title: Antimicrobial Use and Veterinary Care among Agro-Pastoralists in Northern Tanzania.
abstract: 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.
authors.affiliation: Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.|Department of Anthropology, Washington State University, Pullman, Washington, United States of America.
authors.forename: Mark A
authors.identifier: http://orcid.org/0000-0003-4456-3318
authors.initials: MA
authors.lastname: Caudell
authors.affiliation: Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.|Department of Anthropology, Washington State University, Pullman, Washington, United States of America.
authors.forename: Marsha B
authors.initials: MB
authors.lastname: Quinlan
authors.affiliation: Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.
authors.forename: Murugan
authors.initials: M
authors.lastname: Subbiah
authors.affiliation: Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Call
authors.affiliation: Department of Anthropology, San Diego State University, San Diego, California, United States of America.
authors.forename: Casey J
authors.initials: CJ
authors.lastname: Roulette
authors.affiliation: Department of Anthropology, Washington State University, Pullman, Washington, United States of America.
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Roulette
authors.affiliation: Department of Sociology, Washington State University, Pullman, Washington, United States of America.
authors.forename: Adam
authors.initials: A
authors.lastname: Roth
authors.affiliation: Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Matthews
authors.affiliation: Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America.|Department of Anthropology, Washington State University, Pullman, Washington, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Quinlan
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002417:Cattle; D002418:Cattle Diseases / Q000188:drug therapy / Q000382:microbiology*; D004352:Drug Resistance, Microbial / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D012641:Selection, Genetic / Q000235:genetics*; D013636:Tanzania
chemical_list: D000900:Anti-Bacterial Agents