Small Ruminants’ Production System Characteristics and Their Influence on Antimicrobial Use, Alternatives, and Resistance in Nigeria

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Antimicrobial use practices are continually explored in larger food-producing animals; however, small ruminants (sheep and goats) receive comparatively less research attention. Our study addresses this gap by investigating small ruminant production practices in Nigeria and exploring how they affect the use of antimicrobials and alternatives. We adopted a mixed-methods design, combining semi-structured questionnaires with focus group discussions. Results Of the 785 questionnaire respondents, 68% of farmers never vaccinated their flock. Numerous health problems were regularly experienced by animals, including peste de petits ruminants (PPR), mastitis, and dermatophilosis. Diseases were mostly self-managed with antibiotics and herbs rather than through reliance on veterinary care. More farmers (48%) used antibiotics than herbal remedies (14%) over the previous three months. Farmers' use of herbs was affected by their having low awareness of available options and how to use them appropriately. Perceived effectiveness also influenced farmers' choice between antibiotics and herbs, while economic considerations also led them to sell off sick animals before or during treatment. Among farmers who used animal health services, more farmers (59%) consulted unlicensed para-veterinarians and drugstore vendors rather than licensed government and private veterinarians (36%), a disparity attributed to the unavailability of qualified veterinary doctors. Farmers had poor knowledge, attitudes, and practices towards AMU and AMR. Conclusions We recommend conducting further studies to identify and investigate the efficacy of currently used herbs in treating common diseases. There is a crucial need to improve farmers’ access to vaccines, veterinary care, and laboratory diagnostics. Barriers that hinder better compliance with regulations that govern the use of nonprescribed antimicrobials should be explored. Awareness programmes could be conducted to improve farmers’ awareness on AMR and appropriate disease preventive practices. AMR sheep goats alternatives antibiotics herbs production Nigeria ruminants Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Highlights - 48% of farmers self-administered antibiotics within the last three months. - Less than 5% of farmers vaccinate their flock regularly. - 58% of farmers do not use antimicrobial alternatives in their production. - Low awareness and availability affect farmers’ use of herbal remedies. - Economic considerations cause farmers to sell off ill and dying animals before or during treatment. 1. Background Livestock production plays a crucial role in Nigeria’s agricultural sector, accounting for roughly one-third of the country’s agricultural gross domestic product (GDP) ( 1 ). Small ruminants are a substantial portion of Nigeria’s livestock, with an estimated population of 19 million sheep and 28 million goats ( 2 ). Small ruminant production is particularly prominent in rural communities, as they contribute substantially to food security and maintaining incomes in low- and middle-income households ( 3 , 4 ). In many cases, households integrate small ruminant farming with cattle and/or crop production to maximise general output and reduce costs ( 5 , 6 ). Most farmers adopt extensive and semi-intensive grazing systems, in which animals rely largely on outdoor forages and refuse dumps in the environment. These systems increase animals’ possibility of exposure to diseases endemic in the environment ( 7 , 8 ). Diseases commonly affecting small ruminants in Nigeria include mastitis, peste des petits ruminants (PPR), and poxviruses ( 9 – 11 ). A study on PPR in Nigeria estimated its prevalence to be 6% in sheep and 21% in goats ( 9 ). Another study estimated the incidence of mastitis as 40.4% across three states in Nigeria, 30.4% of which were subclinical mastitis cases with no obvious physical signs ( 11 ). These diseases are considered to be widespread and circulating actively across Nigeria, leading to increased morbidity and mortality within the affected flock ( 9 – 11 ). In this regard, mastitis is a particularly significant disease, as it causes consistent underperformance in terms of milk production and increases kid mortality due to resultant starvation ( 11 ). To curtail these losses, farmers rely on antimicrobials, especially antibiotics, for health management ( 12 , 13 ). These drugs are often misused. A study on pastoralist ruminant farmers in Nigeria observed that 65% of farmers did not consult veterinary services and rather practiced self-administration. 67% of farmers administered antibiotics arbitrarily and without clear protocols, and only 16% observed withdrawal periods after antibiotic use (ABU) ( 12 ). Indiscriminate antimicrobial use (AMU) in this manner has led to the deposition of subtherapeutic dosages of antimicrobial residues in the gut of animals, conferring selection pressure and leading to the development of antimicrobial resistant genes (ARGs) in infectious microbes ( 12 – 14 ). This pattern has also been observed across other countries in the world, for instance, in a Portuguese study, 83% of samples obtained from 65 small ruminant farms contained at least one antimicrobial resistant gene (ARG) ( 14 ). Through non-observance of withdrawal periods in food-producing animals, ARGs can be passed from livestock to humans and the environment through risk pathways of milk consumption and poor manure disposal. Antimicrobial residues have also been implicated in human allergic reactions, damage to vital organs such as the kidneys, liver, and bone marrow, increased cancer risk, and developmental problems in foetuses and children ( 14 , 15 ). The most undesirable effect of ARGs, however, is the replication of AMR, a significant global health threat projected to cause 10 million human deaths annually by 2050 ( 15 , 16 ). Currently, efforts are being put in place globally to reduce AMU in livestock production through the development of antimicrobial alternatives (ATAs). ATAs are tools and substances that can prevent or control infections, thereby reducing the need for antimicrobials and subsequently the risk of AMR. These include vaccines, herbal plants, antimicrobial peptides, bacteriophages, and probiotics. ( 17 ). Unfortunately, several ATAs have significant hindrances that prevent them from being functional and effective replacements for antimicrobials. For instance, vaccines are available in Nigeria for poxviruses and PPR; however, low vaccination coverage and a general lack of awareness reduce the potential for appreciable impact in this regard ( 18 , 19 ). There is little evidence that vaccines widely used elsewhere are utilised for small ruminant mastitis in Nigeria, due to relatively low research and development efforts in these areas. In addition, studies from other countries report that currently available mastitis vaccines generally have low to inconsistent levels of efficacy, with protection declining over time. Improved hygiene practices are regarded as more reliable alternatives for preventing mastitis ( 20 ). However, hygienic management for mastitis prevention is inconsistently utilised by Nigerian ruminant farmers ( 20 , 21 ). Another group of ATAs used in Nigeria is herbal plants. Herbs such as Solanum spp and Glyphea brevis have been used in Eastern Nigeria for diarrhoea and retained placenta in small ruminants. These herbs have been recorded to have antimicrobial properties, affirming their effectiveness for these conditions. Farmers also utilise regular household materials such as kerosene, palm oil, and salt for remedies ( 22 ). However, some studies have noted that a deeper understanding of the mechanism of action of these herbs, as well as their effective dosage concentrations, is still lacking, preventing their full adoption by Nigerian farmers ( 17 , 22 , 23 ). There exist clear evidence gaps regarding the current use of ATAs in Nigeria, as well as an understanding of the factors that restrict small ruminant farmers from using them when compared to antimicrobials. Thus, this study presents an exploratory sequential mixed-methods approach aimed at characterising the small ruminant production system in Nigeria and identifying possible influences on the use of antimicrobials and ATAs in the management of infectious disease conditions. 2. Materials and Methods 2.1. Study setting and sampling The study was conducted in two predominantly ruminant-farming states in North-Central Nigeria: Kwara and Niger (Fig. 1 ). Kwara is located between latitude 8° 05’ N and 10° 05’ and longitude 2° 50’ E to 6° 05’ E, while Niger lies approximately between 8° 00′ N and 11° 30′ N latitude and 3° 30′ E to 7° 40′ E longitude. Niger and Kwara are divided into 3 and 4 Agricultural Development Zones (ADPs), respectively ( 24 , 25 ). The target populations for the questionnaire survey included small ruminant farmers, herders, and farm workers within the study area. The sample size was determined to be 384 per state via OpenEpi, with an estimated proportion of 50%, a 5% margin of error, and a 95% confidence level. Ultimately, 785 respondents were surveyed to account for possible incomplete or non-responses. Sampling was multistage random. The first stage involved the selection of three ADPs in each state. For Kwara, the three zones with the highest ruminant farming activities were selected. The second stage involved a systematic random selection of 4 pastoral communities from each zone (12 communities per state). Communities selected in Kwara were Amoyo, Lajiki, Amberi/Ijagbo, Ajase-Ipo, Kaiama, Ilesha Baruba, Okuta, Kageji, Fufu, Afon, Oke Oyi, and Tafatafa. In Niger, selected communities included Bida, Agaie, Bosso, Edati, Gbako, Gurara, Katcha, Lapai, Lavum, Mokwa, Agwara, and Suleija. The third stage involved a purposive sampling of 32–33 appropriate respondents from each community. 2.2. Study Design: The study was conducted in four phases from January 2025 to February 2026. Phase I consisted of the design and administration of the questionnaire survey (January to March 2025). In Phase II, survey data were compiled and analysed (March to September 2025). Phase III involved reviewing the quantitative results and organising a focus group discussion (FGD) to generate further insights ( October 2025). Phase IV involved qualitative thematic analysis and report writing (October 2025 to February 2026). 2.3. Questionnaire design and administration: The research team developed the questionnaire following a series of meetings and a literature review of similar studies conducted in Nigeria ( 26 , 27 ). The questionnaire was developed in English and administered by researchers who were fluent in English and Yoruba, English and Fulani, or all three languages. The questionnaire was piloted with 10 farmers in a pastoral community to ascertain its validity, after which necessary revisions were made. The final version consisted of five sections: (a) farmers’ socio-demographics, (b) farm characteristics, (c) livestock management practices, (d) animal health management practices, and (e) knowledge, attitudes, and practices (KAP) of AMU and AMR (Additional File 1). The questionnaire was semi-structured and comprised single-choice, multiple-choice, and open-ended questions. It was administered through face-to-face interviews. Bilingual/trilingual researchers conducted the survey, translating questions from English to Yoruba or Fulani. Received responses were collated in English on paper or electronic forms. These forms were checked for completeness before being input into KoboToolbox (v.2.024.36). 2.4. Quantitative data analysis: Data analysis began with initial data cleaning in Microsoft Excel, during which missing values and logical inconsistencies were identified and addressed. The cleaned data were then imported into R (v. 4.5.1). Findings were summarized descriptively using frequencies, proportions, averages, and ranges. For the KAP, the farmers were asked 4 knowledge questions, 10 attitude questions, and 12 practice questions. Under the section, knowledge questions were scored 1 for a correct answer and 0 for ‘Yes’ and ‘No,’ respectively. Attitude questions were scored on a 3-point Likert scale ( 0 = Disagree/ I don’t know, 1 = Neutral, 2 = Agree). Practice questions could be answered ‘Most likely’, ‘Likely’ or ‘Not Likely’ which were given scores of 2, 1 and 0 respectively. Negative questions in each section were scored in reverse. To enable relative comparison within our study population, we obtained a data driven cutoff using the group mean, consistent with previous studies ( 28 , 29 ). The above-mean section included scores above the population average (≥ 1.23 for knowledge, ≥ 8.46 for attitudes, and ≥ 11.43 for practices). As questions were all scored with whole numbers, this translated to ≥ 2 for knowledge, ≥ 9 for attitudes, and ≥ 12 for practices. Pearson’s chi-square test further tested the associations between KAP scores and farmers’ demographic characteristics. All significant associations at the p < 0.05 level were subsequently entered into a multivariate logistic regression model to test for independent associations. Finally, a Spearman’s correlation test was conducted to determine the associations between the three scored groups. 2.5. Focus group discussions: The research team reviewed findings from the survey and highlighted key areas that required further exploration. Subsequently, a focus group discussion was organised. First, an interview guide was developed via team meetings. The guide comprised 11 questions focused on farmers’ health management practices, the economic impact of diseases, and factors that affected the use of antibiotics, ATAs, and animal health service providers ( the guide is attached as Additional File 2. 23 stakeholders were recruited from the Nigerian small ruminant farming industry, including small ruminant farmers, veterinarians, para-veterinarians, and butchers/meat vendors. Demographics in this group reflect those of the survey in terms of age, gender and state of origin. Participants were split into three round tables, and for each table, a trained moderator was assigned to lead the discussion using the interview guide. A co-moderator/note taker was taking notes and, when possible, recording the conversation for each table. 2.6. Qualitative (thematic) analysis: Audio recordings were transcribed manually and using the TurboScribe software. Supplementary notes taken by the co-moderator captured nonverbal cues and group dynamics. Thereafter, analysis was conducted based on Braun and Clarke’s guide to reflexive thematic analysis ( 30 ). The analysis was deductive with a majorly semantic coding approach. First, transcripts were read multiple times to allow for data familiarisation. Visual maps were also created to aid researchers with retention. Two independent researchers generated initial codes. Afterwards, researchers came together to search for potential themes. Final themes were decided after multiple rounds of discussion and reflection. These themes have been explored in the Results section. Thematic interactions were integrated into a rich picture using Lucidchart to illustrate interactions between factors influencing farmers’ health management decisions. 3. Results 3.1. Demographic Characteristics: Demographic characteristics of 785 survey respondents are summarised in Table 1 , with geographical distribution in Fig. 2. Most respondents (60.8%) were between 31 and 50 years of age. The majority of respondents (78.1%) were male. Most (65.7%) had more than 10 years of farming experience. The majority (82.2%) owned fewer than 50 small ruminants in their flock. Table 1 Demographic characteristics of farmers. Demographics n (%) Age (years) 60 38 (4.84) Gender Male 613 (78.09) Female 172 (21.91) State Kwara 377 (48.03) Niger 408 (51.97) Level of Education No formal education 461 (58.73) Primary School 114 (14.52) Secondary School 128 (16.30) Tertiary Education 82 (10.45) Role on Farm Owner 461 (58.73) Owner and manager 248 (31.59) Manager 51 (6.50) Worker 25 (3.18) Number of years in ruminant farming ≤ 10 269 (34.27) 11–20 258 (32.87) 21–30 145 (18.47) 31–40 74 (9.42) > 40 39 (4.97) Herd size of animals ≤ 25 299 (38.09) 26–50 346 (44.08) 51–75 81 (10.32) > 75 59 (7.51) Figure 2. Geographical distribution of respondents within the study areas. 3.2. Farm Characteristics and Management Practices. Most farms (65%) kept a mixed herd of sheep and goats. The largest herd segment was females above prime reproductive age for both species (> 2 years) (Additional File 3).. Fewer than 40% of farmers routinely kept feeding, reproduction, or health records (Table 2 ). Flocks (54.2%) were mostly housed in an open area without netting, and a significant portion (46.8%) was reared in an extensive grazing system. The majority of farmers (83.9%) relied on natural pasture to feed their flock (Additional File 4). Table 2 Farm characteristics and management. Farm Characteristics and Management n (%) Housing systems Open housing system without netting 425 (54.14) Open housing system with netting 221 (28.15) Closed housing system 139 (17.71) Feeding practices Extensive system 367 (46.75) Semi-intensive system 306 (38.98) Intensive system 112 (14.27) Purchase replacement animals? Yes 364 (46.37) No 421 (53.63) Use of community grazing lands Yes 476 (61.74) No 272 (35.28) I don’t know 23 (2.98) Record keeping Feeding 214 (27.26) Reproduction 263 (33.50) Veterinary Health Products 244 (31.08) Vaccination programs 179 (22.80) 3.3. Prevalent Diseases and Farmers’ Health Management Practices The most prevalent diseases affecting the small ruminant flock were mastitis, dermatophilosis, and PPR. 13.9% if farmers had experienced mastitis in their flock over the last 12 months. FGD participants who also reared cattle stated the disease was more prevalent in small ruminants than in cattle: “We can go 10 years at a time without seeing [mastitis] in our cattle but we usually experience it in [our] sheep and goats.” – R3, small ruminant farmer. 