7%) respondents studied in Nigeria, 177 (50.1%) in Sudan and 71 (20.1%) in South Africa (Table 1) giving a total of 353 responses from eight schools of veterinary medicine
Summary
Antimicrobial-resistant organisms are emerging and spreading rapidly in humans, animals and the environment. Recent reports from the United Nations World Health Organization (WHO) and other sister global health agencies issued warnings on the rise of multi-drug resistant (MDR) pathogens; with suggestions that drug-resistant infections could cause 10 million deaths each year by 2050, result in catastrophic economic damage similar to the 2008– 2009 global financial crisis, and that by 2030, antimicrobial resistance (AMR) could have forced up to 24 million people into extreme poverty, if no coordinated and multisectoral “One Health” approach is enforced to checkmate the global rise in MDR bacterial infections (https://news.un.org/en/story/2019/ 04/1037471) Another frightening report of the AMR from researchers of the University of York, established that hundreds of rivers in the world are contaminated with antimicrobials, which would potentially escalate the development of resistance among the environmental microflora with implications for human and animal health [3, 4]. In Bangladesh, one river was found to carry antibiotic (Metronidazole) levels about 300 times higher than is considered “safe” for the environment
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