Background: The use and misuse of antibiotics for treating animal and human infections are a key driver of the emergence of resistant bacterial strains at the human-animal-environment interface. This inappropriate use threatens ecological balance and poses a significant risk to human health. The lack of relevant knowledge of the right attitudes and practices regarding antimicrobial stewardship among fish farmers, antibiotic drug retailers, and government agencies has significantly exacerbated this serious environmental and public health issue. This study aimed to assess the knowledge, attitude, and practices of key stakeholders regarding the use of antibiotics in cage aquaculture on Volta Lake in Ghana.
Method: We conducted a qualitative and quantitative field survey involving interviews, key informant discussions, and observations. The participants were fish farmers across three scale: small, medium, and large, veterinary drug retailers and government officials from the fisheries, aquaculture, and veterinary sectors to gather insights about their knowledge, attitudes, and practices on antibiotics use in aquaculture. The study covered 91 fish farmers, and 40 stakeholders, comprising 18 veterinary drug retailers, 12 general pharmaceutical shop operators, five Fisheries Commission officials, and five government-trained veterinary personnel operating along the stratum II of the Volta Lake of Ghana. All quantitative and qualitative data were analysed using STATA and thematic analysis.
Results: From the survey, all sampled populations admitted to antibiotic applications in their fish farming operation. Knowledge of antibiotic types was mainly influenced by peers (46.15%), with tetracycline being the most recognized and used. There was a significant reliance on the empirical use of antibiotics, with 52.75% of farmers using them based on personal experience and 40.66% without a prescription. When initial treatments failed, 41.76% of the farmers would change or combine drugs. Older farmers (over 51 years) and those with tertiary education demonstrated significantly better KAP scores regarding antibiotic use. Strong correlations were also found among knowledge, attitudes, and practices in antibiotic usage. The qualitative survey revealed that drug retailers possess limited knowledge, expertise, and education on the use of antibiotics in fish farming. The results further revealed a lack of regulation in selling veterinary drugs to farmers. Despite this, the results indicate insufficient coordination between government officials, drug retailers, and fish farmers regarding the usage of antibiotics in aquaculture on Lake Volta.
Conclusions: Regular joint training programs are encouraged to improve and enhance knowledge, attitudes, and practices among government officials, veterinary drug retailers, and fish farmers. Under the One Health framework, efforts to integrate veterinary drug retailers, fish farmers, and other stakeholders of concern in antibiotic governance are required to address the increasing burden of antibiotic misuse and abuse in aquaculture in Ghana and the world.
Keywords: antibiotics; knowledge; attitude; practice (KAP); cage aquaculture; government officials, veterinary drug retailers; Volta Lake; Ghana