Antimicrobial Use and Veterinary Care among Agro-Pastoralists in Northern Tanzania

• Published in: PloS one 2017-01, Vol.12 (1), p.e0170328
• Main Authors: Caudell, Mark A, Quinlan, Marsha B, Subbiah, Murugan, Call, Douglas R, Roulette, Casey J, Roulette, Jennifer W, Roth, Adam, Matthews, Louise, Quinlan, Robert J
• Format: Article
• Language: English
• Subjects: Animals; Annual variations; Anti-Bacterial Agents - adverse effects; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Bacteria; Biology and Life Sciences; Bovidae; Cattle; Cattle Diseases - drug therapy; Cattle Diseases - microbiology; Consultation; Drug resistance; Drug Resistance, Microbial - drug effects; Drug Resistance, Microbial - genetics; E coli; Ecological effects; Ecological monitoring; Escherichia coli; Households; Humans; Livestock; Meat; Medicine and Health Sciences; Microbial drug resistance; Milk; Minority & ethnic groups; Oxytetracycline; Pathogens; People and Places; Professionals; Public health; Risk factors; Selection, Genetic - genetics; Tanzania; Urban areas; Urban environments; Urbanization; Veterinarians; Veterinary antibiotics; Veterinary medicine; Veterinary surgeons
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0170328

Frequent and unregulated use of antimicrobials (AM) in livestock requires public health attention as a likely selection pressure for resistant bacteria. Studies among small-holders, who own a large percentage of the world's livestock, are vital for understanding how practices involving AM use might influence resistance. We present a cultural-ecological mixed-methods analysis to explore sectors of veterinary care, loosely regulated AM use, and human exposure to AMs through meat and milk consumption across three rural to peri-urban Tanzanian ethnic groups (N = 415 households). Reported use of self-administered AMs varied by ethnic group (Maasai: 74%, Arusha: 21%, Chagga: 1%) as did consultation with professional veterinarians (Maasai: 36%, Arusha: 45%, Chagga: 96%) and observation of withdrawal of meat and milk from consumption during and following AM treatment (Maasai: 7%, Arusha: 72%, Chagga: 96%). The antibiotic oxytetracycline was by far the most common AM in this sample. Within ethnic groups, herd composition differences, particularly size of small-stock and cattle herds, were most strongly associated with differences in lay AM use. Among the Arusha, proxies for urbanization, including owning transportation and reliance on "zero-grazing" herds had the strongest positive associations with veterinarian consultation, while distance to urban centers was negatively associated. For Maasai, consultation was negatively associated with use of traditional healers or veterinary drug-shops. Observation of withdrawal was most strongly associated with owning technology among Maasai while Arusha observance displayed seasonal differences. This "One-Health" analysis suggests that livelihood and cultural niche factors, through their association with practices in smallholder populations, provide insight into the selection pressures that may contribute to the evolution and dissemination of antimicrobial resistance.