69.8% of farmers surveyed had no idea of the origin of mastitis, while 18.3% believed the disease originated from poor management. Farmers regularly put up their animals for human consumption after treatment failure, as in this account: “I have experienced [mastitis] and if it doesn’t [improve after treatment], we just sell it [to the butchers].” – R07, small ruminant farmer. Dermatophilosis was likewise considered a significant burden due to its regular occurrence and the loss incurred by farmers once it was discovered: “ In 10 animals, we [usually] have 1–2 cases [of dermatophilosis]. From experience, if we see dermatophilosis on our farm, we sell them out immediately at a loss of 75%.” - R12, small ruminant farmer. PPR was considered one of the most severe diseases, as it led to substantial mortalities: “ My major challenge is [PPR]. I had small ruminants but [PPR] wiped out the whole stock.” - R01, small ruminant farmer. Other less prevalent infections included foot rot and lameness. Most farmers surveyed (68.2%) did not vaccinate their flock. Within the last one year, 28.4% of farmers vaccinated against PPR and 3.3% against CBPP (Table 3 ). In diagnosing diseases experienced, farmers primarily relied on their experience (72.1%) and changes in animal behaviour (62.1%), with far less focus on veterinary consultation (< 15%) (Fig. 3 ). Over the last three months, 383 (48.8%) of farmers had consulted various animal health services. Figure 4 summarises the animal health services used and services provided. Of the 156 farmers who had vaccinated their animals within the time period, 67.1% relied on government veterinarians. For treatment, farmers mostly consulted para-veterinarians (39.4%) and drugstore vendors (20.1%) rather than government veterinarians (19.29%) and private veterinarians (farmers (16.5%). 58.0% of farmers did not generally use antimicrobial alternatives (ATAs) in their ruminant production. Reasons for this included unavailability (33.6%) and their being difficult to administer (33.2%) (Fig. 5 ). Table 3 Animal health management practices of farmers. Animal Health Management Practices n (%) Vaccination Never 535 (68.15) Sometimes 214 (27.26) Always 36 (4.59) Use of antimicrobial alternatives (ATAs) in animal production Yes 141 (17.96) No 455 (57.96) I don’t know 189 (24.08) Diseases vaccinated against in the last year PPR 223 (28.41) CCPP 26 (3.31) Anthrax 21 (2.68) Blackquarter 3 (0.38) Use of animal health services over last 3 months Yes 383 (48.79) No 397 (50.57) I don’t know 5 (0.64) Actions taken to protect from mastitis Nothing 589 (75.03) Proper management 190 (24.20) Conventional treatment 4 (0.51) Alternatives to antibiotics 2 (0.25) Methods used to currently detect mastitis Observation 513 (65.35) Laboratory tests 16 (6.04) I don’t know 256 (32.61) First step on suspicion of mastitis Nothing 405 (51.59) Consult a veterinarian or para-veterinarian 235 (29.94) Use self-prescribed antibiotics 85 (10.83) Use ATAs 40 (5.10) Isolation 14 (1.78) Culling and selling 6 (0.76) A significant portion of farmers (47.6%) had self-prescribed antibiotics to their herd over the last three months. The most commonly prescribed antibiotics include oxytetracycline (22.4%), tylosin (14.3%), and procaine penicillin (11.1%) (Fig. 6 ). These antibiotics were primarily sourced from (unlicensed) animal feed stores, veterinarians, and livestock markets (Additional File 5). Over the last three months, 14.0% and 4.6% of farmers reported using herbal plants and salt as ATAs, respectively. Herbs include dongoyaro (Yorubá and Hausa name for neem plant or Azadirachta indica ), Àgánwò/Kahi (Yorubá and Fulani names for mahogany hardwood or Khaya senegalensis) , bitter leaf plant ( Vernonia amygdalina), Kadanya (Fulani name for shea butter tree or Vitellaria paradoxa ), ígí ìpín (Yorubá name sandpaper tree or Ficus exasperata ). Of these, mahogany hardwood was used in treating mastitis and CCPP. Sandpaper tree could be used for mastitis. Farmers also used some materials such as potash, shea butter, heat, lime, and beans. These were used for various diseases. One farmer described using beans to treat mastitis here: “I don’t use conventional drugs. I use the herbal way, with bean peel. For the [animals] whose teats are hard and there is no milk, we give [beans peel] to them. […] We also feed it [to the animals] and [the teat] will become soft.” - R09, small ruminant farmer. 3.4. Knowledge, Attitudes and Practices (KAP) towards antibiotics and AMR: Averagely, farmers demonstrated poor knowledge about antibiotics and attitudes but higher scores for practices (Table 4 ). Among the knowledge findings, 55.5% and 31.9% of farmers had heard of the terms ‘antibiotic’ and ‘AMR’ respectively. Only 14.8% of farmers knew that mastitis could be caused by AMR pathogens. Table 4 Total KAP scores for farmers. KAP(Total possible score) Average score Above mean n (%) Below mean n (%) Knowledge ( 4 ) 1.23 299 (38.09) 486 (61.91) Attitudes ( 20 ) 8.46 418 (53.25) 367 (46.75) Practices ( 24 ) 11.43 447 (56.94) 338 (43.06) Farmers' attitudes regarding AMU and AMR are summarized in Fig. 7 . 42.0% of farmers agreed that overuse of antibiotics could lead to resistance. 41.8% of farmers agreed that antibiotics were no longer effective. 30.0% agreed that AMR could become a problem in their animals. Only 19.3% of farmers disagreed that ABU in animals should be reduced. Factors influencing practices summarised on Fig. 8 . Disease symptoms in animals prompted 92.4% of farmers to use antibiotics (52% of whom responded “Most Likely” and a further 40.4% “Likely”). Increases in mortality and morbidity, and reduction in animals’ appetites were also “Most Likely” or “Likely” to trigger antibiotic use for most farmers. More farmers were “Most Likely” or “Likely” to use antibiotics on the advice of a paraveterinarian above advice from another farmer or a drugstore seller (26.6/59.8%; 16.2/57.6%; and 14.2/51.3% respectively) 77.6% of farmers indicated they were “Most Likely” (19.9%) or “Likely” (57.7%) to use antibiotics as a means of improving the growth rate or productivity of their animals, suggesting this is still a problematic area in small ruminant management and 77.2% were “Most Likely” (18.2%) or “Likely” (59.0%) to antibiotics prophylactically. Overall, 60.6% of farmers indicated the cost of antibiotics as being “Most Likely” (16.8%) and “Likely” (43.8%) to be a factor influencing their use, and 65% indicated availability of antibiotics being a factor (18.6% Most Likely and 46.4% Likely). Bivariate analysis indicated that the herd size was the only demographic variable not significantly associated with the KAP of farmers (Additional File 6). In the multivariate model, farmers aged 60 years or older were 24 times more likely to have higher knowledge than farmers younger than 20 years (OR: 23.7, 95% CI: 2.7–560.0, p : 0.013) (Table 5 ). Farmers from Niger state were 3 times more likely to have higher knowledge scores than farmers from Kwara state (OR: 2.9, 95% CI: 1.9–4.4, p < 0.001). Niger State farmers were also four times as likely to have higher practice scores (OR: 4.0, 95% CI: 2.7–6.1, p < 0.001) but 83% less likely to have better attitudes than Kwara State farmers. Farmers with secondary and tertiary levels of education were likely to have higher knowledge scores when compared to farmers with no formal education. Spearman’s correlation indicated that all categories (knowledge, attitudes, and practices) were positively correlated with each other ( p < 0.001) (Table 6 ). Table 5 Multivariate Analysis for KAP. Variables Category Knowledge Attitudes Practices OR (95% CI) p-value OR (95% CI) p-value OR (95% CI) p-value Age (years) < 20 r r r 21–30 7.57 (1.01–166.00) 0.092 0.71 (0.14–4.20) 0.688 8.34 (1.29–165.00) 0.059 31–40 5.11 (0.69–111.00) 0.172 0.75 (0.15–4.36) 0.728 8.90 (1.39–176.00) 0.051 41–50 9.12 (1.22–200.00) 0.066 0.74 (0.15–4.36) 0.719 8.28 (1.27–164.00) 0.060 51–60 8.59 (1.12–191.00) 0.076 0.94 (0.18–5.71) 0.945 8.49 (1.27–170.00) 0.059 > 60 23.70 (2.68–560.00) 0.013 1.49 (0.24–10.80) 0.676 4.32 (0.55–92.6) 0.222 Gender Male r r r Female 1.08 (0.72–1.61) 0.724 0.74 (0.48–1.15) 0.186 0.94 (0.63–1.39) 0.761 State Kwara r r r Niger 2.90 (1.93–4.39) < 0.001 0.17 (0.11–0.25) < 0.001 4.02 (2.69–6.08) < 0.001 Level of Education No formal education r r r Primary School 1.28 (0.78–2.10) 0.318 0.80 (0.47–1.37) 0.421 0.54 (0.32–0.88) 0.014 Secondary School 2.70 (1.70–4.32) < 0.001 0.65 (0.39–1.09) 0.102 0.86 (0.54–1.37) 0.524 Tertiary Education 2.40 (1.38–4.20) 0.002 0.59 (0.32–1.11) 0.106 0.69 (0.39–1.19) 0.179 Role on Farm Owner r r r Owner and manager 0.94 (0.65–1.36) 0.756 1.63 (1.12–2.38) 0.012 1.46 (1.03–2.07) 0.032 Manager 2.01 (1.07–3.82) 0.031 1.16 (0.58–2.29) 0.677 2.04 (0.85–5.21) 0.192 Worker 4.33 (1.69–12.80) 0.003 0.51 (0.13–1.53) 0.275 0.65 (0.33–1.23) 0.121 Number of years in ruminant farming ≤ 10 r r r 11–20 1.38 (0.92–2.09) 0.121 1.49 (0.97–2.31) 0.070 0.68 (0.46–1.00) 0.052 21–30 1.34 (0.76–2.40) 0.315 1.78 (0.99–3.19) 0.054 0.82 (0.47–1.42) 0.482 31–40 1.27 (0.76–2.40) 0.501 0.76 (0.38–1.52) 0.438 1.23 (0.63–2.43) 0.540 > 40 0.90 (0.32–2.44) 0.846 0.85 (0.32–2.31) 0.743 1.97 (0.79–4.93) 0.145 Table 6 Spearman’s correlation test for KAP Knowledge Knowledge Attitudes Practices - 0.25 ( p < 0.001) 0.19 ( p < 0.001) Attitudes - - 0.15 ( p < 0.001) Practices - - - . 3.5. Factors influencing farmers’ treatment decisions and use of antibiotic and ATAs: Themes uncovered from the FGDs center economics, effectiveness, and availability. Figure 9 summarises the interactions of these factors and how they influence farmers’ health management decisions. The themes are discussed below: Figure 9. Rich picture describing the factors influencing farmers’ treatment decisions. Antimicrobials include antibiotics, antiparasitics, and antivirals. Alternatives include herbs, vaccines, and all household materials used by farmers. Veterinarians are licensed professionals authorized to prescribe antimicrobials. Para-veterinarians include all unlicensed professionals who prescribe antimicrobials. Fulani herdsmen are local pastoralists who utilise herbs in managing ruminant diseases. Arrows with a (+) sign demonstrate a positive causal relationship between the initial and succeeding factor. Arrows with a (-) sign indicate the opposite. 3.5.1. Economic pragmatism outweighs animal health considerations in farmers’ health management decisions: Many small ruminant farmers also kept a cattle herd. As cattle had more monetary value, farmers tended to prioritize and treat disease outbreaks within this herd. Small ruminants, however, were more likely to be sold off after farmers observed diseases among them. A farmer said the following when comparing cattle to small ruminants: “Anyone [who is] rearing cattle has to be very careful [with their health management practices]. You can take risks on sheep and goats but not cattle.” – R05, small ruminant farmer. One farmer remarked on the difference in cost value after diseases between the two species here: “Earlier this year we had two cows. If they were healthy, they are worth about ₦800,000 each, but they were affected by tick infestation. We later sold them at ₦450,000 [...] For ram, if it was worth at least ₦100,000, we can mostly sell it at ₦40,000 [after dermatophilosis]..” - R12, small ruminant farmer. Some diseases, such as mastitis, were considered to not affect the cost of sale in a significant manner: “[Mastitis] doesn’t actually affect the cost of sale like you think. [The cost of sale] is only affected when the [disease is evident] on the body. When the [symptoms are internal], and you buy [the animal] and flame it [before cutting it up for retail sale], [the disease] will not show. During [slaughter], if we see [evidence] of mastitis, we can cut [the teat] out. I can’t really specify [how much loss might be incurred then] [...] It could be a 25% loss.” - R02, animal seller/butcher. 3.5.2. Trust and perceived effectiveness drive farmers’ use of treatment options and health networks: While some farmers used veterinarians, most farmers primarily relied on themselves to manage diseases due to unavailability of veterinarians and a lack of trust in their prescribed treatments, as stated here: “I don’t consult doctors. I have consulted before but there was no solution to our problem, so I go on self-medication.” – R04, small ruminant farmer. Para-veterinarians, though widely used, were similarly distrusted due to their penchant for providing illicit, expired, or potentially dangerous mixtures. One farmer said: “I have seen [a paraveterinarian] mixing tetracycline with petrol and injecting it in the lung [of a cow]. Within 48 hours, 60 of the cows were [dead].” - R13, small ruminant farmer. However, Fulani herdsmen (ruminant farmers with a traditionalist pastoral lifestyle) were trusted by farmers for their traditional herbal remedies: “ There was a case of lameness [on my farm] that I doubted the Fulani man but the next morning [after the Fulani man used some herbs to treat the animal], the animal [could stand]. So I believe it works. We want [good] results and we are getting it. That is all that matters.” - R12, small ruminant farmer. While using antibiotics and ATAs personally, farmers were split regarding perceptions of farmers. Some farmers believed that herbs were more effective than antibiotics, while some farmers thought the opposite. Two farmers said: · “I don’t use antibiotics and we get [good] results anytime I use the herbs.” - R03, small ruminant farmer. “The herbal remedies are not as effective as before [for mastitis].” - R18, small ruminant farmer. 3.5.3. Availability, access and information affect farmers’ use of antibiotics and ATAs: Antibiotics were widely used by farmers because they were readily available from unlicensed drug stores. Farmers who distrusted the validity of drugstore supplies could also procure them from licensed veterinary stores. One farmer said: “ We use antibiotics [on our farm]. We get it from reputable veterinary outlets not [drug store vendors] and street hawker s.” - R16, small ruminant farmer. Conversely, some farmers could not easily use herbs because they were not easy to procure: “Our major problem with the herbs is the scarcity of the [herbs]. I prefer it to conventional [antibiotics], but sometimes I don’t have access to them easily.” - R09, small ruminant farmer. Many farmers also did not know which plants were effective herbs for specific conditions. This caused farmers to rely on Fulani herdsmen (traditional pastoralists skilled in herbal preparations) for consultations. However, Fulani herdsmen were usually secretive about the herbs. One farmer said: “ I do [use herbs]. I get it from the herdsman (Fulani), but he won’t disclose the concoction content” - R12, small ruminant farmer. The lack of knowledge about effective herbs and their dosages affected farmers use of them: “The problem is the dosage of these herbs [which I don’t know].” - R05, small ruminant farmer. Veterinarians were also considered unavailable and inaccessible, compared to para-veterinarians and drugstore vendors, who were widespread: “Before, [farmers in our community] used to call vet doctors that moved around (doing ambulatory services). But now, many farmers don’t know [any] vet doctors. [Vet doctors] have not come [to our community] since 15 years ago. Now, just anybody sells the drugs. Some are not even educated, and they are selling the drugs, because there is no doctor.’ - R15, small ruminant farmer. 4. Discussion Our survey investigated the production characteristics of small ruminant farmers in Nigeria, their health management practices, and possible factors influencing the use of antimicrobials and ATAs. The majority of small ruminant farmers were male and owned less than 50 animals in their stock. Similar reports on gender distribution and flock size have been observed in other Nigerian small ruminant studies ( 3 , 31 , 32 ). However, our finding contrasts other studies that identify women as primary actors in small ruminant rearing particularly on a household level ( 33 ). It should be noted that our study primarily recruited people who engaged in small ruminant farming as a commercial venture rather than for subsistence only. While women are also involved in ruminant farming in this regard, societal constraints often limit their ability to participate fully ( 32 , 33 ). Ishaku et al. noted that commercial small ruminant farming in Nigeria is often undertaken by the whole household, with women more prominent in duties such as grooming and general care of animals, while men often handle health management and animal marketing tasks ( 33 ). Thus, men are more likely to be aware of health management practices and factors influencing these decisions. Our findings indicated that most farmers kept a mixed flock rather than sheep or goats alone. Both sheep and goats are valued across Nigeria for economic and nutritional purposes. In addition, each species is specifically utilised across specific cultures and religions for festivities ( 7 ). It is economically profitable for farmers to rear both, as each species experiences high demand at certain periods of the year, based on seasonal celebrations ( 7 ). However, sheep and goats have varying disease susceptibility. Goats are more susceptible to PPR than sheep, and mastitis prevalence is often found to be higher in the former ( 9 , 34 ). CCPP is also primarily a disease of goats, with sheep only becoming affected when they are within close proximity to goats ( 35 ). Farmers mostly used an open housing system without netting. Within this housing system, animals may be attacked more frequently by insects, and therefore are more susceptible to insect-borne infections such as dermatophilosis and trypanosomosis ( 36 , 37 ). Diseases affecting small ruminants as observed by farmers in our study included mastitis, PPR and dermatophilosis. While other studies have similarly documented the high prevalence of these diseases, additional evidence suggests that there are several more endemic conditions affecting small ruminants in Nigeria ( 9 , 11 , 38 , 39 ) A recent meta-analysis reported a pooled prevalence of 72% for helminthiasis among ruminants in Northern Nigeria ( 38 ). CCPP disease is also highly endemic in North-Central Nigeria, our study location, with an estimated prevalence of 32.9% ( 39 ). It is likely that these diseases occur frequently within farms surveyed; however, farmers may not have reported them due to misdiagnosis. As farmers rely mostly on physical observation to diagnose, CCPP may be mistaken as PPR due to similarities in their clinical presentations. ( 