Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Biosecurity Ecosystems and Veterinary Public Health, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
PLoS One. 2023 Jun 2;18(6):e0284822. doi: 10.1371/journal.pone.0284822. eCollection 2023.
Antibiotics are increasingly becoming ineffective as antimicrobial resistance (AMR) continues to develop and spread globally-leading to more difficult to treat infections. Countries such as Uganda are still challenged with implementation of AMR related strategies due to data paucity. This includes a lack of data on the prevailing knowledge and awareness of antimicrobial resistance and antibiotic use among farming communities, both commercial and subsistence, which are instrumental in the implementation of targeted interventions. The aim of our study was to assess the knowledge, attitudes and practices on AMR among subsistence and commercial farmers in Wakiso district, central Uganda.
A cross-sectional study was conducted using a semi-structured questionnaire in Wakiso district, Central Uganda in between June and September 2021. Polytomous latent class analyses were performed to group participants based on their responses. Multivariable regression and conditional inference trees were used to determine the association between demographic factors and knowledge on antibiotics and AMR.
A total of 652 respondents participated in the study among whom 84% were able to correctly describe what antibiotics are. Subsistence farmers (OR = 6.89, 95% CI [3.20; 14.83]), and to a lesser extent, farming community members which obtained their main income by another business (OR = 2.25, 95% CI [1.345; 3.75]) were more likely to be able to describe antibiotics correctly than individuals involved in commercial farming. Based on the latent class analysis, three latent classes indicating different levels of knowledge on AMR, were found. Subsistence farming, higher educational level and younger age were found to be associated with belonging to a class of better knowledge.
The majority of participants were able to correctly describe antibiotics and aware of AMR, however there was some degree of misunderstanding of several AMR concepts. Targeted AMR interventions should improve awareness and also ensure that not only subsistence farmers, but commercial farmers, are included.
随着抗菌药物耐药性（AMR）的不断发展和全球传播，抗生素的疗效越来越差，导致感染更难治疗。乌干达等国家仍然面临着实施 AMR 相关战略的挑战，因为数据匮乏。这包括缺乏有关商业和自给农业社区普遍的 AMR 知识和认识以及抗生素使用的数据，而这些数据对于实施有针对性的干预措施至关重要。我们的研究旨在评估乌干达中部瓦基索地区自给和商业农民对抗菌药物耐药性的知识、态度和实践。
在 2021 年 6 月至 9 月期间，在乌干达中部瓦基索区进行了一项横断面研究，使用半结构式问卷。采用多变量潜在类别分析根据参与者的反应对其进行分组。多变量回归和条件推理树用于确定人口统计学因素与抗生素和 AMR 知识之间的关联。
共有 652 名受访者参加了这项研究，其中 84%能够正确描述抗生素是什么。自给农民（OR=6.89，95%CI[3.20；14.83]），在较小程度上，主要收入来自其他业务的农业社区成员（OR=2.25，95%CI[1.345；3.75]）比从事商业农业的个体更有可能正确描述抗生素。根据潜在类别分析，发现了三个表示 AMR 知识不同水平的潜在类别。自给农业、较高的教育水平和较年轻的年龄与属于知识水平较高的类别有关。
大多数参与者能够正确描述抗生素和意识到 AMR，但对几个 AMR 概念存在一定程度的误解。有针对性的 AMR 干预措施应提高认识，并确保不仅包括自给农民，还包括商业农民。
