Knowledge, Attitudes and Practices on Antimicrobial Resistance Among Practising Veterinary and Para-veterinary Professionals in Zambia

Abstract In this study, we aimed to assess the knowledge, attitudes, and practices (KAP) of veterinary and para-veterinary professionals concerning antimicrobial resistance (AMR), in order to identify key drivers of inappropriate antimicrobial use and gaps in current stewardship efforts. Data was collected from a cross-sectional survey of 144 veterinary and para-veterinary professionals (n=144) using an online structured self-administered questionnaire in ZOHO software. We analyzed data using descriptive statistics and logistic regression in IBM SPSS Statistics Version 25. The findings revealed a high foundational knowledge of AMR, with 66.7% correctly defining AMR. The majority of respondents (82%) acknowledged that overuse of antimicrobials reduces their effectiveness and expressed strong support for mitigation efforts, with 95.8% endorsing farmer education as a key strategy. However, significant gaps in practice persisted: 75% of animal owners frequently initiated antibiotic use without supervision; professionals largely relied on empirical treatment (62.5%); and only 20.8% of professionals routinely performed antimicrobial susceptibility testing (AST), due to barriers like cost and laboratory accessibility. Logistic regression analysis revealed no significant associations between socio-demographic variables and levels of AMR knowledge or attitudes. This suggests that barriers to responsible antimicrobial use may be more structural than individual. We conclude that while Zambian practicing veterinary and para-veterinary professionals possess strong AMR awareness and positive attitudes, risky practices do persist. We recommend strengthening AMR stewardship with a holistic One Health approach by improving veterinary services to promote more appropriate and effective antimicrobial use. Author Summary Antibiotics are essential for treating sick animals, but their misuse can lead to antimicrobial resistance, where bacteria no longer respond to the drugs meant to kill them. This problem threatens both animal and human health. In Zambia, veterinary and para-veterinary professionals are actively involved in administering treatments and supporting decisions related to antibiotic use in livestock and pets. We wanted to understand what these professionals know, believe, and do when it comes to using antibiotics responsibly. To find out, we surveyed 144 veterinary and para-veterinary professionals from across the country. We learned that most of them were aware that misuse of antibiotics can make treatments less effective and that drug-resistant bacteria can spread between animals and people. Many also supported educating farmers and working with human health experts to tackle the issue. However, we also discovered that antibiotics were often used in animals without proper testing or diagnosis, mainly because of limited laboratory access and cost concerns. Our findings show that while knowledge and attitudes are strong, actual practices need improvement. We believe improved access to diagnostic services, more explicit rules, and ongoing training can help veterinary and veterinary paraprofessionals protect both animal and public health from the growing threat of antibiotic resistance.