Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

Abstract

A cross sectional, multicentre survey utilizing a questionnaire was used to assess 6 th -(final-) year veterinary medical students' perceptions, attitude and knowledge about antibiotic resistance (ABR) and stewardship (ABS) in 5 convenientlyselected veterinary schools in Nigeria. Data obtained were analyzed by Fischer's exact and χ 2 tests at a significance level of P < 0.05. Out of 175 final-year veterinary students, 95 (54.3% i.e., response rate) completed the survey. Of the 95, 17% have heard about ABS and 7% knew the meaning of ABS. Less than 10% knew the core principles and goals of ABS and less than 20% of the respondents knew the ideal members of an ABS team. All the respondents rightly knew that no antibiotic stewardship programme (ASP) exist in veterinary hospitals in Nigeria, nearly all of them (97%) reported that antibiograms are rarely used during antibiotic (AB) prescription in their institutional veterinary teaching hospital (VTH) and about two-third (65%) believed that ABs are overused in most veterinary hospitals in Nigeria. Most of the respondents believed that ABR is of greater concern at national level than in their institutional VTHs and majority of them (92%) believed that ABR is a global problem (P = 0.009). Minority of the respondents knew that inadequate personal hygiene, use of substandard ABs, prescription of ABs by non-veterinarians/professionals, poor infection control practices, treating self-limiting infections with ABs, suboptimal and incomplete AB doses (P = 0.017), are factors that promote ABR. Minority of the respondents knew that education on AB therapy (44%), development of antibiotic usage policies (35%), reduction of AB use (14%), establishment of national AB resistance surveillance (28%) and development of institutional guidelines for AB use (29%), are critical interventions to curb ABR. Only 17% of the respondents felt that their education on ABR is adequate for their veterinary career. Most of the respondents believed that strong knowledge of ABs is important for their future veterinary career and would like more education about ABR and ABS. Overall mean correct score of 29% on clinical knowledge vignettes with similar scores across the schools in all the areas, was recorded. This survey has shown that Nigerian veterinary students' perception and knowledge about ABR and ABS are poor and therefore creates doubt about their preparedness to practice ABS. There is urgent need for improved ABS education in Nigerian veterinary schools.

Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey

“…On key terms in AMR, only 42.3% of respondents were aware of the term "AMR". This is confirmed by the previous observation of Anyanwu et al [26]. Similar low scores (approximately 25%) were observed for "superbugs", "antimicrobial stewardship", "Global Antimicrobial Resistance Surveillance System", "Global Antibiotic Research and Development Partnership", and the "Global Action Plan on Antimicrobial Resistance".…”

“…These findings signify a deficiency in aspects of the clinical training curricula, especially microbiology, pharmacology, and medicine, or lack of integration of knowledge as well as poor exposure of Nigerian veterinary students to associated outcomes of AMR. Comparably, in another survey, low knowledge about AMR was documented among final year veterinary students [26] It was not surprising that the senior-level students possess higher knowledge levels on AMR compared to others. In this study, satisfactory knowledge of AMR increased with an increasing academic year of the veterinary studentship.…”

“…For the "National Action Plan for Antimicrobial Resistance, Nigeria", three-fourths of respondents were unaware. This low level of awareness on AMR could be attributable to the lack of in-depth AMR education in Nigerian veterinary schools [26] and deficiencies in veterinary curricula [38,39]. Furthermore, the unexpectedly low national attention accorded to AMR in food animals and the environment could contribute to the low awareness observed.…”

“…The scope of AMR in the academic training of undergraduate veterinary students in most Nigerian schools is not clearly defined. A previous survey of final year students in five conveniently selected veterinary schools in Nigeria indicated poor knowledge of AMR [26]. In this study, we conducted a cross-sectional survey on personal antimicrobial usage among students (year two to year six), studying for the degree of doctor of veterinary medicine (DVM) from 10 veterinary schools in the country.…”

Knowledge, Attitudes, and Perceptions Associated With Antimicrobial Stewardship Among Veterinary Students: A Multi-Country Survey From Nigeria, South Africa, and Sudan

“…Little or scanty information exist on KAP of veterinary and medical professionals from African countries. It is also a fact that healthcare systems is "less" rigorously regulated in the region (31) and moreso, the global threats and burdens of emergence of antimicrobial resistant bacteria is increasing, particularly in the low-and-middle income countries (LMICs), particularly those from African and Asian countries (32)(33)(34). This study represents one of the rare continental attempts in the African region to assess the KAP of veterinary medical students, in this case, from Nigeria, South Africa and Sudan.…”