Assessment of Knowledge, Attitudes, and Practices Related to Injection Site Complications Among Animal Health Providers in Small Ruminants in Kumasi, Ghana

Assessment of Knowledge, Attitudes, and Practices Related to Injection Site Complications Among Animal Health Providers in Small Ruminants in Kumasi, Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Knowledge, Attitudes, and Practices Related to Injection Site Complications Among Animal Health Providers in Small Ruminants in Kumasi, Ghana Augustine Teye, Bismark Gyasi, Albright Stephen Effah Ameyaw, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8659048/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Background Injection site complications (ISCs) are an under-recognised challenge in small ruminant production in Ghana. Poor injection practices can result in tissue damage, abscess formation, drug residues, and carcass condemnation, posing economic and public health risks. Although veterinarians are legally authorised to administer injections, para-veterinarians and herders frequently perform these procedures in practice. The knowledge, attitudes, and practices (KAP) of animal health providers regarding injection site complications were assessed in the study. Methods A comparative cross-sectional approach was adopted using structured questionnaire techniques and abattoir record reviews in a retrospective design. A stratified random sample of 230 respondents was used in the survey of veterinarians, para-veterinarians, and herders in the Kumasi region of Ghana. Abattoir records between January and August of the year 2025 were retrospectively analysed for the prevalence of injection site lesions. Descriptive statistical and chi-squared tests were employed in the evaluation of the results. Results Herders scored lower in their knowledge of injection site anatomy than veterinarians (p < 0.001). While the latter primarily preferred the neck region in performing intramuscular injections, herders preferred the thighs or rump region; the latter was associated with increased lesions in the abattoir examination of the slaughtered animals. Abattoir examination revealed a significant prevalence of injection site abscesses, fibrosis, and granulomas. Conclusions There is a significant gap in knowledge and injection practices of herders in particular, which could be associated with the observed injection site lesions in the abattoir examination of the slaughtered animals. Injection site complications Injection techniques Ghana Small ruminants Veterinarians Figures Figure 1 Figure 2 Background Small ruminants play a crucial role in Ghana’s livestock economy, serving as a source of income, nutrition, and resilience for traders and households [ 1 ][ 2 ]. Their management requires the frequent administration of injectable medications for treatment, prevention of diseases, and basic husbandry practices [ 3 ][ 4 ]. While injections are a common practice in veterinary medicine, improper techniques result in tissue damage, abscesses, necrosis, fibrosis, and injuries from needles [ 5 ]. These complications can reduce meat quality, lower market value, weaken animal welfare, and result in carcass trimming or condemnation [ 6 ][ 7 ]. Globally, ISCs have been associated with a lack of anatomical understanding, poor hygiene practices, inappropriate techniques, and a lack of training, particularly among non-formal animal health practitioners [ 8 ] [ 9 ] [ 10 ]. In Ghana, veterinarians, para-veterinarians, and herders all administer injections, but their training, competence, and adherence to best practices vary widely [ 11 ]. Despite field observations and abattoir reports showing injection-related lesions in small ruminants, there is no systematic documentation of the extent of the problem or its human-related drivers, which may include the knowledge, attitudes, and practices (KAP) of veterinarians, para-veterinarians, and herders regarding injection site complications. [ 4 ][ 12 ] Though veterinarians are the only ones with legal licensure to undertake injections within Ghana, para-veterinarians and herders often undertake such injections because of a lack of veterinary service reach and accessibility, as well as livestock owners’ dependence on alternative animal health practitioners [ 13 ]. Nevertheless, no study has addressed this gap within Ghana, and such a gap limits training and policy formulation for improvement [ 12 ][ 14 ]. Farm owners and butchers could suffer economic losses as a result of such negative outcomes and also pose a welfare threat to animals, as well as reducing productivity and increasing treatment expenses with a possible condemnation of slaughtered animals at meat inspection [ 15 ]. The practice by para-professionals and livestock owners, often with no proper training regarding safe injection practice, contributes to this problem. Despite injectable medications being common for small ruminant treatment within Ghana, no study has addressed the levels of competencies within animal health practitioners within Ghana. To create focused interventions that increase injection safety, boost animal welfare, and protect meat quality for customers, it is crucial to understand the gaps in KAP of veterinarians and other animal handlers, such as para-veterinarians and herders who often perform these procedures due to limited veterinary coverage [ 4 ][ 12 ]. Therefore, this study includes all veterinarians, para-veterinarians, and herders who administer injections in practice, regardless of legal authorisation, to better reflect the full range of behaviours influencing injection-site lesions. Methodology Study Design A cross-sectional survey approach was used to assess the knowledge, attitude and practices of