Veterinary Drug Usage and Food Safety Challenges in Zambia J.B Muma; G. Mainda; M. Munyeme; B. Hangombe; B. Kunda; C. Mubita; S. Malama; F. Bumbangi; G. S Pandey. Department of Disease Control, School of Veterinary Medicine, the University of Zambia

PRESENTATION OUTLINE General introduction on the problems associated with the veterinary drug usage and potential food safety challenges Summaries of the selected studies we have conducted in Zambia Study designs and methods Main findings General discussion and conclusions

General introduction Use of vet drugs has greatly contributed to the control of livestock diseases and improve livestock productivity. Vet drug treatments leave residues in the tissues of these animals and the foods derived from them. Vet drug residues pose a significant public health threat because once they enter the food chain they may cause adverse effects in people. Effects on human health may include allergies, cancer, alterations in the intestinal flora, bacterial resistance and the inhibition of fermentation in the dairy industry.

Introduction continues Use of vet drug can also led to bacteria drug resistance Multi-drug resistance is brought about by various factors such as; uncontrolled use of antibiotics for purposes such as growth promotion, prophylaxis, or therapeutics, improper administration. MDR strains are transmitted to humans through consumption of contaminated water and/or food of animal origin.

Summaries of selected studies we have conducted in Zambia We report our findings from separate studies concerning veterinary drug usage and the antimicrobial resistance in Zambia.

Antibiograms of Faecal Escherichia coli and Enterococci species Isolated From Pastoralist Cattle in the Interface Areas of The Kafue Basin In Zambia – Mubita et al., 2008. Study aim The aim of the study was to evaluate the level of intestinal bacteria resistance to antimicrobial agents in pastoral cattle especially E. coli and Enterococci.

Veterinary Drug usage 2008 (Mubita et al., 2008) Cross-sectional survey Study: area-Shibuyunji district 254: Cattle faecal samples Questionnaire on drugs usage E. coli and Enterococci species as an indicator organism Resistance patterns based on disk diffusion

Antibiogram and prevalence of resistance of E Antibiogram and prevalence of resistance of E. coli and Enterococci spp isolates from pastoral cattle in Zambia (Mubita et al. 2008). Antibiotic agent E. coli E. faecium E. Faecalis No. of resistant isolates % of resistant isolates Amoxycillin 12 14.5 19 65.5 39 62.9 Ampillicn 7 8.43 15 51.7 47 75.8 Cotrimoxazole 59 71.1 26 89.7 53 85.5 Erythromycin 69 83.1 21 72.7 35 56.5 Gentmycin 2 2.41 28 96.6 Nitrofuratoin 22.9 41.9 Tetracycline 3 3.60

Key Findings from the Mubita et al., 2008 Majority of the farmers used Tetracycline and Penicillin drugs routinely E. coli isolates showed a pattern of resistance to erythromycin 83.1%, cotrimoxazole 71.1% and nitrofurantoin 22.9%. E. faecium and E. faecalis were resistant to gentamycin; cotrimoxazole; penicillin erythromycin; amoxicillin; nitrofurantoin, tetracycline; and ampicillin (See Table below).

Prevalence and patterns of antimicrobial resistance among Escherichia coli strains isolated from Zambian dairy cattle across different production systems (Mainda et al., 2015) Study objective The primary objective of the present study was to determine the association between the prevalence of antibiotic resistant enteric E. coli in dairy cattle and the use of veterinary antibiotics by dairy farmers in Lusaka (capital city) and the surrounding districts in Zambia. In addition, we aimed to determine if there was appropriate stewardship of antibiotic use in this sector and identify potential ways to improve on usage practices.

Study settings Cross-sectional survey Study in central Zambia A stratified random sample of 104 farms was studied, representing approximately 20% of all dairy farms in the region. On each farm, faecal samples were collected from a random sample of animals and a standardised questionnaire on the usage of antibiotics was completed Resistance patterns based on disk diffusion Mainda et al., 2015

Prevalence of antibiotic Resistant E. coli by farm scale (Mainda et al Farming scale No resistant animals/total Population based design adjusted prevalence Small 29/226 13.7 (7.4-22.4) Medium 9/56 13.0 (5.6-24.2) Commercial 23/86 11.7 (2.5-30.0) Overall 61/371 12.3 (4.7-19.8)

