National consumption of antimicrobials intended for use in animal livestock health: a retrospective data analysis of antimicrobial imports to Uganda from 2018 to 2020.

Abstract

BACKGROUND: Antimicrobial use in animals is one of the major drivers for the emergence and spread of resistant microorganisms. Antimicrobial resistance (AMR) can spread from animals to humans and vice versa. However, there is scanty data on antimicrobial consumption in livestock in low and middle income countries especially Uganda. Monitoring antimicrobial consumption and use (AMCU) in the veterinary sector is important to identify areas of overuse and misuse and to design targeted interventions to reduce the need for unintentional exposure. This study aimed to quantify and characterize by pharmacological class the antimicrobials intended for use in animals in different livestock production systems imported annually in Uganda. METHODS: We extracted data from the Uganda National Drug Authority (NDA) database on antimicrobials imported intended for veterinary use from 2018 to 2020. We analysed the quantities of the active pharmaceutical ingredient using the World Organization for Animal Health (WOAH) methodology and reported the consumption in kilograms and tonnes. RESULTS: For our study period from 2018 to 2020; 210,419 kg, 150,032 kg and 142,069 kg of antimicrobials for animal use were imported into the country respectively with annual average importation of 167,507 kg (167.6 tons). Antibacterials accounted for 82% and antiprotozoals accounted for 18% of the total quantities over the three years. Oxytetracycline was the top most consumed antibacterial. The top five pharmacological classes were tetracyclines (22.5 tons, 44.8%), aminogylcosides + penicillin combination (15.3 tons, 29.7%), sulfonamides and trimethoprim (6.14 tons, 12.4%), macrolides (1.88 tons, 3.9%) and fluoroquinolones (1.676 tons, 3.5%). 97% (97%) of the antibacterials were from the WHO Veterinary Critically Important Antimicrobials, 57.1% were from the WHO Highly Important Antimicrobials group, 32.1% were from the Critically Important Antimicrobials group and 10.7% were from the Highest Priority group. The European Medicines Agency AMEG analysis revealed that 57.1% were from the lowest risk (D) category, 36.5% were from the intermediate risk (C) category and 6.5% were from the restricted use (B) category. CONCLUSION: This study provides baseline data on the national-level consumption of antimicrobials used in animal health in different livestock production systems in Uganda for future reference. Annual quantification and analysis of veterinary AMCU should continue to inform monitoring distribution and use in relationship to livestock population numbers and the burden of diseases. Antimicrobial stewardship and pharmacovigilance activities in the animal health sector should focus on raising awareness to adhering to national and international guidance for appropriate and prudent use of antimicrobial agents.