Dairy farmers' levels of awareness of antibiotic use in livestock farming in Pakistan

Food security in Pakistan, particularly concerning dairy farming, is threatened by the widespread misuse of antimicrobials. The Food and Agriculture Organization (FAO) defines food security based on four dimensions: availability, utilization, access, and stability. In Pakistan, the focus often prioritizes food quantity over quality and safety. The uncontrolled use of antimicrobials in dairy farms contributes to food insecurity and unsustainable practices. Antimicrobials are crucial for disease prevention and treatment in livestock, but their overuse leads to antibiotic resistance, a major global health concern. Sources of antibiotics in the ecosystem include sewage, aquaculture, agriculture runoff, and veterinary drug usage. The excessive use of antibiotics in developing countries like Pakistan is alarming due to the high prevalence of infectious diseases and the consequent impact on therapeutic practices, economic conditions, and public health. The pressure exerted by farmers on veterinarians often leads to increased antibiotic use, necessitating a collaborative approach to improve antimicrobial stewardship. This study, the first of its kind in Lahore, Pakistan, aims to explore the knowledge, attitudes, and perceptions of dairy farm owners regarding antibiotic use and resistance among their animals to understand and address this critical issue.

The majority of research on self-medication and antibiotic resistance focuses on hospitals, universities, and communities. Limited studies have examined these practices on dairy farms, particularly from the farmers' perspectives. Existing literature emphasizes the role of farmer knowledge and perception in the rational use of antibiotics, highlighting the need for awareness campaigns and policy interventions to improve practices. Studies in various regions (e.g., Karachi, Pakistan; Saudi Arabia; India) show similar trends of self-medication and lack of consultation with veterinarians, underscoring the global nature of this problem. These studies frequently note the influence of financial constraints and peer pressure on farmer behavior. The lack of awareness regarding the dangers of antibiotic misuse is another recurring theme in the existing literature.

This study conducted an interview-based survey of 270 dairy farmers in urban and suburban Lahore, Pakistan, during 2019-2020. Farms were selected based on criteria including animal numbers, farm size, reported disease burden, and antibiotic usage. A structured questionnaire was developed after consultation with experts and the analysis of existing questionnaires. The questionnaire consisted of two parts: the first gathered demographic information (age, education level, place of living, income, household size); the second focused on knowledge, attitudes, and perceptions about antibiotic use and resistance. Data analysis used SPSS version 16, employing descriptive statistics to calculate frequencies and percentages and bar graphs for comparative analysis. The reliability and internal consistency of the interview responses were verified using Cronbach's alpha.

The study found that 22% of farmers do not consult a veterinarian, 32.9% do not follow correct dosage instructions, and 39% discontinue treatment prematurely. A concerning 40% of farmers were unaware of the dangers of antibiotic misuse, with many saving leftover antibiotics for future use and sharing them with others (20.7%). The majority (90%) perceived self-medication as more economical than consulting a veterinarian. Analysis revealed an indirect relationship between farmers' education levels and their antibiotic-sharing behavior. A negative correlation existed between the use of integrated disease management and animal overcrowding, and a negative correlation was observed between education level and location of residency. There was a significant positive link between awareness of antibiotic misuse dangers and location of residency. The highest percentage of farmers who admitted to improper disposal practices were illiterate (33.9%).

This study's findings align with other research indicating widespread antibiotic misuse and lack of awareness among farmers in developing countries. The reliance on self-medication due to financial constraints and peer pressure is a significant barrier to improved antibiotic stewardship. The low level of trust in veterinarians and the preference for advice from non-veterinary sources highlight the need to build stronger relationships between farmers and professionals. The misuse of antibiotics, including incorrect dosage, premature discontinuation of treatment, and inappropriate sharing, contributes to antibiotic resistance and compromises food safety. The lack of awareness regarding the potential consequences of misuse further exacerbates this problem. These findings underscore the urgent need for targeted interventions.

This study highlights the significant challenges of antibiotic misuse among dairy farmers in Lahore, Pakistan, and its link to food security concerns. The low levels of education and awareness, coupled with financial constraints, contribute to irresponsible practices. A multi-pronged approach is required including education campaigns, policy changes to regulate antibiotic dispensing, promotion of integrated disease management, and addressing financial barriers to veterinary care. Future research should focus on strengthening data collection on dairy farms and integrating various stakeholders to minimize antibiotic misuse.

The study was limited to Lahore, Pakistan, and the findings might not be generalizable to other regions. The reliance on self-reported data might introduce bias, and the cross-sectional nature of the study limits causal inferences. The lack of precise figures for the total number of dairy farms and farmers in the study area also limits the precise estimation of prevalence rates. Future studies incorporating longitudinal data and a larger sample size are recommended.