Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship.

Introduction: Antimicrobial resistance (AMR) is a global public health crisis. This study assessed the general public's consumption of antibiotics and associated factors in the Lusaka district of Zambia. Methods: This cross-sectional study was conducted among 2038 participants between December 2022 and January 2023. Data were analysed using Stata 13.0. Multivariable regression techniques were used to determine the factors that influenced antibiotic consumption. Results: Of the 2038 participants, 53.4% were female, and 51.5% had attended at least secondary school. Antibiotic use was 99.2%, of which 40.9% were appropriately used. Overall, 79.1% of antibiotics were prescribed in hospitals, while 20.9% were used from leftovers and accessed without prescriptions. This study found that the appropriate use of antibiotics was associated with being female, being aged 35 years and above, attaining secondary school or tertiary education, having a monthly expenditure of 195 USD and above, being aware that antibiotics were not the same as painkillers, and being confident that when someone was hospitalized, they would get well. Conclusions: This study found that the appropriate use of antibiotics was low, and this is an urgent public health issue requiring community engagement in tackling AMR and adherence to treatment guidelines in healthcare facilities. Additionally, there is a need to implement and strengthen antimicrobial stewardship programmes in healthcare facilities to promote the rational use of antibiotics in Zambia. There is also a need to heighten community awareness campaigns and educational activities on the appropriate use of antibiotics.

Seroprevalence and risk factors of Newcastle disease virus in local chickens in Njombe and Bahi districts in Tanzania.

Newcastle disease virus (NDV) causes significant losses of poultry in Tanzania. Like in many African countries, the regular surveillance of NDV is important for the control of disease. The objective of this study was to determine seroprevalence of NDV in unvaccinated backyard poultry in Bahi and Njombe districts of Tanzania over the rainy (May) and dry (November) seasons in 2016. Using hemaglutination inhibition test, the overall seroprevalence was determined to be 26.8%. The significant differences in seroprevalence were between seasons (higher (34.9%) in dry season, p < 0.0001) and age (higher (30.3%), p < 0.0001 in adult birds). There were no significant differences in seroprevalence between the districts or sex. The higher levels of "protective" antibody titers were significantly associated with location: Njombe (RR 1.15), dry season (RR 1.08), and age: adult birds (RR 1.16); however, the prevalence of these titers was not high enough to conclude any herd immunity among these flocks. This study therefore concludes that local chickens are naturally exposed to NDV and the birds in highlands, dry season, and adults are more protected. Future studies focusing on transmission, strain type, and monthly dynamics of NDV in backyard flocks will provide greater insight into the disease dynamics and allow new practical strategies to alleviate the effects of NDV for the smallholder farmers.