9 , 39 ). The misdiagnosis of bacterial diseases as viral diseases, or vice versa, may lead to antimicrobial misuse, raising implications for AMR. In addition, some diseases may be overlooked entirely. For instance, subclinical mastitis (SCM) is the most common form of mastitis affecting small ruminants in Nigeria, but farmers in this survey did not account for it ( 11 ). This is likely because SCM, like helminthiasis, does not present with physical lesions but rather through poor productivity and performance ( 11 , 38 ). Flocks likely suffer from more health issues than farmers are currently aware of. This suggests consistent flock underperformance and unquantified losses to diseases. Our results indicated that preventive measures were rarely adopted on farms for mastitis, and low vaccination rates generally observed for CCPP and PPR. In 2024, the Federal Government of Nigeria launched a PPR vaccination campaign as part of the PPR Global Eradication Programme (PPR - GEP) by the Food and Agricultural Organisation (FAO) ( 40 , 41 ). This might explain the higher vaccination rates noticed for PPR. Still, only 27% of surveyed farms had received the PPR vaccine, suggesting the campaign did not reach the majority of small ruminant farms. More research is necessary to uncover the current strategies being employed within the national PPR vaccination programme, as well as how to improve these and thereby increase vaccination reach. For CCPP, less than 1% of all farmers reported vaccinating against this disease. While CCPP vaccines exist in Nigeria, there is little documented evidence regarding national vaccination programmes against this disease, as well as low information about its use and acceptability among small ruminant farmers ( 39 ). According to our findings, farmers majorly rely on government veterinarians to access vaccines; thus, the lack of governmental programmes for CCPP correspond to low vaccination rates. The high proportion of farmers who did not implement preventive practices against mastitis is not surprising, as most farmers were unaware of the causes of mastitis. Therefore, it would be difficult for farmers to know what measures to implement. Our finding aligns with a previous study that noted that a significant portion of Nigerian dairy farmers did not use mastitis preventive measures such as handwashing after milking and maintaining good housing conditions ( 21 ). Much progress can be achieved in preventing diseases if farmers are equipped with the right tools (vaccines, information, and veterinary services) for protecting their flocks. One case study of this is the 2012 “DairyCo Mastitis Control Plan (DMCP),” a United Kingdom (UK) structured plan to reduce the prevalence of bovine mastitis. Here, veterinarians were trained to go to farms across the country, assess the current management practices contributing to mastitis, and design targeted intervention plans. UK farmers who implemented these plans recorded more than a 20% drop in mastitis cases ( 42 , 43 ). The potential of using a similar model for small ruminant mastitis in Nigeria could be assessed, while methods to improve vaccine reach for CCPP and PPR are investigated. Antibiotic use was self-guided and unconstrained among farmers. A previous study on North-Central Nigerian pastoralists observed that most farmers practiced self-administration, and only 27% of farmers followed the label instructions ( 12 ). Similarly, findings from a USA study noted that 80% of small ruminant farmers self-administered antibiotics on their farms ( 44 ). Antibiotic classes commonly used included tetracyclines, penicillins, and macrolides. Similarly, these antibiotics have been reported to be commonly misused in small ruminant farms in Nigeria and the USA ( 12 , 44 ). All of these antibiotic classes have been classified as Veterinary Critically Important Antimicrobial Agents (VCIAs) by the World Organisation for Animal Health (WOAH), due to their effectiveness against serious animal infections and the scarcity of potent therapeutic substitutes when resistance to these antibiotics arises ( 45 ). In addition, the macrolide class of antibiotic has also been classified as a Critically Important Antimicrobial (CIA) in humans by the World Health Organisation (WHO) as one of the few effective treatments for campylobacteriosis ( 46 ). The misuse of these antibiotics in small ruminants bears significant consequences for animal and human health, as ARGs can be transmitted between animals and from animals to humans through risk pathways of environmental contamination and consumption of contaminated food products ( 12 , 46 , 47 ). Farmers’ KAP regarding antibiotics and AMU and AMR is of concern and is reflected in the high percentage who are ‘very likely’ or ‘likely’ to use antibiotics for growth promotion and to boost productivity. Most farmers had not heard of the term ‘AMR’ and did not think AMU in animals should be reduced, even though a significant portion believed that antibiotics were no longer effective. This indicates that farmers are starting to observe a growing problem with AMR, but there is generally low awareness about how AMR develops, or methods to curtail it. Similarly, an Ethiopian study found that 56% of animal producers were not aware that their AMU contributed to AMR ( 48 ). Dewi et al. also found that only 35% of farmers in an Indonesian province were aware that over- and underdosing during AMU contributed to AMR ( 49 ). Low knowledge and awareness likely contributed to practices observed, including selling off sick animals, including during treatment that seemed not to be working, and using antibiotics as a means to improve animal appetite and growth rate. These practices promote the administration of antibiotics at sub-therapeutic dosages and contribute to increasing selection pressure for resistant strains of microbes. Currently, Nigeria’s livestock AMU is expected to increase by 163% before 2031 ( 50 ). There is a need for urgent practice reform within Nigerian small ruminant farming in order to improve AMU practices, and studies elsewhere show that education programmes can have a dramatic influence: a study in France found that cephalosporin use in swine production fell by 90% in the five years following farmers’ enrolment in an antimicrobial stewardship (AMS) programme ( 51 ). As observed in our study, more highly educated farmers had better knowledge of AMR, and higher knowledge translated to better attitudes than practices. This indicates that raising awareness among Nigerian farmers about antimicrobial misuse may improve their current practices. Herbal plants and household materials were used for health management, such as the use of Khaya senegalensis and beans in treating mastitis. Chah et al. observed that small ruminant farmers in Eastern Nigeria used Spondias monbin for the treatment of mastitis while also employing various herbs in managing diarrhoeal symptoms from PPR ( 22 ). Conversely, none of the farmers interviewed mentioned being aware of this herb. This indicates that plants used in small ruminant farming may differ by region in Nigeria, highlighting the extensive diversity of herbs in the country. Unfortunately, some regions may also lack sufficient herbal options. Similar to disease diagnosis, farmers appeared to use ATAs primarily for alleviating physical symptoms, such as the hardness of teat observed in clinical mastitis. Thus, farmers may consider an animal healed while the animal is still infected and manifesting less obvious symptoms. Still, herbs identified by farmers have been recorded to possess antibacterial activities. Khaya senegalensis has been proven to inhibit the growth of bacterial isolates during lab-based studies, including Staphylococcus aureus and Escherichia coli , implicated in small ruminant mastitis ( 52 , 53 ). Likewise, Vernonia amygdalina has also exhibited antibacterial activity even against multidrug-resistant bacterial isolates ( 54 ). However, very few studies have been conducted to determine the mechanisms of action of these drugs against small ruminant diseases, nor the effective therapeutic dosages required. Thus, more research and development (R&D) efforts are indicated in these areas. Cost affected farmers’ decisions regarding treatment, with some farmers selling off ill animals or animals currently undergoing treatment. These practices have been banned in high-income countries like the United Kingdom to protect human health from possible zoonotic transmission ( 55 ). Similarly, the Nigerian Criminal Code prohibits the sale of diseased animals for human consumption ( 56 ). Our finding indicates that these laws are weakly enforced. Due to economic considerations, farmers were less reluctant to expend efforts in treating small ruminants when compared to cattle. This is not surprising, as FGD participants estimated the value of a diseased cattle to be four times higher than that of healthy small ruminants. As ATAs, particularly herbal plants, are the cheapest form of treatment available, cost-saving interests likely motivate farmers to use them rather than antibiotics for managing small ruminant diseases. Likewise, Chah et al’s study observed that farmers stated they used herbal plants as therapeutic agents due to their being low or no cost ( 22 ). However, we observed that most farmers did not use ATAs, citing reasons of low access and availability. Most farmers were unaware of specific plants effective for diseases, where to procure them from, and what dosages to use. These reasons likely contributed to why far fewer farmers (14%) used herbs over the last three months when compared to farmers who used antibiotics (48%). Similarly, a previous study reported that 43% of livestock farmers in a Western Nigerian state did not use herbal remedies due to poor knowledge of herbs and their application ( 23 ). In our study, farmers relied on the expertise of Fulani herdsmen when unaware of how to use the herbs. The Fulanis are Northern Nigerians with a traditional pastoralist lifestyle and a culture of preserving ethnoveterinary knowledge through verbal communication across generations ( 57 ). However, Fulani herdsmen require payment for their consulting services and were reported by farmers to be generally secretive about herbs used. Other farmers considered herbs not to be as effective for certain conditions. This contrasts with other studies in Northern Nigeria where Fulani herdsmen reported a wide range of herbs effective for common livestock diseases ( 57 , 58 ). Generally, without relying on Fulani herdsmen, farmers appear to be unaware of the full assortment of herbs available in their community, proper use practices, and their efficacy against endemic conditions. However, we observed that less than 5% of farmers consulted herbalists (including Fulani herdsmen) for treatment services within the last three months. It is likely that farmers’ perceptions about herbal effectiveness and their own unawareness about the herbs reduced their interest in using this enterprise, and consequently their dependence on herbal remedies. Trust in veterinarians was uneven and shaped by farmers’ perceptions of their treatments being effective. In a study conducted in India, veterinarians stated that farmers only consulted them after trying multiple treatment options and when AMR had set in ( 59 ). Likewise, farmers here stated that the most significant factor influencing their antibiotic prescription was the observation of disease symptoms in their flock, rather than advice from veterinarians. Therefore, farmers likely consulted veterinarians after self-treatment had failed, leading to veterinarians being unlikely to succeed at treatment using antimicrobials due to resistant development. Possible reasons identified for farmers’ delay in consulting veterinarians include an intent to save costs and the general unavailability of veterinarians. Currently, veterinarians are relatively scarce in Nigeria, with an estimated ratio of 1 veterinarian per 37,500 animals ( 60 , 61 ). Due to the lack of veterinarians, more farmers tended to consult with unqualified para-veterinarians. Other studies have reported that para veterinarians are a regular feature in LMICs where qualified veterinary services are scarce, as they are widespread and charge less for consultation ( 59 ). While farmers stated they distrusted them, para-veterinarians were still the most frequented animal healthcare service provider, as they were the most available. It is crucial to examine and address the lack of qualified animal healthcare professionals for small ruminants in Nigeria, as this is a significant motivator for self-prescribed AMU, and consequently rising AMR risk. Limitations: Disease prevalence estimates were not determined through epidemiological survey and laboratory analysis, but based on farmers’ reports. Therefore, figures may be affected by memory recall and reliance on physical observation for diagnosis. However, this approach was used to fully understand small ruminant farmers’ perceptions of prevalent diseases and their health management practices. 5. Conclusions and Recommendation. There is a general dependence on self-prescribed antibiotics over vaccines and herbal ATAs among small ruminant farmers in Nigeria. This is due to poor vaccine availability, insufficient knowledge about herbal remedies, and a general lack of awareness of preventive practices against prevalent diseases. Veterinarians are relatively unavailable, and antibiotics are freely available and accessible via unlicensed drugstore vendors. Consequently, AMU is indiscriminate and bears grave implications for AMR.There is a need to improve access of farmers to vaccines, government veterinarians, and laboratory diagnostic services. It is also essential to curtail the unlicensed sale of veterinary drugs through the enforcement of veterinary AMU regulations. Farmers also sell off ill animals and do not observe withdrawal periods after AMU. These practices must equally be strictly regulated and banned. To further reduce farmers’ indiscriminate AMU and improve dependence on ATAs, future initiatives can focus on: ( 1 ) improving farmers’ awareness of AMR and its risk practices; ( 2 ) conducting awareness programmes to sensitize farmers about effective disease preventive measures and the importance of maintaining proper hygiene and sanitary conditions; ( 3 ) investigating the current vaccine distribution channels in Nigeria and how to improve delivery and reach; ( 4 ) researching currently available herbal remedies in Nigeria and assessing their effectiveness against prevalent small ruminant diseases; ( 5 ) exploring barriers that hinder better compliance with antimicrobial regulations. All of these will lead to improved health outcomes for small ruminants while reducing AMR risk pathways from small ruminants to humans and the environment. Declarations Ethics approval and consent to participate Ethical approval for the study was obtained from the University of Ilorin Ethical Review Committee (UERC) (UERC Approval Number: UERC/ASN/2024/2915) and from the Royal Holloway University of London Research Ethics Committee (Application ID 4210) . Data from research participants was ethically collected in accordance with the declaration of Helsinki (62). Informed consent was obtained in verbal and written forms from all survey and focus group participants. Confidentiality assurances were also communicated, with a clear option to opt out at any time during survey data collection and focus group discussions. Consent for publication Participants were made fully aware that their responses would be published and informed consent in this regard was obtained prior to their enrollment in the study. Availability of data and materials The data that support the findings of this study are obtainable from the corresponding author upon reasonable request. Competing interests The authors declare no competing interests. Funding This work was carried out with financial support from the International Development Research Centre (IDRC), Canada, and the Global AMR Innovation Fund (GAMRIF), part of the UK Government’s Department of Health and Social Care (DHSC). (Grant number: 110337). Drafting and review of the paper were supported under the British Academy International Writing Workshop grant number IWW24\110690. The funders did not play a role in the design, analysis, and reporting of the study. Authors' contributions Mahmoud Eltholth: Conceptualization, Investigation, Funding acquisition, Methodology, Project administration, Supervision, Writing – review & editing. Rodiat Olabisi Omotoso: Investigation, Data curation, Writing – original draft, Writing- review & editing, Formal analysis, Validation. Ismail Adewuyi Adeyemo: Investigation, Writing- original draft, Writing - review & editing. Jadesola Juliana Ajao: Writing -original draft, Writing – review & editing, Investigation, Validation, Formal analysis, Visualization, Data curation. Olayiwola Akeem Ahmed: Investigation, Writing- original draft, Writing - review & editing. Nma Bida Alhaji: Investigation, Supervision, Writing- review & editing. Musa Imam Abubakar: Investigation, Writing- original draft, Writing - review & editing. Rodhiat Oyinlola Ade-Yusuf: Data curation, Investigation, Writing- original draft. Ibrahim Adisa Raufu: Supervision, Writing- review & editing. Victoria Olusola Adetunji: Supervision, Writing- review & editing. Jennifer Cole: Writing - original draft, Writing - review & editing. Elsabagh Mabrouk: Writing- review & editing. Elena Garcia Fruitós: Conceptualization, Investigation, Writing – review & editing. Anna Aris: Conceptualization, Investigation, Funding acquisition, Writing – review & editing. Ismail Ayoade Odetokun: Conceptualization, Funding acquisition, Methodology, Investigation, Project administration, Resources, Writing – review & editing, Supervision. Acknowledgements We extend our sincere gratitude to the study participants in Kwara and Niger State, Nigeria, who with their contribution, made this research possible. References Alabi AA, Idris-Adeniyi KM, Busari AO, Ayandiran KS, Ajuwon AP. Comparative analysis of indigenous and improved small ruminant management techniques among rural households in Iwo Agricultural Zone, Osun State, Nigeria. Agric Sci Technol. 2025;17:98–112. 10.15547/ast.2025.03.037 . Adetunmbi T, Chineke CA. Improving global food systems, human health, and alleviating poverty through small ruminant production: the Nigerian gains. 