COMPARATIVE ASSESSMENT OF KNOWLEDGE, ATTITUDES AND PRACTICES REGARDING ANTIMICROBIAL USE AND RESISTANCE AMONG CATTLE FARMERS UNDER EXTENSIVE PRODUCTION SYSTEMS IN KOINADUGU AND FALABA DISTRICTS, SIERRA LEONE

Abstract

Antimicrobial resistance (AMR) threatens animal health and food safety, yet evidence on livestock farmers’ antimicrobial use in Sierra Leone remains limited. This study compared knowledge, attitudes and practices (KAP) regarding antimicrobial use and AMR among cattle farmers in extensive production systems in Koinadugu and Falaba Districts. A comparative cross-sectional survey was conducted among 358 farmers (Koinadugu, n=187; Falaba, n=171) using an interviewer-administered questionnaire. Data were summarised descriptively, and district differences were assessed using chi-square or Fisher’s exact tests, Holm-adjusted p values and Cramér’s V. Both districts showed weak knowledge, particularly regarding antibiotic specificity, differentiation of antibiotics from other medicines, disease recognition and AMR mechanisms. Attitudes differed markedly: all 13 testable items remained significant after Holm adjustment (adjusted p<0.001); 12 showed large effects, while willingness to pay for veterinary consultation showed a moderate effect (V=0.443). However, the clearest finding was that stronger stewardship attitudes rarely translated into appropriate practice. Veterinary consultation occurred at least sometimes among 75.40% of Koinadugu respondents and 45.03% of Falaba respondents, but no respondent in either district consistently completed prescribed treatment courses. Withdrawal periods were observed at least sometimes by only 5.88% in Koinadugu and none in Falaba, while treatment record-keeping was virtually absent. District-specific strengths were observed in vaccination, expiry checking, disposal, diagnosis, consultation, isolation, hygiene and administration. Overall, the findings demonstrate a knowledge–attitude–practice gap shaped by limited veterinary access, medicine literacy and weak stewardship systems. District-specific interventions combining farmer education, mobile veterinary services, prescription control, pictorial treatment and withdrawal guidance, diagnostic referral and antimicrobial use surveillance are recommended.