veterinarians, para-veterinarians, and animal herders regarding injection site complications in small ruminants from June to August 2025. Study Area and Sampling The survey was implemented in Kumasi, the capital city of Ashanti Region (Fig. 1 ). The city is ideal for researching injection-related issues in small ruminants due to its blend of urban and peri-urban livestock systems, cattle trade, and the wide range of animal health specialists. A stratified random sampling technique was employed to ensure proportional representation of all three professional categories. Random selection continued within each stratum until the required sample was achieved. Study Population The study involved 230 respondents: 60 veterinarians (26.1%), 53 para-veterinarians (23.0%), and 117 animal herders (50.9%). Participants were recruited from three groups: veterinarians listed in the Veterinary Services Directorate registry within the Kumasi Metropolitan Area; para-veterinarians and agro-vet shop employees obtained through agro-vet shop directories and Ghana Veterinary Medical Association practitioner lists; and animal herders identified via farm registries, livestock extension officer records, and farmer association membership lists. In each group, participants were recruited using random sampling, with substitutions for people who did not want to be involved. The inclusion of para-veterinarians and herders did not indicate that they were authorised to perform injections. They were involved because they play an active part in treating livestock without necessarily holding licenses. The inclusion of these two groups was important because they regularly conduct injections without necessarily holding licenses. Sample Size To determine the required sample size, Yamane’s formula [ 16 ], n = N1 + N(e) 2 was used​. In this context, N is the estimated number of animal health workers in Kumasi, n is the sample size to be selected, and e is the margin of error, set at 0.05 for a corresponding 95% confidence level. Assuming a population of N = 500, the calculation was made as follows: n = 500/1 + 500(0.05) 2 =500/2.25 = 222 The final sample was proportionately divided between the focus group and the control group, with about 74% (or roughly 170 participants) being animal herders and para-veterinarians, and approximately 26% (or approximately 60 participants) being veterinarians. To be conservative, ensure representation, and account for non-respondents, the smallest calculated size of 222 was increased to 230 participants. Data Collection Instrument and Data A structured survey, adopted from a study [ 7 ] and modified, was used to assess the knowledge, attitude, and practices of veterinarians, para-veterinarians, and animal herders in Kumasi on injection site lesions in small ruminants. The questionnaire was divided into four sections: Demographics (age, sex, education level, years of experience, location); Knowledge (awareness of injection techniques, anatomical Knowledge of drug administration, knowledge of complications); Attitudes (attitudes towards injection practices and meat quality); and Practices (commonly used anatomical injection sites and lesion prevalence and Injection Site Selection). Pre-launch testing was conducted on 12 participants not part of the study sites to test the understanding and useful application. The alpha value obtained was 0.70; this is acceptable according to [ 17 ] because Cronbach's alpha values range from 0.70 to 0.90 when the scale is still in development. The study made appropriate improvements. Cumulative data from the Kumasi Abattoir were examined retrospectively for January through August 2025, with a view to identifying prevalence and attributes of injection-site lesions found among slaughtered sheep and goats. All data included cumulative numbers of sheep and goats slaughtered monthly, cumulative numbers of injection-site lesions observed on monthly post-mortems, and regions where injection-site lesions accumulated. Qualified slaughterhouse inspectors were utilised for identifying injection-site lesions by abscess formation, fibrosis, granulomatous lesions, or needle trauma sites. Data Analysis Survey data collected using a structured questionnaire were entered into Microsoft Excel version 19 for cleaning and imported into Statistical Package for Social Science (SPSS) version 27 for analysis. Descriptive statistics were summarised with frequencies, percentages, and means. Comparative analysis between the focus and control groups was conducted using Chi-square tests for categorical variables. Results were clearly presented in tables. Results Prevalence of Injection-Site Lesions Between January and August 2025, there were 43,483 animals slaughtered or processed, and a total of 100 injection-site lesions were found. The highest number of lesions (25) occurred in January, with a prevalence of 0.34%, while the lowest number of lesions (5) was in May, with a prevalence of 0.1% ( Table 1 ) . Table 1 Prevalence of Injection-Site lesions in processed meat of small ruminants in the Kumasi Abattoir. Month (2025) Animals Slaughtered/Processed Injection-Site Lesions Common-Injection Location of Lesions January 7351 25 (0.34%) Neck (58%), Thigh (21%), Shoulder (21%) February 4982 13 (0.26%) March 4638 15 (0.32) April 5369 15 (0.28) Thigh (88%), Shoulder (12%) May 5094 5 (0.1%) Thigh (89%) Neck (11%) June 5285 7 (0.13%) July 5123 12 (0.23%) Thigh (100%) August 5641 8 (0.14%) Neck (64%) Thigh (36%) Total 43483 100 Prevalence calculated as (number of lesions detected / total animals processed) × 100. Primary lesion locations were recorded for cases where anatomical site could be clearly identified during post-mortem inspection. Data source: Kumasi Abattoir monthly inspection