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Peste des Petits Ruminants Global Eradication Programme II & III: through a coordinated, time–bound programme to stop the needless suffering of animals and reduce human poverty. FAO. 2024. https://openknowledge.fao.org/server/api/core/bitstreams/7cc37bdf-c2a3-4874-8504-ef93593d05bb/content . Accessed 30 Jan 2026. Black H et al. The DairyCo Mastitis Control Plan — report on three year delivery programme 2009–2012 (conference poster). 2012:93–94. Mastitis Control Plan. What is the plan? Mastitis Control Plan. 2009–2026. https://www.mastitiscontrolplan.co.uk/what-is-the-plan . Accessed 30 Jan 2026. Aniume T, et al. Influences of management practices, information sources, and awareness on use of antibiotics among small-scale goat and sheep farmers. Appl Anim Sci. 2023;39(5):317–29. World Organisation for Animal Health (WOAH). WOAH list of antimicrobial agents of veterinary importance (January 2025). WOAH. 2025. https://www.woah.org/app/uploads/2021/06/202501-en-woah-trd-list.pdf . Accessed 30 Jan 2026. World Health Organization. WHO list of medically important antimicrobials: a risk management tool for mitigating antimicrobial resistance due to non-human use. World Health Organization. 2024. https://cdn.who.int/media/docs/default-source/gcp/who-mia-list-2024-lv.pdf . Accessed 30 Jan 2026. Akinyemi KO, Fakorede CO, Olaosebikan RI, et al. Human and animal brucellosis in Nigeria: a systemic review and meta-analysis in the last twenty-one years (2001–2021). Vet Sci. 2022;9(8):384. Gebeyehu DT, Bekele D, Mulate B, Gugsa G, Tintagu T. Knowledge, attitude and practice of animal producers towards antimicrobial use and antimicrobial resistance in Oromia zone, north eastern Ethiopia. PLoS ONE. 2021;16(5):e0251596. 10.1371/journal.pone.0251596 . Dewi RR, Sihombing JM, Jajere SM, et al. Knowledge, attitudes and practices regarding antimicrobial resistance, usage and residues among livestock farmers in North Sumatra, Indonesia. BMC Agric. 2025;1:19. 10.1186/s44399-025-00019-5 . Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, et al. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci U S A. 2015;112(18):5649–54. Verliat F, Hémonic A, Chouet S, et al. An efficient cephalosporin stewardship programme in French swine production. Vet Med Sci. 2021;7(2):432–9. 10.1002/vms3.377 . Osman W, Gibreel HH, Salih RR, Mirghani M. Antimicrobial effects of aqueous bark extracts of Khaya senegalensis, Azadirachta indica and Eucalyptus camaldulensis against different bacterial pathogens. Brito GI, Cerqueira LA, Perecmanis S, Borges JRJ, de Castro MB, Câmara ACL. Clinical mastitis in small ruminants referred to a veterinary teaching hospital: 23 cases. Microorganisms. 2025;13(7):1512. 10.3390/microorganisms13071512 . Evbuomwan L, Chukwuka EP, Obazenu EI, Ilevbare L. Antibacterial activity of Vernonia amygdalina leaf extracts against multidrug resistant bacterial isolates. J Appl Sci Environ Manage. 2018;22(1):17–21. Food Standards Agency. Food safety: farmed meat, farm produce and animal feed. GOV.UK. 2012. https://www.gov.uk/guidance/food-safety-farmed-meat-farm-produce-and-animal-feed . Accessed 30 Jan 2026. Esan M. Overview of Nigerian animal law. In: Schaffner JE, editor. Elgar concise encyclopedia of animal law. Cheltenham (UK): Edward Elgar Publishing; 2025. pp. 303–6. Ayeni EA, Basiri B. Ethnoveterinary survey of plants used in treating livestock among the Fulani people of Girei, Adamawa State, Nigeria. World News Nat Sci. 2018;16:53–66. Usman IS. Ethno-veterinary care amongst the nomadic Fulani herdsmen in southern zone of Adamawa State, Nigeria. J Anim Sci Vet Med. 2016;1:108–17. Eltholth M, Govindaraj G, Das B, Shanabhoga MB, Swamy HM, Thomas A, Cole J, Shome BR, Holmes MA, Moran D. Factors influencing antibiotic prescribing behavior and understanding of antimicrobial resistance among veterinarians in Assam, India. Front Vet Sci. 2022;9:864813. 10.3389/fvets.2022.864813.​ . Kalu U, Nwachukwu IM, Apu U. Farmers’ use of improved animal health management technologies in small ruminant production in South East, Nigeria. J Community Commun Res. 2021;6(2):53–60. Saganuwan SA. Ethnoveterinary values of Nigerian medicinal plants: an overview. Eur J Med Plants. 2017;18(4):1–35. 10.9734/EJMP/2017/29321 . World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. 10.1001/jama.2013.281053 . Additional Declarations No competing interests reported. Supplementary Files AdditionalFilesLegends.docx AdditionalFile1.docx AdditionalFile2.docx AdditionalFile3.docx AdditionalFile4.jpg AdditionalFile5.jpg GraphicalAbstract1.png Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 06 Apr, 2026 Reviews received at journal 01 Apr, 2026 Reviews received at journal 27 Mar, 2026 Reviews received at journal 24 Mar, 2026 Reviewers agreed at journal 24 Mar, 2026 Reviews received at journal 23 Mar, 2026 Reviewers agreed at journal 22 Mar, 2026 Reviewers agreed at journal 22 Mar, 2026 Reviewers agreed at journal 22 Mar, 2026 Reviews received at journal 21 Mar, 2026 Reviewers agreed at journal 21 Mar, 2026 Reviewers agreed at journal 21 Mar, 2026 Reviewers agreed at journal 21 Mar, 2026 Reviewers agreed at journal 20 Mar, 2026 Reviews received at journal 19 Mar, 2026 Reviewers agreed at journal 19 Mar, 2026 Reviewers agreed at journal 19 Mar, 2026 Reviewers agreed at journal 19 Mar, 2026 Reviewers invited by journal 19 Mar, 2026 Editor assigned by journal 19 Mar, 2026 Editor invited by journal 19 Mar, 2026 Submission checks completed at journal 18 Mar, 2026 First submitted to journal 17 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9085231","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":610072083,"identity":"9b15a2ca-68a1-4fbb-b79b-afb05dad9733","order_by":0,"name":"Mahmoud 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of the study participants.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/207e131e1f1719bbe6561a8a.jpg"},{"id":105239926,"identity":"fd29977d-a2d8-4295-9043-fc483060efd7","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":87896,"visible":true,"origin":"","legend":"\u003cp\u003eGeographical distribution of respondents within the study areas.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/65b32e49ce45037a17fa765e.jpg"},{"id":105239927,"identity":"4d3d4d85-3830-44e8-a511-0760438fa731","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":38156,"visible":true,"origin":"","legend":"\u003cp\u003eMethods used by farmers in diagnosing diseases.\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/1d078f763ad81ae9ee18f368.jpg"},{"id":105564702,"identity":"db990141-b1b2-4e5c-829f-c7c03d48c75c","added_by":"auto","created_at":"2026-03-27 12:50:33","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":43427,"visible":true,"origin":"","legend":"\u003cp\u003eAnimal health service providers used over the last three months according to services provided.\u003c/p\u003e","description":"","filename":"Figure4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/ad247a232c0d4855dbe32517.jpg"},{"id":105564431,"identity":"ee7d37d6-d7a0-41b1-a568-b5676e2a58b2","added_by":"auto","created_at":"2026-03-27 12:49:32","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":42476,"visible":true,"origin":"","legend":"\u003cp\u003eReasons farmers (n = 455) provided for not using antimicrobial alternatives.\u003c/p\u003e","description":"","filename":"Figure5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/c07a3022d0973b80af678562.jpg"},{"id":105239933,"identity":"80c3d870-0b19-4793-9975-801e873c2704","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":44119,"visible":true,"origin":"","legend":"\u003cp\u003eAntibiotics and ATAs used by farmers over the last three months.\u003c/p\u003e","description":"","filename":"Figure6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/0e2f911f7ffdf6bf8d256417.jpg"},{"id":105564396,"identity":"671da09a-dfa2-46f9-a4c9-68f78b23ea50","added_by":"auto","created_at":"2026-03-27 12:49:27","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":153982,"visible":true,"origin":"","legend":"\u003cp\u003eFarmers’ attitudes regarding the use of antibiotics.\u003c/p\u003e","description":"","filename":"Figure7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/86c28541af16867f27928061.jpg"},{"id":105564520,"identity":"ddb9b65a-c566-404f-a118-ee0b842f0815","added_by":"auto","created_at":"2026-03-27 12:49:53","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":150162,"visible":true,"origin":"","legend":"\u003cp\u003eFactors influencing farmers’ antibiotic practices in their herd.\u003c/p\u003e","description":"","filename":"Figure8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/9f20526e454c03546477ded8.jpg"},{"id":105239931,"identity":"6d8931cc-10cd-452e-afcf-79b6e08ce5b1","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"jpg","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":75433,"visible":true,"origin":"","legend":"\u003cp\u003eRich picture describing the factors influencing farmers’ treatment decisions. Antimicrobials include antibiotics, antiparasitics, and antivirals. Alternatives include herbs, vaccines, and all household materials used by farmers. Veterinarians are licensed professionals authorized to prescribe antimicrobials. Para-veterinarians include all unlicensed professionals who prescribe antimicrobials. Fulani herdsmen are local pastoralists who utilise herbs in managing ruminant diseases. Arrows with a (+) sign demonstrate a positive causal relationship between the initial and succeeding factor. Arrows with a (-) sign indicate the opposite.\u003c/p\u003e","description":"","filename":"Figure9.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/625e76562d2c52926af65962.jpg"},{"id":105728043,"identity":"c64043a8-27e9-4418-9a5b-74d4b08b3d2f","added_by":"auto","created_at":"2026-03-30 11:08:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2335200,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/7f999db7-096c-43cb-b046-28f20e00452d.pdf"},{"id":105239925,"identity":"c1ef8fc5-c450-46e9-92b9-e615e3845238","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":14040,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFilesLegends.docx","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/8cbd77a1d2e16e670ecf1d11.docx"},{"id":105564442,"identity":"a82c46ad-5e58-4fa1-ac4a-4d6c4394b424","added_by":"auto","created_at":"2026-03-27 12:49:33","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":482793,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/faf8306232f84fdb944df0ee.docx"},{"id":105564448,"identity":"4c29a28a-b486-4455-b6c6-e261ba4d7adf","added_by":"auto","created_at":"2026-03-27 12:49:34","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":199767,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile2.docx","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/f8a6c7a6084d8e905f347d7d.docx"},{"id":105564475,"identity":"d6aa7ec0-1bfe-4d01-979c-713a0925aa9c","added_by":"auto","created_at":"2026-03-27 12:49:43","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":8091,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile3.docx","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/a672b88962eff93a9cc939f7.docx"},{"id":105563952,"identity":"c5469c4e-929e-400e-8cd8-8bf731b9520c","added_by":"auto","created_at":"2026-03-27 12:48:16","extension":"jpg","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":46273,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/739d47331ecaefe85c88c037.jpg"},{"id":105564307,"identity":"5cc489fe-30d7-4ac3-992d-d5f4c1eed7d6","added_by":"auto","created_at":"2026-03-27 12:49:15","extension":"jpg","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":233665,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/85b2db0ff8a6513e62fdde24.jpg"},{"id":105239935,"identity":"d0501d4f-2f20-4e68-911d-c210dbdb2050","added_by":"auto","created_at":"2026-03-23 21:58:56","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"supplement","size":340599,"visible":true,"origin":"","legend":"","description":"","filename":"GraphicalAbstract1.png","url":"https://assets-eu.researchsquare.com/files/rs-9085231/v1/a46f1c0a3ae02f09daa95e20.png"}],"financialInterests":"No competing interests reported.","formattedTitle":"Small Ruminants’ Production System Characteristics and Their Influence on Antimicrobial Use, Alternatives, and Resistance in Nigeria","fulltext":[{"header":"Highlights","content":"\u003cp\u003e- 48% of farmers self-administered antibiotics within the last three months.\u003c/p\u003e\u003cp\u003e- Less than 5% of farmers vaccinate their flock regularly.\u003c/p\u003e\u003cp\u003e- 58% of farmers do not use antimicrobial alternatives in their production.\u003c/p\u003e\u003cp\u003e- Low awareness and availability affect farmers\u0026rsquo; use of herbal remedies.\u003c/p\u003e\u003cp\u003e- Economic considerations cause farmers to sell off ill and dying animals before or during treatment.\u003c/p\u003e\u003cp\u003e \u003c/p\u003e"},{"header":"1. Background","content":"\u003cp\u003eLivestock production plays a crucial role in Nigeria\u0026rsquo;s agricultural sector, accounting for roughly one-third of the country\u0026rsquo;s agricultural gross domestic product (GDP) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Small ruminants are a substantial portion of Nigeria\u0026rsquo;s livestock, with an estimated population of 19\u0026nbsp;million sheep and 28\u0026nbsp;million goats (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Small ruminant production is particularly prominent in rural communities, as they contribute substantially to food security and maintaining incomes in low- and middle-income households (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). In many cases, households integrate small ruminant farming with cattle and/or crop production to maximise general output and reduce costs (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Most farmers adopt extensive and semi-intensive grazing systems, in which animals rely largely on outdoor forages and refuse dumps in the environment. These systems increase animals\u0026rsquo; possibility of exposure to diseases endemic in the environment (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiseases commonly affecting small ruminants in Nigeria include mastitis, peste des petits ruminants (PPR), and poxviruses (\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). A study on PPR in Nigeria estimated its prevalence to be 6% in sheep and 21% in goats (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Another study estimated the incidence of mastitis as 40.4% across three states in Nigeria, 30.4% of which were subclinical mastitis cases with no obvious physical signs (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). These diseases are considered to be widespread and circulating actively across Nigeria, leading to increased morbidity and mortality within the affected flock (\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In this regard, mastitis is a particularly significant disease, as it causes consistent underperformance in terms of milk production and increases kid mortality due to resultant starvation (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTo curtail these losses, farmers rely on antimicrobials, especially antibiotics, for health management (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). These drugs are often misused. A study on pastoralist ruminant farmers in Nigeria observed that 65% of farmers did not consult veterinary services and rather practiced self-administration. 67% of farmers administered antibiotics arbitrarily and without clear protocols, and only 16% observed withdrawal periods after antibiotic use (ABU) (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Indiscriminate antimicrobial use (AMU) in this manner has led to the deposition of subtherapeutic dosages of antimicrobial residues in the gut of animals, conferring selection pressure and leading to the development of antimicrobial resistant genes (ARGs) in infectious microbes (\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). This pattern has also been observed across other countries in the world, for instance, in a Portuguese study, 83% of samples obtained from 65 small ruminant farms contained at least one antimicrobial resistant gene (ARG) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Through non-observance of withdrawal periods in food-producing animals, ARGs can be passed from livestock to humans and the environment through risk pathways of milk consumption and poor manure disposal. Antimicrobial residues have also been implicated in human allergic reactions, damage to vital organs such as the kidneys, liver, and bone marrow, increased cancer risk, and developmental problems in foetuses and children (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The most undesirable effect of ARGs, however, is the replication of AMR, a significant global health threat projected to cause 10\u0026nbsp;million human deaths annually by 2050 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCurrently, efforts are being put in place globally to reduce AMU in livestock production through the development of antimicrobial alternatives (ATAs). ATAs are tools and substances that can prevent or control infections, thereby reducing the need for antimicrobials and subsequently the risk of AMR. These include vaccines, herbal plants, antimicrobial peptides, bacteriophages, and probiotics. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Unfortunately, several ATAs have significant hindrances that prevent them from being functional and effective replacements for antimicrobials. For instance, vaccines are available in Nigeria for poxviruses and PPR; however, low vaccination coverage and a general lack of awareness reduce the potential for appreciable impact in this regard (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). There is little evidence that vaccines widely used elsewhere are utilised for small ruminant mastitis in Nigeria, due to relatively low research and development efforts in these areas. In addition, studies from other countries report that currently available mastitis vaccines generally have low to inconsistent levels of efficacy, with protection declining over time. Improved hygiene practices are regarded as more reliable alternatives for preventing mastitis (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). However, hygienic management for mastitis prevention is inconsistently utilised by Nigerian ruminant farmers (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Another group of ATAs used in Nigeria is herbal plants. Herbs such as \u003cem\u003eSolanum spp\u003c/em\u003e and \u003cem\u003eGlyphea brevis\u003c/em\u003e have been used in Eastern Nigeria for diarrhoea and retained placenta in small ruminants. These herbs have been recorded to have antimicrobial properties, affirming their effectiveness for these conditions. Farmers also utilise regular household materials such as kerosene, palm oil, and salt for remedies (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, some studies have noted that a deeper understanding of the mechanism of action of these herbs, as well as their effective dosage concentrations, is still lacking, preventing their full adoption by Nigerian farmers (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere exist clear evidence gaps regarding the current use of ATAs in Nigeria, as well as an understanding of the factors that restrict small ruminant farmers from using them when compared to antimicrobials. Thus, this study presents an exploratory sequential mixed-methods approach aimed at characterising the small ruminant production system in Nigeria and identifying possible influences on the use of antimicrobials and ATAs in the management of infectious disease conditions.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Study setting and sampling\u003c/h2\u003e \u003cp\u003eThe study was conducted in two predominantly ruminant-farming states in North-Central Nigeria: Kwara and Niger (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Kwara is located between latitude 8\u0026deg; 05\u0026rsquo; N and 10\u0026deg; 05\u0026rsquo; and longitude 2\u0026deg; 50\u0026rsquo; E to 6\u0026deg; 05\u0026rsquo; E, while Niger lies approximately between 8\u0026deg; 00\u0026prime; N and 11\u0026deg; 30\u0026prime; N latitude and 3\u0026deg; 30\u0026prime; E to 7\u0026deg; 40\u0026prime; E longitude. Niger and Kwara are divided into 3 and 4 Agricultural Development Zones (ADPs), respectively (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The target populations for the questionnaire survey included small ruminant farmers, herders, and farm workers within the study area. The sample size was determined to be 384 per state via OpenEpi, with an estimated proportion of 50%, a 5% margin of error, and a 95% confidence level. Ultimately, 785 respondents were surveyed to account for possible incomplete or non-responses.\u003c/p\u003e \u003cp\u003eSampling was multistage random. The first stage involved the selection of three ADPs in each state. For Kwara, the three zones with the highest ruminant farming activities were selected. The second stage involved a systematic random selection of 4 pastoral communities from each zone (12 communities per state). Communities selected in Kwara were Amoyo, Lajiki, Amberi/Ijagbo, Ajase-Ipo, Kaiama, Ilesha Baruba, Okuta, Kageji, Fufu, Afon, Oke Oyi, and Tafatafa. In Niger, selected communities included Bida, Agaie, Bosso, Edati, Gbako, Gurara, Katcha, Lapai, Lavum, Mokwa, Agwara, and Suleija. The third stage involved a purposive sampling of 32\u0026ndash;33 appropriate respondents from each community.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Study Design:\u003c/h2\u003e \u003cp\u003eThe study was conducted in four phases from January 2025 to February 2026. Phase I consisted of the design and administration of the questionnaire survey (January to March 2025). In Phase II, survey data were compiled and analysed (March to September 2025). Phase III involved reviewing the quantitative results and organising a focus group discussion (FGD) to generate further insights \u003cb\u003e(\u003c/b\u003eOctober 2025). Phase IV involved qualitative thematic analysis and report writing (October 2025 to February 2026).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Questionnaire design and administration:\u003c/h2\u003e \u003cp\u003eThe research team developed the questionnaire following a series of meetings and a literature review of similar studies conducted in Nigeria (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The questionnaire was developed in English and administered by researchers who were fluent in English and Yoruba, English and Fulani, or all three languages. The questionnaire was piloted with 10 farmers in a pastoral community to ascertain its validity, after which necessary revisions were made. The final version consisted of five sections: (a) farmers\u0026rsquo; socio-demographics, (b) farm characteristics, (c) livestock management practices, (d) animal health management practices, and (e) knowledge, attitudes, and practices (KAP) of AMU and AMR (Additional File 1). The questionnaire was semi-structured and comprised single-choice, multiple-choice, and open-ended questions. It was administered through face-to-face interviews. Bilingual/trilingual researchers conducted the survey, translating questions from English to Yoruba or Fulani. Received responses were collated in English on paper or electronic forms. These forms were checked for completeness before being input into KoboToolbox (v.2.024.36).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Quantitative data analysis:\u003c/h2\u003e \u003cp\u003eData analysis began with initial data cleaning in Microsoft Excel, during which missing values and logical inconsistencies were identified and addressed. The cleaned data were then imported into R (v. 4.5.1). Findings were summarized descriptively using frequencies, proportions, averages, and ranges. For the KAP, the farmers were asked 4 knowledge questions, 10 attitude questions, and 12 practice questions. Under the section, knowledge questions were scored 1 for a correct answer and 0 for \u0026lsquo;Yes\u0026rsquo; and \u0026lsquo;No,\u0026rsquo; respectively. Attitude questions were scored on a 3-point Likert scale ( 0\u0026thinsp;=\u0026thinsp;Disagree/ I don\u0026rsquo;t know, 1\u0026thinsp;=\u0026thinsp;Neutral, 2\u0026thinsp;=\u0026thinsp;Agree). Practice questions could be answered \u0026lsquo;Most likely\u0026rsquo;, \u0026lsquo;Likely\u0026rsquo; or \u0026lsquo;Not Likely\u0026rsquo; which were given scores of 2, 1 and 0 respectively. Negative questions in each section were scored in reverse. To enable relative comparison within our study population, we obtained a data driven cutoff using the group mean, consistent with previous studies (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The above-mean section included scores above the population average (\u0026ge;\u0026thinsp;1.23 for knowledge, \u0026ge;\u0026thinsp;8.46 for attitudes, and \u0026ge;\u0026thinsp;11.43 for practices). As questions were all scored with whole numbers, this translated to \u0026ge;\u0026thinsp;2 for knowledge, \u0026ge;\u0026thinsp;9 for attitudes, and \u0026ge;\u0026thinsp;12 for practices. Pearson\u0026rsquo;s chi-square test further tested the associations between KAP scores and farmers\u0026rsquo; demographic characteristics. All significant associations at the \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level were subsequently entered into a multivariate logistic regression model to test for independent associations. Finally, a Spearman\u0026rsquo;s correlation test was conducted to determine the associations between the three scored groups.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5. Focus group discussions:\u003c/h2\u003e \u003cp\u003eThe research team reviewed findings from the survey and highlighted key areas that required further exploration. Subsequently, a focus group discussion was organised. First, an interview guide was developed via team meetings. The guide comprised 11 questions focused on farmers\u0026rsquo; health management practices, the economic impact of diseases, and factors that affected the use of antibiotics, ATAs, and animal health service providers \u003cb\u003e(\u003c/b\u003ethe guide is attached as Additional File 2. 23 stakeholders were recruited from the Nigerian small ruminant farming industry, including small ruminant farmers, veterinarians, para-veterinarians, and butchers/meat vendors. Demographics in this group reflect those of the survey in terms of age, gender and state of origin. Participants were split into three round tables, and for each table, a trained moderator was assigned to lead the discussion using the interview guide. A co-moderator/note taker was taking notes and, when possible, recording the conversation for each table.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6. Qualitative (thematic) analysis:\u003c/h2\u003e \u003cp\u003eAudio recordings were transcribed manually and using the TurboScribe software. Supplementary notes taken by the co-moderator captured nonverbal cues and group dynamics. Thereafter, analysis was conducted based on Braun and Clarke\u0026rsquo;s guide to reflexive thematic analysis (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The analysis was deductive with a majorly semantic coding approach. First, transcripts were read multiple times to allow for data familiarisation. Visual maps were also created to aid researchers with retention. Two independent researchers generated initial codes. Afterwards, researchers came together to search for potential themes. Final themes were decided after multiple rounds of discussion and reflection. These themes have been explored in the Results section. Thematic interactions were integrated into a rich picture using Lucidchart to illustrate interactions between factors influencing farmers\u0026rsquo; health management decisions.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Demographic Characteristics:\u003c/h2\u003e \u003cp\u003eDemographic characteristics of 785 survey respondents are summarised in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, with geographical distribution in Fig.\u0026nbsp;2. Most respondents (60.8%) were between 31 and 50 years of age. The majority of respondents (78.1%) were male. Most (65.7%) had more than 10 years of farming experience. The majority (82.2%) owned fewer than 50 small ruminants in their flock.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of farmers.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDemographics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (1.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e130 (16.56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e277 (35.29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e200 (25.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e132 (16.81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (4.84)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e613 (78.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e172 (21.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eState\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKwara\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e377 (48.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNiger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e408 (51.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e461 (58.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114 (14.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128 (16.30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e82 (10.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRole on Farm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOwner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e461 (58.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOwner and manager\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e248 (31.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManager\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51 (6.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (3.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of years in ruminant farming\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le; 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e269 (34.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e258 (32.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145 (18.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74 (9.42)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39 (4.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHerd size of animals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e299 (38.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e346 (44.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u0026ndash;75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81 (10.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59 (7.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 2.\u003c/b\u003e Geographical distribution of respondents within the study areas.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Farm Characteristics and Management Practices.\u003c/h2\u003e \u003cp\u003eMost farms (65%) kept a mixed herd of sheep and goats. The largest herd segment was females above prime reproductive age for both species (\u0026gt;\u0026thinsp;2 years) (Additional File 3).. Fewer than 40% of farmers routinely kept feeding, reproduction, or health records (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Flocks (54.2%) were mostly housed in an open area without netting, and a significant portion (46.8%) was reared in an extensive grazing system. The majority of farmers (83.9%) relied on natural pasture to feed their flock (Additional File 4).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFarm characteristics and management.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarm Characteristics and Management\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousing systems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpen housing system without netting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e425 (54.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpen housing system with netting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e221 (28.15)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClosed housing system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e139 (17.71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFeeding practices\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExtensive system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e367 (46.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSemi-intensive system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e306 (38.98)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112 (14.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePurchase replacement animals?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e364 (46.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e421 (53.63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of community grazing lands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e476 (61.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e272 (35.28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (2.98)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecord keeping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e214 (27.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReproduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e263 (33.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVeterinary Health Products\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e244 (31.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaccination programs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e179 (22.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Prevalent Diseases and Farmers\u0026rsquo; Health Management Practices\u003c/h2\u003e \u003cp\u003eThe most prevalent diseases affecting the small ruminant flock were mastitis, dermatophilosis, and PPR. 13.9% if farmers had experienced mastitis in their flock over the last 12 months. FGD participants who also reared cattle stated the disease was more prevalent in small ruminants than in cattle: \u003cem\u003e\u0026ldquo;We can go 10 years at a time without seeing [mastitis] in our cattle but we usually experience it in [our] sheep and goats.\u0026rdquo; \u0026ndash; R3, small ruminant farmer.\u003c/em\u003e 69.8% of farmers surveyed had no idea of the origin of mastitis, while 18.3% believed the disease originated from poor management. Farmers regularly put up their animals for human consumption after treatment failure, as in this account: \u003cem\u003e\u0026ldquo;I have experienced [mastitis] and if it doesn\u0026rsquo;t [improve after treatment], we just sell it [to the butchers].\u0026rdquo; \u0026ndash; R07, small ruminant farmer.\u003c/em\u003e Dermatophilosis was likewise considered a significant burden due to its regular occurrence and the loss incurred by farmers once it was discovered: \u0026ldquo;\u003cem\u003eIn 10 animals, we [usually] have 1\u0026ndash;2 cases [of dermatophilosis]. From experience, if we see dermatophilosis on our farm, we sell them out immediately at a loss of 75%.\u0026rdquo; - R12, small ruminant farmer.\u003c/em\u003e PPR was considered one of the most severe diseases, as it led to substantial mortalities: \u0026ldquo;\u003cem\u003eMy major challenge is [PPR]. I had small ruminants but [PPR] wiped out the whole stock.\u0026rdquo; - R01, small ruminant farmer.\u003c/em\u003e Other less prevalent infections included foot rot and lameness.\u003c/p\u003e \u003cp\u003eMost farmers surveyed (68.2%) did not vaccinate their flock. Within the last one year, 28.4% of farmers vaccinated against PPR and 3.3% against CBPP (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). In diagnosing diseases experienced, farmers primarily relied on their experience (72.1%) and changes in animal behaviour (62.1%), with far less focus on veterinary consultation (\u0026lt;\u0026thinsp;15%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Over the last three months, 383 (48.8%) of farmers had consulted various animal health services. Figure\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e4\u003c/span\u003e summarises the animal health services used and services provided. Of the 156 farmers who had vaccinated their animals within the time period, 67.1% relied on government veterinarians. For treatment, farmers mostly consulted para-veterinarians (39.4%) and drugstore vendors (20.1%) rather than government veterinarians (19.29%) and private veterinarians (farmers (16.5%). 