Key findings (Mainda et al., 2015) The apparent prevalence suggest a much higher prevalence in the commercial dairy farms (26.4%) compared to the small (12.7%) or medium scale farms (15.0%). However when the analysis takes account of the study design, there was no significant differences in true resistance prevalence across farm scales. Resistance to tetracycline was the most prevalent (overall 11.2%) Resistance to ampicillin was the second most prevalent (6.5%) followed by sulfamethoxazole/trimethoprim prevalence of resistance to cefpodoxime ciprofloxacin and gentamicin was very low among the E. coli isolates obtained

Key findings cont.. (Mainda et al., 2015) Cattle diseases were the main drivers for using antibiotics on the farms. The most common disease at farm level was mastitis with a prevalence of 100.0% (95%CI: 95.0–100.0) among the commercial, 77% (95%CI: 61.9– 91.2) among the medium scale and 47% (95%CI: 37.99–56.78) at the small scale. Mastitis was mostly treated with an intra-mammary infusion (Mastiject : tetracycline hydrochloride 200 mg, neomycin base 250 mg, bacitracin 2000 I.U, prednisolone 10 mg) Diarrhoea was the second most common disease in all three different farming scales with a prevalence of 77.8% (95%CI: 56.1–99.4) among the commercial, 64.8 (95%CI: 46.1–83.6) in the medium

Kunda et al., 2015 Study aim The purpose of this study was to assess the SCC and Antimicrobial residues in raw milk produced by Small Holder Dairy Farmers (SHDFs) in Lusaka Province of Zambia.

Study settings (Kunda et al., 2015) Cross-sectional survey Study in Lusaka province 83 SHDFs from dairy cooperatives 26 farmers belonged to Palabana dairy scheme MCC, 20 to Mapepe dairy co-operative society MCC and 27 to Lusaka west farming block who deliver milk directly to Parmalat milk processor the Copan Milk Test 100 (Copan Diagnostics Inc. USA) kit was used to test milk samples for presence of Antimicrobial Resistance.

Key findings (Kunda et al., 2015) Milk from 51 out of the 83 farms (61.44%) had SCC above the recommended maximum limit of 300,000 cells/ml of raw milk. Milk from 25 out of 83 farmers (30.12%) tested positive for presence of Antibiotic residues.

Compositional and microbial quality of heat-treated milk brands marketed in Lusaka, Zambia (Kunda et al., 2015) Study aim The purpose of this study was to assess the compositional and microbial quality of pasteurized and Ultra High Temperature (UHT) treated milk purchased randomly from supermarkets in Lusaka, Zambia.

Study setting (Kunda et al., 2015) 18 brands of milk (7 pasteurized and 11 UHT treated) were purchased from supermarkets in Lusaka. The quality of milk was evaluated by assessing it for Total Bacteria Count (TBC), Total Coliform Count (TCC), isolation of Staphylococcus spp, Salmonella spp and Clostridium perfringes by culturing the samples. Milk components, freezing point and added water were determined using LactiCheck ultrasonic milk analyser while antibiotic residue using Copan Milk Test and Beta Star Combo Test kit.

Key findings (Kunda et al. 2015) Test results for presence of ARs in pasteurized and UHT Milk Type No. Sampled Number positive % positive UHT 11 1 9.1 Pasteurised 7 2 28.6 Overall, 3 out of 18 milk samples (16.7%) were positive for ARs. Those samples positive on Copan Milk Test were also found positive on Beta Star Combo test.

General discussion, conclusion and recommendations Farmers were probably not using antibiotics correctly and were not observing recommended withdrawal periods of antibiotics before supply of milk to processors. Tetracycline and penicillin were probably the most abused vet drugs and this was having an impact on antimicrobial resistance. Quantitative studies are needed to access whether these observed residues exceed the Maximum Residue Limits (MRL).

The regulatory authority in Zambia should establish maximum limits for ARs in foods sold to public or processors. The training in good livestock farm management practices should be conducted regularly in order to assist farmers in herd health management and adhere to correct usage of antibiotics. Consumer education to demand safe products

General discussion, conclusion and recommendations continues There is need for periodical monitoring of milk quality before it is sold to consumers. Our results highlight the need for state public health authorities to set a maximum residual level for antimicrobial agents in milk and establish monitoring programmes to determine antimicrobial residues in milk.

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