Presentation by Abdullah Al Sattar of Chattogram Veterinary and Animal Sciences University to the the World One Health Congress held in Singapore, November 2022.

1. Barriers to comprehensive
veterinary care in poultry farms
in Bangladesh & their impact
on rising antimicrobial
resistance
A qualitative study
Abdullah Al Sattar*, Nusrat Irin, Afsana Sultana, Meherjan Islam, Easrat
Jahan Esha, Syeda Munira Dilshad, Shahriar saif, Rashed Mahmud, Tony
Barnett, Ivo Syndicus, Eve Houghton, Md. Ahasanul Hoque

2. • Identify farmers’ sequential responses when suspecting
the presence of disease in the shed
• Identify actors’ contribute to the provision of veterinary
care & antimicrobials and their challenges
• Asses current state of the AMR knowledge of actors
• Identify how the above factors contribute to the emergence of
antibiotic-resistant bacteria on farms
Objectives

3. Methodology
Study: Qualitative investigation through
semi-structured interviews
Duration: January 2021 – June 2022
Study area: 10 districts in Bangladesh
Study participants:
Veterinarians (n=45)
Poultry feed Sellers (n=29)
Poultry farmers (n=35)

4. Methodology
Study: Qualitative investigation through
semi-structured interviews
Duration: January 2021 – June 2022
Study area: 10 districts in Bangladesh
Study participants:
Veterinarians (n=45)
Poultry feed Sellers (n=29)
Poultry farmers (n=35)
• PubMed,
• Scopus,
• Web of science,
• Cab Abstracts,
• Google scholar
Systematic review & meta-analysis:

5. Feed sellers
(also sell medicine)
Farmer Mobile traders/
Middleman
Cash
Credit
Market vendors Consumer
Cash
Credit
After sale
credit Reimburse
to Feed sellers
Poultry Production & Distribution Network (PDN) Bangladesh
PDN at a glance
Credit

6. Feed sellers
(also sell medicine)
Farmer Mobile traders/
Middleman
Cash
Credit
Market vendors Consumer
Cash
Credit
After sale
credit Reimburse
to Feed sellers
Poultry Production & Distribution Network (PDN) Bangladesh
PDN at a glance
Credit
Company
(Contract farm)
Company
Fixed price

7. Vet
Feed sellers Drug seller
Vet Lab
1Farmer’s
experience
2Feed
sellers
3Vet
1st line of treatment If the first treatment fails
Sick
birds
Treatment
Sources of treatments
in poultry farms

8. Farmer’s/ feed
seller’s own
experience
Drug seller’s
advice
Veterinarian
consultation
. Insufficient Vets
. Dependent on feed seller
for farm access
Lack of legislation:
Over-the-counter drug
sale (e.g. antimicrobials)
Power dynamics
- Feed seller domination
- Farmer’s credit dependency
Credit Factors influencing veterinary care access
Many farmers contact
us directly if farm chickens
are sick. But most of them
notify the feed sellers first,
and we reach the farm
through the help of feed
sellers.
“
Feed company veterinarian

9. Farmer’s own
experience
Veterinarian
consultation
Farmer’s distrust on vets
Fear of superfluous and
costly prescription from vet
Over confidence
(from longtime farming
experience)
Cash Factors influencing veterinary care access
I usually try to use the medicine according to the doctor's advice,
but sometimes the doctor prescribes so much medicine that it costs
about 30,000 BDT. Then I go to the drug store and talk to the seller
about the disease diagnosed by the doctor and buy the medicine
according to their advice which is relatively cheap.
“
Large scale Sonali farmer

10. Factors influencing veterinary care access
Veterinarian consultation
Regular farm visit by Vet
Quality & prompt veterinary care
Constant monitoring
- Prioritize good management & biosecurity
- Discourage use of medicines, e.g. antimicrobials
Contract
Company vets visit my farm every alternate day. They keep track of the
overall farm situation, like feed consumption rate, any physical problems, deaths,
etc. Also, sometimes do postmortem here. The farm's entire condition is
constantly monitored. They instantly send these data to the company database.
“
Contract farmer of company X