58.0% of farmers did not generally use antimicrobial alternatives (ATAs) in their ruminant production. Reasons for this included unavailability (33.6%) and their being difficult to administer (33.2%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnimal health management practices of farmers.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnimal Health Management Practices\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaccination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e535 (68.15)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e214 (27.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (4.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUse of antimicrobial alternatives (ATAs) in animal production\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e141 (17.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e455 (57.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e189 (24.08)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases vaccinated against in the last year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e223 (28.41)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCPP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (3.31)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnthrax\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (2.68)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlackquarter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse of animal health services over last 3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e383 (48.79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e397 (50.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (0.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActions taken to protect from mastitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e589 (75.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProper management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190 (24.20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConventional treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (0.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlternatives to antibiotics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMethods used to currently detect mastitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObservation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e513 (65.35)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaboratory tests\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (6.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e256 (32.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst step on suspicion of mastitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e405 (51.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsult a veterinarian or para-veterinarian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e235 (29.94)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse self-prescribed antibiotics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85 (10.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse ATAs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (5.10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (1.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCulling and selling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (0.76)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eA significant portion of farmers (47.6%) had self-prescribed antibiotics to their herd over the last three months. The most commonly prescribed antibiotics include oxytetracycline (22.4%), tylosin (14.3%), and procaine penicillin (11.1%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e6\u003c/span\u003e). These antibiotics were primarily sourced from (unlicensed) animal feed stores, veterinarians, and livestock markets (Additional File 5). Over the last three months, 14.0% and 4.6% of farmers reported using herbal plants and salt as ATAs, respectively. Herbs include \u003cem\u003edongoyaro\u003c/em\u003e (Yorub\u0026aacute; and Hausa name for neem plant or \u003cem\u003eAzadirachta indica\u003c/em\u003e), \u003cem\u003e\u0026Agrave;g\u0026aacute;nw\u0026ograve;/Kahi\u003c/em\u003e (Yorub\u0026aacute; and Fulani names for mahogany hardwood or \u003cem\u003eKhaya senegalensis)\u003c/em\u003e, bitter leaf plant (\u003cem\u003eVernonia amygdalina), Kadanya\u003c/em\u003e (Fulani name for shea butter tree or \u003cem\u003eVitellaria paradoxa\u003c/em\u003e),\u003cem\u003e\u0026iacute;g\u0026iacute; \u0026igrave;p\u0026iacute;n\u003c/em\u003e (Yorub\u0026aacute; name sandpaper tree or \u003cem\u003eFicus exasperata\u003c/em\u003e). Of these, mahogany hardwood was used in treating mastitis and CCPP. Sandpaper tree could be used for mastitis. Farmers also used some materials such as potash, shea butter, heat, lime, and beans. These were used for various diseases. One farmer described using beans to treat mastitis here: \u003cem\u003e\u0026ldquo;I don\u0026rsquo;t use conventional drugs. I use the herbal way, with bean peel. For the [animals] whose teats are hard and there is no milk, we give [beans peel] to them. [\u0026hellip;] We also feed it [to the animals] and [the teat] will become soft.\u0026rdquo; - R09, small ruminant farmer.\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Knowledge, Attitudes and Practices (KAP) towards antibiotics and AMR:\u003c/h2\u003e \u003cp\u003eAveragely, farmers demonstrated poor knowledge about antibiotics and attitudes but higher scores for practices (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Among the knowledge findings, 55.5% and 31.9% of farmers had heard of the terms \u0026lsquo;antibiotic\u0026rsquo; and \u0026lsquo;AMR\u0026rsquo; respectively. Only 14.8% of farmers knew that mastitis could be caused by AMR pathogens.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTotal KAP scores for farmers.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKAP(Total possible score)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAverage score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbove mean\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBelow mean\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e299 (38.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e486 (61.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttitudes (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e418 (53.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e367 (46.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractices (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e447 (56.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e338 (43.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFarmers' attitudes regarding AMU and AMR are summarized in Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e7\u003c/span\u003e. 42.0% of farmers agreed that overuse of antibiotics could lead to resistance. 41.8% of farmers agreed that antibiotics were no longer effective. 30.0% agreed that AMR could become a problem in their animals. Only 19.3% of farmers disagreed that ABU in animals should be reduced. Factors influencing practices summarised on Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e8\u003c/span\u003e. Disease symptoms in animals prompted 92.4% of farmers to use antibiotics (52% of whom responded \u0026ldquo;Most Likely\u0026rdquo; and a further 40.4% \u0026ldquo;Likely\u0026rdquo;). Increases in mortality and morbidity, and reduction in animals\u0026rsquo; appetites were also \u0026ldquo;Most Likely\u0026rdquo; or \u0026ldquo;Likely\u0026rdquo; to trigger antibiotic use for most farmers. More farmers were \u0026ldquo;Most Likely\u0026rdquo; or \u0026ldquo;Likely\u0026rdquo; to use antibiotics on the advice of a paraveterinarian above advice from another farmer or a drugstore seller (26.6/59.8%; 16.2/57.6%; and 14.2/51.3% respectively) 77.6% of farmers indicated they were \u0026ldquo;Most Likely\u0026rdquo; (19.9%) or \u0026ldquo;Likely\u0026rdquo; (57.7%) to use antibiotics as a means of improving the growth rate or productivity of their animals, suggesting this is still a problematic area in small ruminant management and 77.2% were \u0026ldquo;Most Likely\u0026rdquo; (18.2%) or \u0026ldquo;Likely\u0026rdquo; (59.0%) to antibiotics prophylactically. Overall, 60.6% of farmers indicated the cost of antibiotics as being \u0026ldquo;Most Likely\u0026rdquo; (16.8%) and \u0026ldquo;Likely\u0026rdquo; (43.8%) to be a factor influencing their use, and 65% indicated availability of antibiotics being a factor (18.6% Most Likely and 46.4% Likely).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eBivariate analysis indicated that the herd size was the only demographic variable not significantly associated with the KAP of farmers (Additional File 6). In the multivariate model, farmers aged 60 years or older were 24 times more likely to have higher knowledge than farmers younger than 20 years (OR: 23.7, 95% CI: 2.7\u0026ndash;560.0, \u003cem\u003ep\u003c/em\u003e: 0.013) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Farmers from Niger state were 3 times more likely to have higher knowledge scores than farmers from Kwara state (OR: 2.9, 95% CI: 1.9\u0026ndash;4.4, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Niger State farmers were also four times as likely to have higher practice scores (OR: 4.0, 95% CI: 2.7\u0026ndash;6.1, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) but 83% less likely to have better attitudes than Kwara State farmers. Farmers with secondary and tertiary levels of education were likely to have higher knowledge scores when compared to farmers with no formal education. Spearman\u0026rsquo;s correlation indicated that all categories (knowledge, attitudes, and practices) were positively correlated with each other (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate Analysis for KAP.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eAttitudes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003ePractices\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.57 (1.01\u0026ndash;166.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.71 (0.14\u0026ndash;4.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.688\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.34 (1.29\u0026ndash;165.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.11 (0.69\u0026ndash;111.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.75 (0.15\u0026ndash;4.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.90 (1.39\u0026ndash;176.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.12 (1.22\u0026ndash;200.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74 (0.15\u0026ndash;4.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.719\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.28 (1.27\u0026ndash;164.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.59 (1.12\u0026ndash;191.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94 (0.18\u0026ndash;5.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.49 (1.27\u0026ndash;170.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e23.70 (2.68\u0026ndash;560.00)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.49 (0.24\u0026ndash;10.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.32 (0.55\u0026ndash;92.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.08 (0.72\u0026ndash;1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74 (0.48\u0026ndash;1.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.94 (0.63\u0026ndash;1.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.761\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eState\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKwara\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNiger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.90 (1.93\u0026ndash;4.39)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.17 (0.11\u0026ndash;0.25)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e4.02 (2.69\u0026ndash;6.08)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eLevel of\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.28 (0.78\u0026ndash;2.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.318\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.80 (0.47\u0026ndash;1.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.54 (0.32\u0026ndash;0.88)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.70 (1.70\u0026ndash;4.32)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.65 (0.39\u0026ndash;1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.86 (0.54\u0026ndash;1.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.40 (1.38\u0026ndash;4.20)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.59 (0.32\u0026ndash;1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.69 (0.39\u0026ndash;1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.179\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eRole on\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eFarm\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOwner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOwner and manager\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.94 (0.65\u0026ndash;1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.63 (1.12\u0026ndash;2.38)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.46 (1.03\u0026ndash;2.07)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eManager\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.01 (1.07\u0026ndash;3.82)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.16 (0.58\u0026ndash;2.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.04 (0.85\u0026ndash;5.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWorker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e4.33 (1.69\u0026ndash;12.80)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.51 (0.13\u0026ndash;1.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.65 (0.33\u0026ndash;1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003eNumber of years in ruminant farming\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le; 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.38 (0.92\u0026ndash;2.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.49 (0.97\u0026ndash;2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.68 (0.46\u0026ndash;1.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.34 (0.76\u0026ndash;2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.78 (0.99\u0026ndash;3.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.82 (0.47\u0026ndash;1.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.27 (0.76\u0026ndash;2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.76 (0.38\u0026ndash;1.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.23 (0.63\u0026ndash;2.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.90 (0.32\u0026ndash;2.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.846\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.85 (0.32\u0026ndash;2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.97 (0.79\u0026ndash;4.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpearman\u0026rsquo;s correlation test for KAP\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAttitudes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePractices\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.25 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.19 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttitudes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.15 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractices\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.5. Factors influencing farmers\u0026rsquo; treatment decisions and use of antibiotic and ATAs:\u003c/h2\u003e \u003cp\u003eThemes uncovered from the FGDs center economics, effectiveness, and availability. Figure\u0026nbsp;9 summarises the interactions of these factors and how they influence farmers\u0026rsquo; health management decisions. The themes are discussed below:\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 9.\u003c/b\u003e Rich picture describing the factors influencing farmers\u0026rsquo; treatment decisions. Antimicrobials include antibiotics, antiparasitics, and antivirals. Alternatives include herbs, vaccines, and all household materials used by farmers. Veterinarians are licensed professionals authorized to prescribe antimicrobials. Para-veterinarians include all unlicensed professionals who prescribe antimicrobials. Fulani herdsmen are local pastoralists who utilise herbs in managing ruminant diseases. Arrows with a (+) sign demonstrate a positive causal relationship between the initial and succeeding factor. Arrows with a (-) sign indicate the opposite.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003e3.5.1. Economic pragmatism outweighs animal health considerations in farmers\u0026rsquo; health management decisions:\u003c/h2\u003e \u003cp\u003eMany small ruminant farmers also kept a cattle herd. As cattle had more monetary value, farmers tended to prioritize and treat disease outbreaks within this herd. Small ruminants, however, were more likely to be sold off after farmers observed diseases among them. A farmer said the following when comparing cattle to small ruminants:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Anyone [who is] rearing cattle has to be very careful [with their health management practices]. You can take risks on sheep and goats but not cattle.\u0026rdquo; \u0026ndash; R05, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eOne farmer remarked on the difference in cost value after diseases between the two species here:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Earlier this year we had two cows. If they were healthy, they are worth about ₦800,000 each, but they were affected by tick infestation. We later sold them at ₦450,000 [...] For ram, if it was worth at least ₦100,000, we can mostly sell it at ₦40,000 [after dermatophilosis]..\u0026rdquo; - R12, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSome diseases, such as mastitis, were considered to not affect the cost of sale in a significant manner:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;[Mastitis] doesn\u0026rsquo;t actually affect the cost of sale like you think. [The cost of sale] is only affected when the [disease is evident] on the body. When the [symptoms are internal], and you buy [the animal] and flame it [before cutting it up for retail sale], [the disease] will not show. During [slaughter], if we see [evidence] of mastitis, we can cut [the teat] out. I can\u0026rsquo;t really specify [how much loss might be incurred then] [...] It could be a 25% loss.