records, provided by Chief Meat Inspector, Mr. Carl Max Apolala. Demographic characteristics of respondents The majority of respondents were between age 20 and 29 years old (51.7%) and male-dominated (78.3%). The largest experience group had 1–5 years of practice (31.7%), while 24.3% had less than one year of experience. Chi-square analysis revealed significant associations between demographic characteristics and KAP scores. The professional category showed highly significant associations with knowledge (p = 0.001), attitude (p = 0.034), and practice (p = 0.001) scores. Similarly, formal training on injection administration was significantly associated with all three KAP domains (p ≤ 0.026 for all comparisons). Age was significantly associated with knowledge (p = 0.038) and attitude (p = 0.018) but not practice (p = 0.058). Gender and years of experience were not significantly associated with any KAP domain (p > 0.05) ( Table 2 ) . The demographic analysis confirmed that professional category and formal training are strongly associated with all three KAP domains. Younger respondents demonstrated lower knowledge and attitude scores compared to older, more experienced practitioners. However, years of experience alone did not significantly predict KAP performance. Gender showed no significant association with any KAP domain ( Table 2 ) . All veterinarians (60) held Doctor of Veterinary Medicine degrees. All para-veterinarians possessed diploma-level certificates in animal health or related fields. Most animal herders (54) completed Senior High School, while 37 attained tertiary education and 26 achieved Junior High School qualifications ( Fig. 2 ) . Table 2 Demographic characteristics of respondents and their associations with KAP domains. Characteristics Category Frequency Percentage P-Value Knowledge Attitude Practice Age 20–29 119 51.7 0.038 0.018 0.058 30–39 65 28.3 40–49 28 12.2 50–59 12 5.2 60–69 6 2.6 Gender Male 180 78.3 0.287 0.084 0.248 Female 50 21.7 Years of experience 10 years 66 28.7 Occupation Veterinarian 60 26.1 0.001 0.034 0.001 Paraveterinarian 53 23.1 Animal herder 117 50.9 Training on administering injections Veterinarians 60 26.1 0.001 0.01 0.026 Para-veterinarians 53 23.0 Animal Herders 117 50.9 Note: P-values represent Chi-square test results comparing KAP score distributions across demographic categories. p < 0.05 (statistically significant). Respondents' Knowledge of injection site The knowledge assessment revealed a clear competency gradient across the three professional groups. Veterinarians demonstrated universal awareness (100%) of all ten ISC types. Para-veterinarians showed high awareness (> 80%) for most complications, with the notable exception of improper drug absorption (86.8%) and hardened/thick tissue (81.1%). Animal herders demonstrated the most variable knowledge profile. While nearly all could identify obvious clinical signs such as localised pain (98.3%), swelling (97.4%), and lameness (94%), fewer recognised deeper pathological processes such as improper drug absorption (38.5%), tissue necrosis (62.5%), and contamination-related infection (66.7%). Only 57.3% could identify damaged skin/muscle, and 76.0% were aware of abscess formation ( Table 3 ). Table 3 Knowledge of injection site complications by professional category Complications Veterinarians Aware (n, %) Para-veterinarians Aware (n, %) Animal Herders Aware (n, %) Abscess (pus/dirty fluid accumulation) 60 (100%) 53 (100%) 89 (76.0%) Swelling or edema at injection site 60 (100%) 53 (100%) 114 (97.4%) Damaged skin/muscle 60 (100%) 47 (88.7%) 67 (57.3%) Nerve damage or lameness 60 (100%) 49 (92.5%) 110 (94%) Hardened/thick tissue 60 (100%) 43 (81.1%) 89 (76.8%) Anaphylactic/allergic reaction 60 (100%) 52 (98.1%) 98 (83.8%) Localized pain or discomfort 60 (100%) 53 (100%) 115 (98.3%) Contamination leading to infection 60 (100%) 50 (94.3%) 78 (66.7%) Improper drug absorption 60 (100%) 46 (86.8%) 45 (38.5%) Injection site necrosis (tissue death) 60 (100%) 50 (94.3%) 73 (62.5%) Frequency of Injection Site Complications Each respondent reported at most one ISC linked to either antibiotics or vaccines. Profession totals are: Veterinarians (n = 60), Para-veterinarians (n = 53), Animal Herders (n = 117). A maximum of one ISC was reported by each respondent in the previous year. Thus, frequencies indicate the number of people reporting each ISC rather than the total number of lesions ( Table 4 ) . Table 4 Frequency of Injection Site Complications (ISCs) Associated with Antibiotics and Vaccines across Professions ISC Type Vets (Antibiotics) Vets (Vaccines) Paravets (Antibiotics) Paravets (Vaccines) Herders (Antibiotics) Herders (Vaccines) Total (n) Abscess 8 (13.3%) 4 (6.7%) 6 (11.3%) 4 (7.5%) 15 (12.8%) 8 (6.8%) 45 Swelling/Edema 6 (10.0%) 8 (13.3%) 5 (9.4%) 6 (11.3%) 12 (10.3%) 14 (12.0%) 51 Damaged Skin/Muscle 4 (6.7%) 2 (3.3%) 4 (7.5%) 1 (1.9%) 9 (7.7%) 4 (3.4%) 24 Nerve Damage/Lameness 3 (5.0%) 1 (1.7%) 3 (5.7%) 2 (3.8%) 7 (6.0%) 3 (2.6%) 19 Hardened/Thick Tissue 3 (5.0%) 1 (1.7%) 2 (3.8%) 1 (1.9%) 6 (5.1%) 3 (2.6%) 16 Anaphylactic Reaction 1 (1.7%) 1 (1.7%) 1 (1.9%) 1 (1.9%) 2 (1.7%) 2 (1.7%) 8 Localized Pain/Discomfort 2 (3.3%) 1 (1.7%) 2 (3.8%) 1 (1.9%) 3 (2.6%) 2 (1.7%) 11 Infection/Contamination 4 (6.7%) 3 (5.0%) 3 (5.7%) 3 (5.7%) 6 (5.1%) 6 (5.1%) 25 Improper Absorption 2 (3.3%) 2 (3.3%) 2 (3.8%) 2 (3.8%) 6 (5.1%) 3 (2.6%) 17 Tissue Necrosis/Death 2 (3.3%) 2 (3.3%) 2 (3.8%) 2 (3.8%) 4 (3.4%) 2 (1.7%) 14 Total ISCs 35 (58.3%) 25(41.7%) 30(56.6%) 23(43.4%) 70(59.8%) 47(40.2%) 230 Common Anatomical Injection Sites Veterinarians predominantly used the neck region (88.33%) as their primary injection site, with only 11.67% using the shoulder muscles. When lesions did occur in