Promoting antimicrobial stewardship on dairy farms in Mekelle, Northern Ethiopia: a field intervention with One Health implications.

Abstract

BACKGROUND: Inappropriate antimicrobial use (AMU) in livestock contributes to antimicrobial resistance (AMR), posing risks to both animal and human health. Despite growing awareness, antimicrobial stewardship (AMS) initiatives remain limited in Ethiopia&#x2019;s dairy sector. This study evaluated the effects of farm-level AMS training on farmers&#x2019; knowledge and attitudes toward AMR and AMU, and disease incidence on dairy farms in Mekelle, Northern Ethiopia. METHODS: A prospective field intervention was conducted from December 2024 to June 2025 among 22 dairy farms with at least 20 lactating cows each. Farms were allocated to intervention (&#x2009;=&#x2009;11) and control (&#x2009;=&#x2009;11) groups based on geographical proximity. Baseline assessments preceded AMS training, with follow-up evaluations at three and six months. The AMS intervention included participatory training on prudent AMU, infection prevention, and record-keeping. Changes in farmers&#x2019; knowledge and attitudes were measured using structured questionnaires; AMU was quantified as treatments per 100 cow-days, and disease incidence as new cases per 100 cow-days. RESULTS: Following AMS training, mean knowledge scores in the intervention group increased from 48.2% to 78.6% (&#x2009;<&#x2009;0.05), while control farms did not significantly change (47.3% to 51.5%). Attitude scores changed from 3.1 to 4.2 (&#x2009;<&#x2009;0.05). Antimicrobial treatment rates changed from 4.5 to 2.0 per 100 cow-days in the intervention group (56% reduction), with minimal change in controls (4.1 to 3.9). Disease incidence declined from 7.9 to 4.5 cases per 100 cow-days, a 43% reduction, with the largest decreases observed for mastitis (52%) and respiratory disease (47%). CONCLUSION: Targeted AMS training was associated with change of farmers&#x2019; knowledge and attitudes, reduction of AMU, and decreased disease incidence on dairy farms. These findings may show the effect of participatory, farm-level stewardship programs in promoting responsible AMU and herd health, with potential benefits for One Health. Sustained follow-up and integration into veterinary extension services are recommended to maintain long-term impact. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12917-026-05385-z.