\u0026rdquo; - R02, animal seller/butcher.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e \u003ch2\u003e3.5.2. Trust and perceived effectiveness drive farmers\u0026rsquo; use of treatment options and health networks:\u003c/h2\u003e \u003cp\u003eWhile some farmers used veterinarians, most farmers primarily relied on themselves to manage diseases due to unavailability of veterinarians and a lack of trust in their prescribed treatments, as stated here:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I don\u0026rsquo;t consult doctors. I have consulted before but there was no solution to our problem, so I go on self-medication.\u0026rdquo; \u0026ndash; R04, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003ePara-veterinarians, though widely used, were similarly distrusted due to their penchant for providing illicit, expired, or potentially dangerous mixtures. One farmer said:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I have seen [a paraveterinarian] mixing tetracycline with petrol and injecting it in the lung [of a cow]. Within 48 hours, 60 of the cows were [dead].\u0026rdquo; - R13, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eHowever, Fulani herdsmen (ruminant farmers with a traditionalist pastoral lifestyle) were trusted by farmers for their traditional herbal remedies:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eThere was a case of lameness [on my farm] that I doubted the Fulani man but the next morning [after the Fulani man used some herbs to treat the animal], the animal [could stand]. So I believe it works. We want [good] results and we are getting it. That is all that matters.\u0026rdquo; - R12, small ruminant farmer.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eWhile using antibiotics and ATAs personally, farmers were split regarding perceptions of farmers. Some farmers believed that herbs were more effective than antibiotics, while some farmers thought the opposite. Two farmers said:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026middot; \u0026ldquo;I don\u0026rsquo;t use antibiotics and we get [good] results anytime I use the herbs.\u0026rdquo; - R03, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The herbal remedies are not as effective as before [for mastitis].\u0026rdquo; - R18, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003e3.5.3. Availability, access and information affect farmers\u0026rsquo; use of antibiotics and ATAs:\u003c/h2\u003e \u003cp\u003eAntibiotics were widely used by farmers because they were readily available from unlicensed drug stores. Farmers who distrusted the validity of drugstore supplies could also procure them from licensed veterinary stores. One farmer said:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eWe use antibiotics [on our farm]. We get it from reputable veterinary outlets not [drug store vendors] and street hawker\u003c/em\u003es.\u0026rdquo; - \u003cem\u003eR16, small ruminant farmer.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eConversely, some farmers could not easily use herbs because they were not easy to procure:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Our major problem with the herbs is the scarcity of the [herbs]. I prefer it to conventional [antibiotics], but sometimes I don\u0026rsquo;t have access to them easily.\u0026rdquo; - R09, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eMany farmers also did not know which plants were effective herbs for specific conditions. This caused farmers to rely on Fulani herdsmen (traditional pastoralists skilled in herbal preparations) for consultations. However, Fulani herdsmen were usually secretive about the herbs. One farmer said:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI do [use herbs]. I get it from the herdsman (Fulani), but he won\u0026rsquo;t disclose the concoction content\u0026rdquo; - R12, small ruminant farmer.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eThe lack of knowledge about effective herbs and their dosages affected farmers use of them:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The problem is the dosage of these herbs [which I don\u0026rsquo;t know].\u0026rdquo; - R05, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eVeterinarians were also considered unavailable and inaccessible, compared to para-veterinarians and drugstore vendors, who were widespread:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Before, [farmers in our community] used to call vet doctors that moved around (doing ambulatory services). But now, many farmers don\u0026rsquo;t know [any] vet doctors. [Vet doctors] have not come [to our community] since 15 years ago. Now, just anybody sells the drugs. Some are not even educated, and they are selling the drugs, because there is no doctor.\u0026rsquo; - R15, small ruminant farmer.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eOur survey investigated the production characteristics of small ruminant farmers in Nigeria, their health management practices, and possible factors influencing the use of antimicrobials and ATAs. The majority of small ruminant farmers were male and owned less than 50 animals in their stock. Similar reports on gender distribution and flock size have been observed in other Nigerian small ruminant studies (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). However, our finding contrasts other studies that identify women as primary actors in small ruminant rearing particularly on a household level (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). It should be noted that our study primarily recruited people who engaged in small ruminant farming as a commercial venture rather than for subsistence only. While women are also involved in ruminant farming in this regard, societal constraints often limit their ability to participate fully (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Ishaku \u003cem\u003eet al.\u003c/em\u003e noted that commercial small ruminant farming in Nigeria is often undertaken by the whole household, with women more prominent in duties such as grooming and general care of animals, while men often handle health management and animal marketing tasks (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Thus, men are more likely to be aware of health management practices and factors influencing these decisions.\u003c/p\u003e \u003cp\u003eOur findings indicated that most farmers kept a mixed flock rather than sheep or goats alone. Both sheep and goats are valued across Nigeria for economic and nutritional purposes. In addition, each species is specifically utilised across specific cultures and religions for festivities (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). It is economically profitable for farmers to rear both, as each species experiences high demand at certain periods of the year, based on seasonal celebrations (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). However, sheep and goats have varying disease susceptibility. Goats are more susceptible to PPR than sheep, and mastitis prevalence is often found to be higher in the former (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). CCPP is also primarily a disease of goats, with sheep only becoming affected when they are within close proximity to goats (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Farmers mostly used an open housing system without netting. Within this housing system, animals may be attacked more frequently by insects, and therefore are more susceptible to insect-borne infections such as dermatophilosis and trypanosomosis (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiseases affecting small ruminants as observed by farmers in our study included mastitis, PPR and dermatophilosis. While other studies have similarly documented the high prevalence of these diseases, additional evidence suggests that there are several more endemic conditions affecting small ruminants in Nigeria (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) A recent meta-analysis reported a pooled prevalence of 72% for helminthiasis among ruminants in Northern Nigeria (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). CCPP disease is also highly endemic in North-Central Nigeria, our study location, with an estimated prevalence of 32.9% (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). It is likely that these diseases occur frequently within farms surveyed; however, farmers may not have reported them due to misdiagnosis. As farmers rely mostly on physical observation to diagnose, CCPP may be mistaken as PPR due to similarities in their clinical presentations. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). The misdiagnosis of bacterial diseases as viral diseases, or vice versa, may lead to antimicrobial misuse, raising implications for AMR. In addition, some diseases may be overlooked entirely. For instance, subclinical mastitis (SCM) is the most common form of mastitis affecting small ruminants in Nigeria, but farmers in this survey did not account for it (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). This is likely because SCM, like helminthiasis, does not present with physical lesions but rather through poor productivity and performance (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Flocks likely suffer from more health issues than farmers are currently aware of. This suggests consistent flock underperformance and unquantified losses to diseases.\u003c/p\u003e \u003cp\u003eOur results indicated that preventive measures were rarely adopted on farms for mastitis, and low vaccination rates generally observed for CCPP and PPR. In 2024, the Federal Government of Nigeria launched a PPR vaccination campaign as part of the PPR Global Eradication Programme (PPR - GEP) by the Food and Agricultural Organisation (FAO) (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). This might explain the higher vaccination rates noticed for PPR. Still, only 27% of surveyed farms had received the PPR vaccine, suggesting the campaign did not reach the majority of small ruminant farms. More research is necessary to uncover the current strategies being employed within the national PPR vaccination programme, as well as how to improve these and thereby increase vaccination reach. For CCPP, less than 1% of all farmers reported vaccinating against this disease. While CCPP vaccines exist in Nigeria, there is little documented evidence regarding national vaccination programmes against this disease, as well as low information about its use and acceptability among small ruminant farmers (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). According to our findings, farmers majorly rely on government veterinarians to access vaccines; thus, the lack of governmental programmes for CCPP correspond to low vaccination rates. The high proportion of farmers who did not implement preventive practices against mastitis is not surprising, as most farmers were unaware of the causes of mastitis. Therefore, it would be difficult for farmers to know what measures to implement. Our finding aligns with a previous study that noted that a significant portion of Nigerian dairy farmers did not use mastitis preventive measures such as handwashing after milking and maintaining good housing conditions (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Much progress can be achieved in preventing diseases if farmers are equipped with the right tools (vaccines, information, and veterinary services) for protecting their flocks. One case study of this is the 2012 \u0026ldquo;DairyCo Mastitis Control Plan (DMCP),\u0026rdquo; a United Kingdom (UK) structured plan to reduce the prevalence of bovine mastitis. Here, veterinarians were trained to go to farms across the country, assess the current management practices contributing to mastitis, and design targeted intervention plans. UK farmers who implemented these plans recorded more than a 20% drop in mastitis cases (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). The potential of using a similar model for small ruminant mastitis in Nigeria could be assessed, while methods to improve vaccine reach for CCPP and PPR are investigated.\u003c/p\u003e \u003cp\u003eAntibiotic use was self-guided and unconstrained among farmers. A previous study on North-Central Nigerian pastoralists observed that most farmers practiced self-administration, and only 27% of farmers followed the label instructions (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Similarly, findings from a USA study noted that 80% of small ruminant farmers self-administered antibiotics on their farms (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). Antibiotic classes commonly used included tetracyclines, penicillins, and macrolides. Similarly, these antibiotics have been reported to be commonly misused in small ruminant farms in Nigeria and the USA (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). All of these antibiotic classes have been classified as Veterinary Critically Important Antimicrobial Agents (VCIAs) by the World Organisation for Animal Health (WOAH), due to their effectiveness against serious animal infections and the scarcity of potent therapeutic substitutes when resistance to these antibiotics arises (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). In addition, the macrolide class of antibiotic has also been classified as a Critically Important Antimicrobial (CIA) in humans by the World Health Organisation (WHO) as one of the few effective treatments for campylobacteriosis (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). The misuse of these antibiotics in small ruminants bears significant consequences for animal and human health, as ARGs can be transmitted between animals and from animals to humans through risk pathways of environmental contamination and consumption of contaminated food products (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFarmers\u0026rsquo; KAP regarding antibiotics and AMU and AMR is of concern and is reflected in the high percentage who are \u0026lsquo;very likely\u0026rsquo; or \u0026lsquo;likely\u0026rsquo; to use antibiotics for growth promotion and to boost productivity. Most farmers had not heard of the term \u0026lsquo;AMR\u0026rsquo; and did not think AMU in animals should be reduced, even though a significant portion believed that antibiotics were no longer effective. This indicates that farmers are starting to observe a growing problem with AMR, but there is generally low awareness about how AMR develops, or methods to curtail it. Similarly, an Ethiopian study found that 56% of animal producers were not aware that their AMU contributed to AMR (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Dewi \u003cem\u003eet al.\u003c/em\u003e also found that only 35% of farmers in an Indonesian province were aware that over- and underdosing during AMU contributed to AMR (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). Low knowledge and awareness likely contributed to practices observed, including selling off sick animals, including during treatment that seemed not to be working, and using antibiotics as a means to improve animal appetite and growth rate. These practices promote the administration of antibiotics at sub-therapeutic dosages and contribute to increasing selection pressure for resistant strains of microbes. Currently, Nigeria\u0026rsquo;s livestock AMU is expected to increase by 163% before 2031 (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). There is a need for urgent practice reform within Nigerian small ruminant farming in order to improve AMU practices, and studies elsewhere show that education programmes can have a dramatic influence: a study in France found that cephalosporin use in swine production fell by 90% in the five years following farmers\u0026rsquo; enrolment in an antimicrobial stewardship (AMS) programme (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). As observed in our study, more highly educated farmers had better knowledge of AMR, and higher knowledge translated to better attitudes than practices. This indicates that raising awareness among Nigerian farmers about antimicrobial misuse may improve their current practices.\u003c/p\u003e \u003cp\u003eHerbal plants and household materials were used for health management, such as the use of \u003cem\u003eKhaya senegalensis\u003c/em\u003e and beans in treating mastitis. Chah \u003cem\u003eet al.\u003c/em\u003e observed that small ruminant farmers in Eastern Nigeria used \u003cem\u003eSpondias monbin\u003c/em\u003e for the treatment of mastitis while also employing various herbs in managing diarrhoeal symptoms from PPR (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Conversely, none of the farmers interviewed mentioned being aware of this herb. This indicates that plants used in small ruminant farming may differ by region in Nigeria, highlighting the extensive diversity of herbs in the country. Unfortunately, some regions may also lack sufficient herbal options. Similar to disease diagnosis, farmers appeared to use ATAs primarily for alleviating physical symptoms, such as the hardness of teat observed in clinical mastitis. Thus, farmers may consider an animal healed while the animal is still infected and manifesting less obvious symptoms. Still, herbs identified by farmers have been recorded to possess antibacterial activities. \u003cem\u003eKhaya senegalensis\u003c/em\u003e has been proven to inhibit the growth of bacterial isolates during lab-based studies, including \u003cem\u003eStaphylococcus aureus and Escherichia coli\u003c/em\u003e, implicated in small ruminant mastitis (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e). Likewise, \u003cem\u003eVernonia amygdalina\u003c/em\u003e has also exhibited antibacterial activity even against multidrug-resistant bacterial isolates (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). However, very few studies have been conducted to determine the mechanisms of action of these drugs against small ruminant diseases, nor the effective therapeutic dosages required. Thus, more research and development (R\u0026amp;D) efforts are indicated in these areas.