veterinarian-treated animals, 75% were located in the neck region and 25% in the gluteal muscles. In contrast, para-veterinarians showed a troubling pattern of site selection, with 84.91% primarily using thigh muscles as an inappropriate high-value site, while only 5.66% used the recommended neck region. Correspondingly, 94.34% of lesions in Paraveterinarian-reated animals occurred in the thigh muscles. Animal herders demonstrated similar patterns to para-veterinarians, with 73.49% primarily using thigh muscles and 21.37% using the gluteal area. Only 3.42% reported using the shoulder region, and none reported using the neck. Lesion distribution showcased these practices, with 73.49% of lesions occurring in thigh muscles, 20.51% in the gluteal region, and 6.00% in the shoulder ( Table 5 ) . Table 5 Common Anatomical Injection Sites and Lesion Prevalence by Profession Profession Most Frequent Anatomical Injection Sites (%) Anatomical Distribution of Detected Lesions (%) Veterinarians Cervical muscles (Neck) (88.33%), Forelimb muscles (Shoulder) (11.67%) Hindlimb, neck (75.00%), Gluteus muscles (25.00%) Para-veterinarians Hindlimb, muscles (Thigh) (84.91%), Gluteus muscles (9.43%), Cervical muscles (Neck) (5.66%) Hindlimb muscles (Thigh) (94.34%), Gluteus muscles (5.66%), Forelimb muscles (Shoulder) Animal Herders Thigh muscles (75.21%), Gluteal area (21.37%), Shoulder region (3.42%) Hindlimb muscles (Thigh) (73.49%), Gluteus muscles (20.51%), Forelimb muscles (Shoulder) (6.00%) Anatomical Knowledge of Drug Administration Site All Veterinarians and Para-veterinarians correctly identified the anatomical sites for subcutaneous (SC), intramuscular (IM), and intravenous (IV) injections. However, a smaller percentage of animal herders were knowledgeable about these sites, with only 88.9% knowing what SC, IM, and IV represent. Animal herders also had the lowest percentage of correct responses regarding injecting into the jugular groove for IV injections, at 53.8% ( Table 6 ) . Table 6 Anatomical Knowledge of Drug Administration Site Anatomical Knowledge of Drug Administration Site Veterinarians (%) Para-veterinarians (%) Animal Herders (%) Fully knew what SC, IM, IV represents 100.0 100.0 88.9 Inject loose skin for SC 98.3 94.3 100.0 Inject around the neck region for IM 100.0 100.0 72.6 Inject into the jugular groove for IV 98.3 94.3 53.8 Note SC = Subcutaneous; IM = Intramuscular; IV = Intravenous. Percentages represent respondents who correctly identified each anatomical landmark or route. Attitude Indicators toward Injection Site Table 6 presents the level of anatomical knowledge related to drug administration sites among veterinarians, para-veterinarians, and animal herders, expressed as percentages. All veterinarians and para-veterinarians (100.0% each) correctly understood what SC, IM, and IV represent, compared with 88.9% of animal herders. The knowledge of the correct sites in the body showed a higher accuracy rate among veterinarians, with 98.3% of them accurately identifying the site for subcutaneous injections as the area of loose skin, as well as the jugular groove for intravenous injections, and all of them (100.0%) accurately identifying the neck area for intramuscular injections. Of the para-veterinarians, 94.3% were accurate in identifying the subcutaneous and intravenous sites, and all of them (100.0%) were accurate in identifying the intramuscular site. However, the animal herders were less accurate in identifying intramuscular (72.6%) and intravenous (53.8%) sites, although all of them (100.0%) were (Table 7 ) . Table 7 Attitude Indicators toward Injection Site Practices Attitude Indicator Veterinarians (n, %) Para-veterinarians (n, %) Animal Herders (n, %) Support for aseptic techniques 60 (100%) 53 (100%) 117 (100%) Importance of withdrawal period 60 (100%) 53 (100%) 87 (74.4%) Concern about meat quality 60 (100%) 48 (90.6%) 60 (51.3%) Awareness of vaccine-induced lesions 60 (100%) 45 (84.9%) 67 (57.3%) Understanding of antimicrobial-induced lesions 60 (100%) 50 (94.3%) 75 (64.1%) Veterinary Practice Responses The study found that a large proportion of all groups reported using correct injection techniques, maintaining injection site hygiene, and reporting complications. However, animal herders were less likely than Veterinarians and Para-veterinarians to observe animals after injection, dispose of used syringes properly, and use proper injection techniques ( Table 8 ) . Table 8 Veterinary Practice Responses by Group Practice Veterinarians Para-veterinarians Animal Herders Use correct injection techniques 60 95 85 Rotate injection sites 55 90 75 Maintain injection site hygiene 60 100 80 Dispose of used syringes 60 53 100 Monitor animals after injection 55 95 75 Report complications 50 85 90 Discussion The study examined veterinarians, para-veterinarians, and herders' knowledge, perceptions, and practices regarding injection site issues in small ruminant husbandry in Kumasi. Given that para-veterinarians and herders are not licensed professionals with the authority to inject animals, their direct involvement in injections exposes a gap in veterinary service delivery. The results indicate knowledge gaps across groups, but it is also seen that poor injection practices appear despite knowledge levels. Veterinarians have a comprehensive perspective of potential risks in injection sites because of their strong knowledge in veterinary anatomy, pathology, and pharmacology. On comparing veterinarians with paraprofessionals regarding knowledge in injection site safety and usage of drugs at injection sites, it is seen that they perform better. Para-veterinarians frequently recognise the most common problems, but they may overlook more subtle issues, such as inadequate