Antimicrobial Use and Veterinary Care among Agro-Pastoralists in Northern Tanzania.
Antimicrobial Use and Veterinary Care among Agro-Pastoralists in Northern Tanzania.
复制标题
坦桑尼亚北部的农业养护者之间的抗菌使用和兽医护理。
DOI：
10.1371/journal.pone.0170328
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Quinlan RJ
中科院分区：
文献类型：
--
作者：
Caudell MA;Quinlan MB;Subbiah M;Call DR;Roulette CJ;Roulette JW;Roth A;Matthews L;Quinlan RJ
在牲畜中频繁和不受管制地使用抗菌剂（AM）需要公共卫生关注，因为这可能是耐药细菌的选择压力。对拥有世界上很大一部分牲畜的小农户进行研究对于了解AM使用的做法如何影响耐药性至关重要。我们提出了一个文化生态混合方法分析，探讨兽医护理，管理松散的AM使用，以及人类暴露于AM通过肉类和牛奶消费在三个农村到城市周边的坦桑尼亚民族（N = 415户）。报告的自我给药AM的使用因种族而异（马赛：74%，阿鲁沙：21%，查加：1%），咨询专业兽医（马赛：36%，阿鲁沙：45%，查加：96%）以及在AM治疗期间和之后观察到的肉类和牛奶停止消费（马赛：7%，阿鲁沙：72%，查加：96%）。抗生素土霉素是该样品中最常见的AM。在种族群体内，畜群组成的差异，特别是小股票和牛群的大小，是最强烈的相关性的差异，奠定AM使用。在阿鲁沙，城市化的代理，包括拥有交通工具和依赖“零放牧”畜群与兽医咨询有最强的正相关，而距离城市中心呈负相关。对于马赛人来说，咨询与使用传统治疗师或兽医药店呈负相关。观察到的撤离与马赛人拥有技术的关系最密切，而阿鲁沙的遵守情况则显示出季节性差异。这种“一个健康”的分析表明，生计和文化生态位因素，通过其与小农人口的做法，提供洞察选择压力，可能有助于抗菌素耐药性的演变和传播。
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.