\u003c/p\u003e \u003cp\u003eCost affected farmers\u0026rsquo; decisions regarding treatment, with some farmers selling off ill animals or animals currently undergoing treatment. These practices have been banned in high-income countries like the United Kingdom to protect human health from possible zoonotic transmission (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e). Similarly, the Nigerian Criminal Code prohibits the sale of diseased animals for human consumption (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). Our finding indicates that these laws are weakly enforced. Due to economic considerations, farmers were less reluctant to expend efforts in treating small ruminants when compared to cattle. This is not surprising, as FGD participants estimated the value of a diseased cattle to be four times higher than that of healthy small ruminants. As ATAs, particularly herbal plants, are the cheapest form of treatment available, cost-saving interests likely motivate farmers to use them rather than antibiotics for managing small ruminant diseases. Likewise, Chah \u003cem\u003eet al\u0026rsquo;s\u003c/em\u003e study observed that farmers stated they used herbal plants as therapeutic agents due to their being low or no cost (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, we observed that most farmers did not use ATAs, citing reasons of low access and availability. Most farmers were unaware of specific plants effective for diseases, where to procure them from, and what dosages to use. These reasons likely contributed to why far fewer farmers (14%) used herbs over the last three months when compared to farmers who used antibiotics (48%). Similarly, a previous study reported that 43% of livestock farmers in a Western Nigerian state did not use herbal remedies due to poor knowledge of herbs and their application (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In our study, farmers relied on the expertise of Fulani herdsmen when unaware of how to use the herbs. The Fulanis are Northern Nigerians with a traditional pastoralist lifestyle and a culture of preserving ethnoveterinary knowledge through verbal communication across generations (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e). However, Fulani herdsmen require payment for their consulting services and were reported by farmers to be generally secretive about herbs used. Other farmers considered herbs not to be as effective for certain conditions. This contrasts with other studies in Northern Nigeria where Fulani herdsmen reported a wide range of herbs effective for common livestock diseases (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e). Generally, without relying on Fulani herdsmen, farmers appear to be unaware of the full assortment of herbs available in their community, proper use practices, and their efficacy against endemic conditions. However, we observed that less than 5% of farmers consulted herbalists (including Fulani herdsmen) for treatment services within the last three months. It is likely that farmers\u0026rsquo; perceptions about herbal effectiveness and their own unawareness about the herbs reduced their interest in using this enterprise, and consequently their dependence on herbal remedies.\u003c/p\u003e \u003cp\u003eTrust in veterinarians was uneven and shaped by farmers\u0026rsquo; perceptions of their treatments being effective. In a study conducted in India, veterinarians stated that farmers only consulted them after trying multiple treatment options and when AMR had set in (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e). Likewise, farmers here stated that the most significant factor influencing their antibiotic prescription was the observation of disease symptoms in their flock, rather than advice from veterinarians. Therefore, farmers likely consulted veterinarians after self-treatment had failed, leading to veterinarians being unlikely to succeed at treatment using antimicrobials due to resistant development. Possible reasons identified for farmers\u0026rsquo; delay in consulting veterinarians include an intent to save costs and the general unavailability of veterinarians. Currently, veterinarians are relatively scarce in Nigeria, with an estimated ratio of 1 veterinarian per 37,500 animals (\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e). Due to the lack of veterinarians, more farmers tended to consult with unqualified para-veterinarians. Other studies have reported that para veterinarians are a regular feature in LMICs where qualified veterinary services are scarce, as they are widespread and charge less for consultation (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e). While farmers stated they distrusted them, para-veterinarians were still the most frequented animal healthcare service provider, as they were the most available. It is crucial to examine and address the lack of qualified animal healthcare professionals for small ruminants in Nigeria, as this is a significant motivator for self-prescribed AMU, and consequently rising AMR risk.\u003c/p\u003e \u003cp\u003eLimitations: Disease prevalence estimates were not determined through epidemiological survey and laboratory analysis, but based on farmers\u0026rsquo; reports. Therefore, figures may be affected by memory recall and reliance on physical observation for diagnosis. However, this approach was used to fully understand small ruminant farmers\u0026rsquo; perceptions of prevalent diseases and their health management practices.\u003c/p\u003e"},{"header":"5. Conclusions and Recommendation.","content":"\u003cp\u003eThere is a general dependence on self-prescribed antibiotics over vaccines and herbal ATAs among small ruminant farmers in Nigeria. This is due to poor vaccine availability, insufficient knowledge about herbal remedies, and a general lack of awareness of preventive practices against prevalent diseases. Veterinarians are relatively unavailable, and antibiotics are freely available and accessible via unlicensed drugstore vendors. Consequently, AMU is indiscriminate and bears grave implications for AMR.There is a need to improve access of farmers to vaccines, government veterinarians, and laboratory diagnostic services. It is also essential to curtail the unlicensed sale of veterinary drugs through the enforcement of veterinary AMU regulations. Farmers also sell off ill animals and do not observe withdrawal periods after AMU. These practices must equally be strictly regulated and banned. To further reduce farmers\u0026rsquo; indiscriminate AMU and improve dependence on ATAs, future initiatives can focus on: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) improving farmers\u0026rsquo; awareness of AMR and its risk practices; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) conducting awareness programmes to sensitize farmers about effective disease preventive measures and the importance of maintaining proper hygiene and sanitary conditions; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) investigating the current vaccine distribution channels in Nigeria and how to improve delivery and reach; (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) researching currently available herbal remedies in Nigeria and assessing their effectiveness against prevalent small ruminant diseases; (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) exploring barriers that hinder better compliance with antimicrobial regulations. All of these will lead to improved health outcomes for small ruminants while reducing AMR risk pathways from small ruminants to humans and the environment.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the University of Ilorin Ethical Review Committee (UERC) \u003cstrong\u003e(UERC Approval Number: UERC/ASN/2024/2915)\u0026nbsp;\u003c/strong\u003eand from the Royal Holloway University of London \u0026nbsp;Research Ethics Committee\u003cstrong\u003e\u0026nbsp;(Application ID 4210)\u003c/strong\u003e. Data from research participants was ethically collected in accordance with the declaration of Helsinki (62). Informed consent was obtained in verbal and written forms from all survey and focus group participants. Confidentiality assurances were also communicated, with a clear option to opt out at any time during survey data collection and focus group discussions. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were made fully aware that their responses would be published and informed consent in this regard was obtained prior to their enrollment in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are obtainable from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was carried out with financial support from the International Development Research Centre (IDRC), Canada, and the Global AMR Innovation Fund (GAMRIF), part of the UK Government\u0026rsquo;s Department of Health and Social Care (DHSC). (Grant number: 110337). Drafting and review of the paper were supported under the British Academy International Writing Workshop grant number IWW24\\110690. The funders did not play a role in the design, analysis, and reporting of the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Authors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eMahmoud Eltholth: Conceptualization, Investigation, Funding acquisition, Methodology, Project administration, Supervision, Writing \u0026ndash; review \u0026amp; editing. Rodiat Olabisi Omotoso: Investigation, Data curation, Writing \u0026ndash; original draft, Writing- review \u0026amp; editing, Formal analysis, Validation. Ismail Adewuyi Adeyemo: Investigation, Writing- original draft, Writing - review \u0026amp; editing. Jadesola Juliana Ajao: Writing -original draft, Writing \u0026ndash; review \u0026amp; editing, Investigation, Validation, Formal analysis, Visualization, Data curation. Olayiwola Akeem Ahmed: Investigation, Writing- original draft, Writing - review \u0026amp; editing. Nma Bida Alhaji: Investigation, Supervision, Writing- review \u0026amp; editing. Musa Imam Abubakar: Investigation, Writing- original draft, Writing - review \u0026amp; editing. Rodhiat Oyinlola Ade-Yusuf: Data curation, Investigation, Writing- original draft. Ibrahim Adisa Raufu: Supervision, Writing- review \u0026amp; editing. Victoria Olusola Adetunji: Supervision, Writing- review \u0026amp; editing. Jennifer Cole: Writing - original draft, Writing - review \u0026amp; editing. Elsabagh Mabrouk: \u0026nbsp; Writing- review \u0026amp; editing. Elena Garcia Fruit\u0026oacute;s: \u0026nbsp;Conceptualization, Investigation, Writing \u0026ndash; review \u0026amp; editing. Anna Aris: Conceptualization, Investigation, Funding acquisition, Writing \u0026ndash; review \u0026amp; editing. \u0026nbsp; Ismail Ayoade Odetokun: Conceptualization, Funding acquisition, Methodology, Investigation, Project administration, Resources, Writing \u0026ndash; review \u0026amp; editing, Supervision.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our sincere gratitude to the study participants in Kwara and Niger State, Nigeria, who with their contribution, made this research possible.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlabi AA, Idris-Adeniyi KM, Busari AO, Ayandiran KS, Ajuwon AP. Comparative analysis of indigenous and improved small ruminant management techniques among rural households in Iwo Agricultural Zone, Osun State, Nigeria. 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Knowledge, attitudes and practices regarding antimicrobial resistance, usage and residues among livestock farmers in North Sumatra, Indonesia. BMC Agric. 2025;1:19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s44399-025-00019-5\u003c/span\u003e\u003cspan address=\"10.1186/s44399-025-00019-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, et al. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci U S A. 2015;112(18):5649\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVerliat F, H\u0026eacute;monic A, Chouet S, et al. An efficient cephalosporin stewardship programme in French swine production. Vet Med Sci. 2021;7(2):432\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/vms3.377\u003c/span\u003e\u003cspan address=\"10.1002/vms3.377\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOsman W, Gibreel HH, Salih RR, Mirghani M. Antimicrobial effects of aqueous bark extracts of Khaya senegalensis, Azadirachta indica and Eucalyptus camaldulensis against different bacterial pathogens.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrito GI, Cerqueira LA, Perecmanis S, Borges JRJ, de Castro MB, C\u0026acirc;mara ACL. Clinical mastitis in small ruminants referred to a veterinary teaching hospital: 23 cases. 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J Community Commun Res. 2021;6(2):53\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaganuwan SA. Ethnoveterinary values of Nigerian medicinal plants: an overview. Eur J Med Plants. 2017;18(4):1\u0026ndash;35. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.9734/EJMP/2017/29321\u003c/span\u003e\u003cspan address=\"10.9734/EJMP/2017/29321\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191\u0026ndash;4. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.2013.281053\u003c/span\u003e\u003cspan address=\"10.1001/jama.2013.281053\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"AMR, sheep, goats, alternatives, antibiotics, herbs, production, Nigeria, ruminants","lastPublishedDoi":"10.21203/rs.3.rs-9085231/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9085231/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\n\u003cp\u003eAs the threat of antimicrobial resistance (AMR) escalates globally, the influence of indiscriminate antimicrobial use (AMU) in livestock cannot be overlooked. Antimicrobial use practices are continually explored in larger food-producing animals; however, small ruminants (sheep and goats) receive comparatively less research attention. Our study addresses this gap by investigating small ruminant production practices in Nigeria and exploring how they affect the use of antimicrobials and alternatives. We adopted a mixed-methods design, combining semi-structured questionnaires with focus group discussions.\u003c/p\u003e\n\u003cp\u003eResults\u003c/p\u003e\n\u003cp\u003eOf the 785 questionnaire respondents, 68% of farmers never vaccinated their flock. Numerous health problems were regularly experienced by animals, including peste de petits ruminants (PPR), mastitis, and dermatophilosis. Diseases were mostly self-managed with antibiotics and herbs rather than through reliance on veterinary care. More farmers (48%) used antibiotics than herbal remedies (14%) over the previous three months. Farmers' use of herbs was affected by their having low awareness of available options and how to use them appropriately. Perceived effectiveness also influenced farmers' choice between antibiotics and herbs, while economic considerations also led them to sell off sick animals before or during treatment. Among farmers who used animal health services, more farmers (59%) consulted unlicensed para-veterinarians and drugstore vendors rather than licensed government and private veterinarians (36%), a disparity attributed to the unavailability of qualified veterinary doctors. Farmers had poor knowledge, attitudes, and practices towards AMU and AMR.\u003c/p\u003e\n\u003cp\u003eConclusions\u003c/p\u003e\n\u003cp\u003eWe recommend conducting further studies to identify and investigate the efficacy of currently used herbs in treating common diseases. There is a crucial need to improve farmers’ access to vaccines, veterinary care, and laboratory diagnostics. Barriers that hinder better compliance with regulations that govern the use of nonprescribed antimicrobials should be explored. Awareness programmes could be conducted to improve farmers’ awareness on AMR and appropriate disease preventive practices.\u003c/p\u003e","manuscriptTitle":"Small Ruminants’ Production System Characteristics and Their Influence on Antimicrobial Use, Alternatives, and Resistance in Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-23 21:58:48","doi":"10.21203/rs.3.rs-9085231/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-06T13:44:35+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-01T23:10:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-27T07:21:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-24T18:37:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21136166968238489294220407082454735810","date":"2026-03-24T15:07:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-23T12:31:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"30356168472638381223220302352733853779","date":"2026-03-23T01:42:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"332701548004834376907435994826422823525","date":"2026-03-22T08:20:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"154511415478951802637627207125196785043","date":"2026-03-22T06:52:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-21T14:44:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"53713043789286543419155899425400633279","date":"2026-03-21T14:39:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"37250050621965269021805252424260188516","date":"2026-03-21T13:03:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17180827177787474120459851002781421293","date":"2026-03-21T12:52:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"149304287279364815855226817196428996863","date":"2026-03-20T12:34:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-19T18:48:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"242978815139236609636102698153973199722","date":"2026-03-19T15:46:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"171651269629096926355357455641741037524","date":"2026-03-19T14:42:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"170501676728010626153200733119461292733","date":"2026-03-19T12:55:14+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-19T12:45:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-19T12:37:41+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-19T11:49:44+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-18T18:17:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Veterinary Research","date":"2026-03-17T17:55:08+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"31489dc6-2708-4c9c-9777-9ebd9a896d74","owner":[],"postedDate":"March 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T10:24:06+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-23 21:58:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9085231","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9085231","identity":"rs-9085231","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}