medication absorption. Other countries, such as Cambodia and Malawi, have shown similar neglect, with minimal practical training in pharmacokinetics. Animal herders know very little about internal issues like tissue necrosis, and they typically focus on symptoms rather than disease mechanisms. It is also worth noting that many herders do not associate the appearance of an abscess with vaccinations. The increasing disparity in the awareness of the locations where subcutaneous, intramuscular, and intravenous injections can be carried out can be related to other pastoral systems practised in Africa. It verifies the significance of professional skills in terms of the correct location of injections [ 12 ][ 14 ]. Veterinarians and para-veterinarians usually remember the location of injections effectively; in this case, the herdsmen lack awareness in this area for IM and IV injections. This distinction is reflected in current practice, in which veterinarians primarily inject in the neck, while para-veterinarians and herders inject in the thigh and gluteal regions. These patterns have appeared in Nigeria and northern Ghana, where non-professional staff who inject often inject into the foremost muscle tissues available to them, despite the fact that these tissues are perhaps not the most valuable ones economically. [ 12 ][ 13 ] Although there was a general positive attitude toward aseptic techniques, this reflects a shared understanding of basic hygiene. There is an evident gap in knowledge concerning the issues of withdrawal times and beef quality. In fact, only 75% of the animal herders understood the reasons why withdrawal times are important, which explains why a greater proportion of small-scale livestock raisers are not yet informed about residues. [ 15 ] and [ 18 ] further established that only a few herders were concerned about problems associated with injection sites regarding cattle quality. In contrast, veterinarians and para-veterinarians were generally aware of the economic and health consequences of injection site problems. In addition, studies show that where an instant financial loss is not incurred through trimming or condemnation of carcasses, the animal caretaker is very likely to attach less value to meat quality. [ 4 ]. This speaks to the need for education linking injection practices with economic loss. Even with adequate knowledge and mostly positive attitudes, all three groups-skilled workers included-demonstrate gaps between what they know and do. Some vets fail to change injection sites consistently and don't check on the animals after injections. Time pressure and client expectations have also exposed knowledge-to-practice gaps in antimicrobial therapy in veterinary medicine [ 19 ]. The most significant gaps appear in the animal herder groups, particularly those related to hygiene and postinjection checks, unsafe syringe disposal poses a real risk of spreading zoonoses. Equipment shortages have been noted, alongside a lack of strong government support in Sub-Saharan Africa. Furthermore, abattoir surveillance revealed a high incidence of injection site lesions, including abscesses, fibrosis, and granulomas. Although illness prevalence does not appear to be significant, routine Meat Hygiene Inspections frequently underreport lesion prevalence, particularly in deep muscle tissue and slaughtered cases at non-commercial slaughter facilities [ 6 ][ 7 ]. Injection site lesions in the economically valuable muscle in the thighs are especially concerning because studies in Europe and America reveal they are linked to significant economic loss through trimming and carcass degradation [ 3 ]. This is especially relevant in Ghana, where profit margins are low. The findings also have practical ramifications for Ghana's livestock business and the country's overall healthcare system. The continuous involvement of para-vets and livestock herders in injection delivery suggests that there is a complementary relationship between veterinary service delivery and enforcement. Even if such changes will be difficult to implement in the short term, it is evident that the message has been given that any intervention approach must include all stakeholders involved in cattle interactions. Antimicrobial resistance stems from knowledge and practice gaps [ 18 ]. Incorrect injection procedures, use of unsuitable injection locations, and a lack of awareness of withdrawal times all contribute to increased drug buildup in meat and intensified animal treatments, all of which drive resistance [ 18 ]. All of these observations are consistent and emphasize the significance of increased support in the livestock sector [ 20 ]. Conclusion and Recommendation The findings from this study indicate significant gaps in knowledge, attitude, and practices on injection site issues among veterinarians, para-veterinarians, and cattle herders in Kumasi, Ghana. Competence was highest among veterinarians, while there were significant deficits in anatomical and injection practices for herders. The improper use of injection sites, mainly by unqualified injectors, was consistent with the lesions seen at slaughter. Future research is needed to determine the economic impact of infection site lesions in Ghana, so that there is a greater motivation for intervention. Longitudinal studies could determine which drugs are related with lesions at injection sites and the severity of these lesions, offering more specific causative insight. Intervention research may find cost-effective approaches to reduce infection-site cases among para-veterinarians and cattle herds. It becomes prudent to investigate improved techniques for combining abattoir observation, training, and feedback. Abbreviations ISC- Injection site