11. Challenges and obstacles
Large working territory &
wider responsibility
Insufficient diagnostic facility
Feed seller’s influence
Farmer not following
prescription
Unavailable
emergency service
Costly Vet
prescription
Inadequate knowledge
of drug use
Drug dependency over
biosecurity

12. Provision of antimicrobials
At the beginning of each new flock, I
supply all required medicines to the farm, along
with feed & DOC.
“
Feed dealer
Every Friday and Saturday, I treat the farm
chickens with ‘Drug X’ (oxytetracycline). Nobody
suggested that, but I realized it should be used to
strengthen chickens
“
Sonali cash farmer
After 15/16 days, we always administer drug X
(amoxicillin). After becoming ill, we can use
medicines. However, if the chickens become
diseased, we typically do not have the time to treat
them. Because of this, we continue to use drugs
before the infection.
“
Broiler credit farmer
I use a few antibiotics from brooding time. Such as
Drug X (Sulfachloropyridazine + Trimethoprim), Y
(Ciprofloxacin), Z (Gentamicin), and so on. I noticed
that after using antibiotics, most of the diseases do
not appear.
“
Broiler credit farmer

13. Provision of antimicrobials
The company doesn't use much medicine
in the flock, just showing medicine cures the
chicken (metaphorically). Occasionally, but
very rarely, antibiotics are applied.
“
Contract farmer of company X

14. AMR knowledge
Have you heard about AMR?
NO
At different occasions, doctors
discussed AMR-related issues. I myself
have taken chickens from my farm to the
laboratory on several times to determine
which drug classes poultry have developed
resistance to.
“
Cash Broiler farmer
A doctor once told me that, the
government has prohibited the use of
colistin antibiotics on poultry. This is
because, Colistin is an extremely potent
antibiotic used in ICU for dying human
patients.
“
Contract farmer of company Y

15. Global scenario (results of systematic review and meta-analysis)
• 31 studies, 17 different countries (Africa, Asia & Europe)
• 13 LMICs, 3 upper-middle-income countries, 1 high-income country
• 4641 poultry farmers (Median sample size=109)
Purpose of antimicrobial use
o Therapeutic purposes 65% (95% CI: 50%-80%)
o Preventive 45% (95% CI: 34%-55%)
o Growth promoter 29% (95% CI: 13%-46%)
Source of advice
o Veterinarians 60% (95% CI: 50%-69%)
o Drug sellers 39% (95% CI: 10%-67%)
o Farmers' self-experience 36% (95% CI: 22%-49%)
AMR knowledge
o Heard about AMR 43% (95% CI: 34%-53%)
o AMR impact on poultry 53% (95% CI: 29%-76%)
o AMR impact on Human 50% (95% CI: 34%-67%)

16. Frequent
antimicrobial
usage under
non- professional
advice
Indiscriminate over-
the-counter (OTC)
sale of
antimicrobials
?
AMR threats

17. Conclusion
▪ Significant communication gap between poultry farmers and veterinarians
▪ Knowledge gaps among poultry farmer regarding judicious AMU and AMR
▪ Antimicrobial practices and knowledge of farmers who maintain regular
contact with veterinarians are relatively good
Barriers
Collaboration
Service
Awarness
AMR
program
Adress potential
barriers in providing &
getting veterinary care
Strong and direct
collaborations
between farmer and
vet
Quality & prompt
veterinary service for
remote poultry farms
Capacity building and
awareness campaign
for stakeholders
AMR surveillance
involving field
vets
Recommendation

18. Visit: onehealthpoultry.org
Follow: @PoultryHub
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The UKRI GCRF One Health Poultry Hub OneHealthPoultry.org
Thank you
Acknowledgement: Study participants