Background Antibiotic resistance is often reported and is of major concern as a public health problem. The hill tribe people in Thailand are considered populations vulnerable to antibiotic resistance due to their poor economic and educational status. The study aimed to estimate the prevalence of, the factors associated with, and the major species of bacteria involved in antibiotic drug resistance among the Lahu hill tribe people in northern Thailand. Methods A cross-sectional study was conducted to gather information from participants between March and September 2019. A validated questionnaire was used for data collection. Participants who presented an illness related to infectious diseases were eligible to participate in the study and were asked to obtain specific specimens. Antibiotic susceptibility was tested by the Kirbey-Bauer disk diffusion test. Chi-square tests and logistic regression were used to detect the associations between variables at the significance level of α = 0.05. Results A total of 240 participants were recruited into the study; 70.4% were females, 25.4% were aged 30–40 years. More than half worked in the agricultural sector (55.4%) and had an education level of less than primary school (45.8%). The majority had urinary tract infections (67.9%) with two major pathogenic species of the infection: Escherichia coli (12.8%) and Enterobacter cloacae (8.0%). The prevalence of antibiotic resistance was 16.0%. Escherichia coli and Klebsiella pneumoniae species were found to have multidrug resistance that was greater than that of other species, while ampicillin was found to have the greatest drug resistance. In the multivariate model, it was found that those who had poor knowledge of antibiotic use had a 2.56-fold greater chance (95% CI = 1.09–5.32) of having antibiotic resistance than did those who had good knowledge of antibiotic use, and those who had poor antibiotic use behaviors had a 1.79-fold greater chance (95% CI = 1.06–4.80) of having antibiotic resistance than did those who had good antibiotic use behaviors. Conclusion Effective public health interventions are urgently needed to reduce antibiotic drug resistance among the Lahu people by improving their knowledge and skills regarding the proper use of antibiotics and eventually minimizing antibiotic resistance.
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