complications KAP- knowledge, attitudes, and practices SPSS- Statistical Package for Social Science SC- Subcutaneous IM- Intramuscular IV- Intravenous Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki and Ethical standards were maintained: verbal consent was given by all participants after study details were explained, participation was voluntary, and withdrawal was allowed at any time. Identifiable data were removed to ensure confidentiality. All data were anonymised and securely stored. Also, the study received a joint ethical approval from the Review Board of Kwame Nkrumah University of Science and Technology. The study recognises that only veterinarians are licensed to administer injections in Ghana. Data on para-veterinarian and herder practices were collected to understand real-life treatment behaviours in the field, not to validate or endorse unlicensed procedures. Consent for publication N/A Availability of data and materials Data used in this study are available on request from the corresponding author. Competing interests The authors declare no conflict of interest Funding This research was carried out without any financial support. Authors’ contribution Augustine Teye, Bismark Gyasi, Albright Stephen Effah Ameyaw: conceptualisation or design of the work, methodology, data collection, and data analysis, writing – original draft. Prince Nana Takyi, Alisa Elise Wepere Luguterah: methodology, investigation, manuscript writing, review, and editing. Tony Opoku-Agyemang, Raphael Deladem Folitse, Benjamin Obukowho Emikpe : conceptualisation or design of the work, methodology, manuscript writing, review and editing, project administration, supervision. Acknowledgement The authors are grateful to the respondents for participating in this study. We also thank Chief Meat Inspector, Mr. Carl Max Apolala for his contribution. References Jatfa JW, Adenkola AY, Victor I, Kisani A, Adamu SS, Onyeyili PA. Retrospctive studies of small ruminant diseases diagnosed at the Veterinary Teaching Hospital, University of Agriculture, Makurdi, Nigeria. Tropical Veterinarian. 2015;33(3-4):95-100. https://www.ajol.info/index.php/tv/article/view/160179 Adams F, Ohene-Yankyera K, Aidoo R, Wongnaa CA. Economic benefits of livestock management in Ghana. Agricultural and Food Economics. 2021 May 10;9(1):17. https://link.springer.com/article/10.1186/s40100-021-00191-7 Plummer PJ, Schleining JA. Assessment and management of pain in small ruminants and camelids. Veterinary Clinics: Food Animal Practice. 2013 Mar 1;29(1):185-208 https://www.vetfood.theclinics.com/article/S0749-0720(12)00092-8/abstract . Hayes L, Britton S, Weerasinghe G, Woodgate RG, Hernandez-Jover M. Insights into the knowledge, practices and training needs of veterinarians working with smallholder livestock producers in Australia. Preventive Veterinary Medicine. 2018 Jun1;154:54-62. https://www.sciencedirect.com/science/article/pii/S0167587718300424 Stewart JL, Shipley CF. Management of reproductive diseases in male small ruminants. Veterinary Clinics: Food Animal Practice. 2021 Mar 1;37(1):105-23. https://www.vetfood.theclinics.com/article/S0749-0720(20)30077-3/abstract Li W, Yin Y, Wang F, Miao S. Beef quality assurance injection sites and techniques. Journal of Agricultural Science. 2012 Jan 1;4(1):91. Cresswell E, Remnant J, Butterworth A, Wapenaar W. Injection‐site lesion prevalence and potential risk factors in UK beef cattle. Veterinary Record. 2017 Jan;180(3):70-. https://bvajournals.onlinelibrary.wiley.com/doi/abs/10.1136/vr.103778 Kermode M, Muani V. Injection practices in the formal & informal healthcare sectors in rural north India. Indian Journal of Medical Research. 2006 Nov 1;124(5):513-20. https://journals.lww.com/ijmr/abstract/2006/24050/injection_practices_in_the_formal___informal.9.aspx Hall LE, Reilly B, Blackie N. Surveying UK sheep farmers’ vaccination techniques and the impact of vaccination training. Veterinary Record. 2022 Aug;191(4):no-. https://bvajournals.onlinelibrary.wiley.com/doi/abs/10.1002/vetr.1798 Arvidsson A, Fischer K, Hansen K, Sternberg-Lewerin S, Chenais E. Diverging discourses: animal health challenges and veterinary care in northern Uganda. Frontiers in Veterinary Science. 2022 Mar 10;9:773903. https://www.frontiersin.org/articles/10.3389/fvets.2022.773903/full Mockshell J, Ilukor J, Birner R. Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?. Tropical animal health and production. 2014 Feb;46(2):475-80. https://link.springer.com/article/10.1007/s11250-013-0518-9 Nuvey FS, Mensah GI, Zinsstag J, Hattendorf J, Fink G, Bonfoh B, Addo KK. Management of diseases in a ruminant livestock production system: a participatory appraisal of the performance of veterinary services delivery, and utilization in Ghana. BMC Veterinary Research. 2023 Nov 15;19(1):237. https://link.springer.com/article/10.1186/s12917-023-03793-z Turkson PK, Naandam J. Assessment of veterinary needs of ruminant livestock owners in Ghana. Preventive veterinary medicine. 2003 Nov 12;61(3):185-94. https://www.sciencedirect.com/science/article/pii/S0167587703002149 Weaver J, Leon E, Edan M, D'Alessio F. Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports. Revue scientifique et technique (International Office of Epizootics). 2012 Aug 1;31(2):631-45. https://europepmc.org/article/med/23413738 Kuiseu J, ZINSOU FE, Olounlade PA, ALOWANOU GE, Adenile AD, Dansou CC, Hounzangbe-Adote S, Babayemi OJ, Edorh PA. Prevalence, effects and alternative control methods of Haemonchus contortus in small ruminants: a review. Journal of Veterinary Medicine and Animal Health. 