Presented by Biruk Alemu, Kebede Amenu, Gezahagn Alemayehu, Hiwot Desta, Michel Dione, Ulf Magnusson and Barbara Wieland at the 15th International Symposium of Veterinary Epidemiology and Economics Chiang Mai, Thailand, 12-16 November 2018

1. Antimicrobial use in smallholder livestock
systems in Ethiopia
Biruk Alemu, Kebede Amenu, Gezahagn Alemayehu, Hiwot Desta,
Michel Dione, Ulf Magnusson and Barbara Wieland
15th International Symposium of Veterinary Epidemiology and
Economics Chiang Mai, Thailand, 12-16 November 2018

2. Introduction
• Globally continued increase in AMU in food-animal
production expected, especially in LMICs
• Irresponsible AMU and the resultant selective pressure
is a major driver for AMR
• Major food safety and public health concerns linked to
AM residues and AMR

3. Introduction
HICs
• Policies to restrict the
use of AM agents in
animals in place and
enforced
• Monitor trends in AMU
and AMR in livestock
LMICs
• Only limited, or unreliable,
data regarding AMU
(counterfeit and illegal
imports)
• Policies are not enforced
• Access to antimicrobials is
improving
•AMR has no boundaries, it is a global issue
•It does not matter where a resistant bacterium originates

4. Ethiopia
• The largest livestock population in Africa
• Different production systems and agro-ecology
• Very scarce information on antimicrobial usage in
animals
• Factors and incentives influencing AMU are poorly
understood

5. Objective
To understand knowledge and practice of smallholder
farmers regarding antimicrobial use, resistance and
residue

6. Materials and methods
• Cross-sectional survey
• 12 representative sites
were selected from six
districts, representing 3
different agro-ecologies
• 379 randomly selected
households

7. Survey tool
• Questions on: HH demographics, farm characteristics,
management of manure, feed types, animal health constraints,
disease prevention, animal health services, antimicrobial use,
farm product consumption and cost of animal health
• Open-ended and closed
questions
• Drug-box prepared
with products bought
in local vetdrug stores
• ODK on tablets for data
collection

8. Drug-box

9. Results

10. Knowledge
• 19% of livestock owners were unable to explain what
antibiotics do
• 17% of livestock owners were unable to explain what
vaccination does

11. Practice – Antimicrobial use
95.3
31.7
71.7
24.2
23.0
89.2
0.0 20.0 40.0 60.0 80.0 100.0
Highland crop-livestock
Lowland crop-livestock
Low/midland Pastoral
Proportion of self reported AM use
Others (Vitamines,
acaricides)
Antibiotic
Dewormer
%% of livestock owners reporting

12. Observation - 95% pastoralist have at least one Ab at hand

13. Proportion of farms using different
antibiotics
15.6
20.6
75.0
0.8
18.5
2.3 0.8
16.114.1
2.4
78.2
0.0 0.0
13.7
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Highland crop-livestock Lowland crop-livestock Low/midland Pastoral
Oxytetracycline Tetracycline (Human preparation)
Sulfonamide Penstrep (Penicillin and aminoglycoside
Procain Penicilin Tylosin (Macrolids)

14. Human antibiotics are being used for veterinary purpose
(18.5% of pastoralist households)

15. Proportion of farms using different
antihelminthics
65.6
31.7
50.8
71.9
0.0
0.0
28.9
0.8
62.5
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0
Highland crop-livestock
Lowland crop-livestock
Low/midland Pastoral
Tetramisole Clozasole Tetraclozan Ivermectin
Fenbendazole Fasinex Albendazole

16. Reasons for use

17. Reason for use
84.5
90.7 87.8
11.3 8.2 10.2
3.1 1.0 3.1
0.0
20.0
40.0
60.0
80.0
100.0
AntihelminthicAntibiotics
6.2 6.0 8.7
64.8 65.7 65.8
50.0
28.4
42.9
0.0
20.0
40.0
60.0
80.0
Cattle Goat Sheep
Treatment Disease prevention Fattening

18. Reason for use
• The most frequent reason for antimicrobial use were:
respiratory problems and digestive/internal parasite
infections

19. Treatment failure
3
12.7
84.2
Antibiotics
4.9
16.5
78.64
Antiheliminthics
Yes, frequently
Yes, sometimes
No, never

20. Inappropriate use
31% of households seem to use antibiotics wrongly

21. Sources of veterinary drugs
 influences how drugs are administered
2.3
14.3
83.1
75.8
36.5 33.132.0
0.0
4.0
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Highland crop-livestock Lowland crop-livestock Lowland
Agropastoral/Pastoral
Private drug supplier Government/official vet Veterinary drug store Market

22. Expiry date of antimicrobials
Pastoral areas - 97% not expired

23. Milk consumption from animals recently treated
with antibiotics
78.6
13.5
Lowland crop-livestock
No Yes
12.9
82.3
Lowland Agropastoral/Pastoral
89.8
9.4
Highland crop-livestock
13.9% report withdrawal
period of <7 days
79.8% report withdrawal
period of <7 days
25% report withdrawal
period of <7 dyas

24. Conclusions
• Differences across production systems
• Lack of knowledge and wrong practices were common
• Need to understand and monitor antimicrobial use in small
holder livestock keepers in Ethiopia
• Access to veterinary drugs limited in some areas (highlands)
• Increase in counterfeit and illegal imports (pastoralist areas)
• Findings of the study help to target future interventions to
reduce antimicrobial use and resistance

25. Outlook
• Further analysis planned: study behavior in more detail
to understand drivers of use
• Identify and target interventions (incentives, address
drivers of use, etc.)
• Check quality of drugs
• Link drug use with residues and AMR in meat and dairy
samples

26. This work is financed by
CRP Livestock, CRP Agriculture for Nutrition and
Health (A4NH), DAAD
Acknowledgements

27. This presentation is licensed for use under the Creative Commons Attribution 4.0 International Licence.
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