Measurement of antibiotic use on poultry farms in Zimbabwe: Evaluation of a tool and procedures

Introduction The emergence of antimicrobial resistance (AMR) as a major global threat to human and animal health and development cannot be overemphasised. Since the misuse and overuse of antimicrobials have been identified as the main drivers of AMR globally, Zimbabwe, through a collaboration between the Department of Veterinary Services (DVS) and the Food and Agriculture Organization (FAO), developed and piloted an antimicrobial use (AMU) tool in the poultry production sector, to quantify antimicrobial use. The purpose of this study was to evaluate the tool and procedures used in the pilot survey and its ability to collect quality AMU data. We identified areas of improvement and developed recommendations for implementation in future AMU surveys in the poultry sector in Zimbabwe. Methods This research used mixed methods, involving quantitative and qualitative approaches. This involved initially piloting a predesigned antibiotic use (ABU) data collection tool in practice, then assessing the tool's ability to collect quality data, and finally evaluating the procedures that enabled and limited the collection of ABU data. The tool was assessed by evaluating the completeness of data collected in the pilot survey and its consistency, appraising the items included in the tool, and determining the analysability of data collected. The procedures used were evaluated by observing the tool's administration in the field and through a focus group discussion involving all data collectors of the pilot survey. Findings AMU data was collected from 191 farms, about 50% of the initially targeted 384 broiler farms. There were missing data on various questions in the tool, including farm georeferences, bird populations, and information about the treatment, including the identification of the antibiotic active ingredient and their concentrations, routes of administration, treatment dosage and duration, as well as the age and weight of birds at the time of treatment. Inconsistencies were also noted in the data collected, particularly in the way antibiotics were recorded. The analysability of data collected was negatively affected by the missing data and question phrasing, in particular, those to do with the treatment of birds with antibiotics, which were found to have excluded the majority of survey respondents from further analyses. Broiler farms in communal areas were over-represented in the pilot survey due to most data collectors working in these areas. Various challenges were encountered during the recruitment of participants, including farmers not keeping birds at the time of the survey, farmers declining to participate in the study due to lack of incentives, some farms being in remote locations, and political interference. Most data collectors in the pilot survey, who were recruited from the Agricultural Extension Services (AGRITEX) department within the Ministry of Agriculture, indicated that the timing of the survey (January to May of the calendar year) was not conducive for them since it coincided with the cropping season in Zimbabwe, which induced high workloads, leaving less time to participate in data collection activities. Conclusions and recommendations The pilot AMU survey in broiler production serves as an important milestone in establishing a monitoring system for the use of antimicrobials in food producing animals in Zimbabwe. To a moderate extent, the pilot tool and procedures used in broilers enabled the collection of AMU data, but some key challenges also arose, mainly related to questionnaire design (i.e., question formulation), data collection procedures, participant recruitment, timing of the survey and inadequate training of data collectors, among other issues. Key recommendations made included using the ‘Drug Bag’ method in monitoring the use of antibiotics in poultry, carefully selecting enumerators to ensure representation of different farming scales, adequately training data collectors prior to surveys, and giving them standard operating procedures to use in data collection to ensure consistency. More research needs to be done in this area of monitoring the use of antimicrobials in food producing animals in Zimbabwe and beyond, to strengthen capacities to collect quality AMU data, thereby contributing to antimicrobial stewardship efforts, and in turn with the global fight against AMR.