2021 Apr 30;13(2):84-97. https://academicjournals.org/journal/JVMAH/article-full-text/DDDF70166663 Oluigbo CU, Ngozi EC, Ohaegbu PM. Determination of sample sizes in research using Taro Yamane formula: An overview. InProceedings of the 1st Annual Faculty of Science International Conference, Niger Delta University 2024 Jan (Vol. 1, pp. 76-84). DeVellis RF. Scale development: Theory and applications. Thousand Oaks. 2003. Matache A, Nenciu F, Vanghele NA, Nae G. Impact evaluation of using antibiotics in animal husbandry practices-Review. Technium. 2023 Oct 1;14. https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=2668778X&AN=172925454&h=jEAn8BybPwywhnyjO3slmvYOLl0qVHaZyH0Gv7MvbfCgBwySJlkbepzEhXEK5WWMAYI0W0EahVhQaYs2EdRmmQ%3D%3D&crl=c Fortané N. Antimicrobial resistance: preventive approaches to the rescue? Professional expertise and business model of French “industrial” veterinarians. Review of Agricultural, Food and Environmental Studies. 2021 Jun;102(2):213-38. https://link.springer.com/article/10.1007/s41130-019-00098-4 Caudell MA, Dorado-Garcia A, Eckford S, Creese C, Byarugaba DK, Afakye K, Chansa-Kabali T, Fasina FO, Kabali E, Kiambi S, Kimani T. Towards a bottom-up understanding of antimicrobial use and resistance on the farm: A knowledge, attitudes, and practices survey across livestock systems in five African countries. PloS one. 2020 Jan 24;15(1):e0220274. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220274 Additional Declarations No competing interests reported. Supplementary Files QUESTIONNAIREINJECTIONSITECOMPLICATIONS.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 03 Apr, 2026 Reviews received at journal 02 Apr, 2026 Reviewers agreed at journal 02 Apr, 2026 Reviews received at journal 17 Feb, 2026 Reviewers agreed at journal 10 Feb, 2026 Reviewers agreed at journal 09 Feb, 2026 Reviewers agreed at journal 05 Feb, 2026 Reviewers invited by journal 02 Feb, 2026 Editor assigned by journal 02 Feb, 2026 Editor invited by journal 02 Feb, 2026 Submission checks completed at journal 31 Jan, 2026 First submitted to journal 31 Jan, 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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and Technology","correspondingAuthor":false,"prefix":"","firstName":"Bismark","middleName":"","lastName":"Gyasi","suffix":""},{"id":584412902,"identity":"427214e1-1bc4-45b7-b943-bb26db2d7348","order_by":2,"name":"Albright Stephen Effah Ameyaw","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Albright","middleName":"Stephen Effah","lastName":"Ameyaw","suffix":""},{"id":584412903,"identity":"829fa55e-86d2-4d80-8bb6-24d16baf1927","order_by":3,"name":"Tony Opoku-Agyemang","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Tony","middleName":"","lastName":"Opoku-Agyemang","suffix":""},{"id":584412905,"identity":"77a9d96d-17ef-46ef-8769-3c197dde91b5","order_by":4,"name":"Raphael Deladem Folitse","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology (KNUST)","correspondingAuthor":false,"prefix":"","firstName":"Raphael","middleName":"Deladem","lastName":"Folitse","suffix":""},{"id":584412908,"identity":"fb624aac-3c1f-4151-b3d5-de5b99f9ff7e","order_by":5,"name":"Prince Nana Takyi","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology (KNUST)","correspondingAuthor":false,"prefix":"","firstName":"Prince","middleName":"Nana","lastName":"Takyi","suffix":""},{"id":584412910,"identity":"fe1ebc15-d32e-45ba-a273-db2825cacca4","order_by":6,"name":"Alisa Elise Wepere Luguterah","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology (KNUST)","correspondingAuthor":false,"prefix":"","firstName":"Alisa","middleName":"Elise Wepere","lastName":"Luguterah","suffix":""},{"id":584412911,"identity":"d292a140-76ac-4419-b574-310309d23e76","order_by":7,"name":"Benjamin Obukowho 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11:37:40","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8659048/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8659048/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101862746,"identity":"fed9cfd4-3441-4c0f-a24e-5c23f345cdac","added_by":"auto","created_at":"2026-02-04 11:58:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":303093,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMap of the study area showing the district\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8659048/v1/559bddcd0194d29450d9b585.png"},{"id":101862701,"identity":"b5af3d72-f5cc-4325-9654-e59f32c4878d","added_by":"auto","created_at":"2026-02-04 11:58:38","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":53185,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEducation Level of Respondents\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8659048/v1/ca79de27bedf0df3fb3f2036.png"},{"id":101862819,"identity":"59c92899-5ffd-446e-95c1-544eff0e2332","added_by":"auto","created_at":"2026-02-04 11:59:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1645988,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8659048/v1/95ee801c-71da-4f37-9846-6342a4356efb.pdf"},{"id":101862742,"identity":"1db17421-79bb-4245-8296-495d60a64f89","added_by":"auto","created_at":"2026-02-04 11:58:50","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":617736,"visible":true,"origin":"","legend":"","description":"","filename":"QUESTIONNAIREINJECTIONSITECOMPLICATIONS.docx","url":"https://assets-eu.researchsquare.com/files/rs-8659048/v1/fc2939c4dbc0671d719cc440.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAssessment of Knowledge, Attitudes, and Practices Related to Injection Site Complications Among Animal Health Providers in Small Ruminants in Kumasi, Ghana\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eSmall ruminants play a crucial role in Ghana\u0026rsquo;s livestock economy, serving as a source of income, nutrition, and resilience for traders and households [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e][\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Their management requires the frequent administration of injectable medications for treatment, prevention of diseases, and basic husbandry practices [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. While injections are a common practice in veterinary medicine, improper techniques result in tissue damage, abscesses, necrosis, fibrosis, and injuries from needles [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These complications can reduce meat quality, lower market value, weaken animal welfare, and result in carcass trimming or condemnation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e][\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGlobally, ISCs have been associated with a lack of anatomical understanding, poor hygiene practices, inappropriate techniques, and a lack of training, particularly among non-formal animal health practitioners [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In Ghana, veterinarians, para-veterinarians, and herders all administer injections, but their training, competence, and adherence to best practices vary widely [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Despite field observations and abattoir reports showing injection-related lesions in small ruminants, there is no systematic documentation of the extent of the problem or its human-related drivers, which may include the knowledge, attitudes, and practices (KAP) of veterinarians, para-veterinarians, and herders regarding injection site complications. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e][\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThough veterinarians are the only ones with legal licensure to undertake injections within Ghana, para-veterinarians and herders often undertake such injections because of a lack of veterinary service reach and accessibility, as well as livestock owners\u0026rsquo; dependence on alternative animal health practitioners [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Nevertheless, no study has addressed this gap within Ghana, and such a gap limits training and policy formulation for improvement [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Farm owners and butchers could suffer economic losses as a result of such negative outcomes and also pose a welfare threat to animals, as well as reducing productivity and increasing treatment expenses with a possible condemnation of slaughtered animals at meat inspection [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The practice by para-professionals and livestock owners, often with no proper training regarding safe injection practice, contributes to this problem. Despite injectable medications being common for small ruminant treatment within Ghana, no study has addressed the levels of competencies within animal health practitioners within Ghana. To create focused interventions that increase injection safety, boost animal welfare, and protect meat quality for customers, it is crucial to understand the gaps in KAP of veterinarians and other animal handlers, such as para-veterinarians and herders who often perform these procedures due to limited veterinary coverage [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e][\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e Therefore, this study includes all veterinarians, para-veterinarians, and herders who administer injections in practice, regardless of legal authorisation, to better reflect the full range of behaviours influencing injection-site lesions.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eA cross-sectional survey approach was used to assess the knowledge, attitude and practices of veterinarians, para-veterinarians, and animal herders regarding injection site complications in small ruminants from June to August 2025.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Area and Sampling\u003c/h3\u003e\n\u003cp\u003eThe survey was implemented in Kumasi, the capital city of Ashanti Region (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The city is ideal for researching injection-related issues in small ruminants due to its blend of urban and peri-urban livestock systems, cattle trade, and the wide range of animal health specialists. A stratified random sampling technique was employed to ensure proportional representation of all three professional categories. Random selection continued within each stratum until the required sample was achieved.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eThe study involved 230 respondents: 60 veterinarians (26.1%), 53 para-veterinarians (23.0%), and 117 animal herders (50.9%). Participants were recruited from three groups: veterinarians listed in the Veterinary Services Directorate registry within the Kumasi Metropolitan Area; para-veterinarians and agro-vet shop employees obtained through agro-vet shop directories and Ghana Veterinary Medical Association practitioner lists; and animal herders identified via farm registries, livestock extension officer records, and farmer association membership lists. In each group, participants were recruited using random sampling, with substitutions for people who did not want to be involved. The inclusion of para-veterinarians and herders did not indicate that they were authorised to perform injections. They were involved because they play an active part in treating livestock without necessarily holding licenses. The inclusion of these two groups was important because they regularly conduct injections without necessarily holding licenses.\u003c/p\u003e\n\u003ch3\u003eSample Size\u003c/h3\u003e\n\u003cp\u003eTo determine the required sample size, Yamane\u0026rsquo;s formula [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], n\u0026thinsp;=\u0026thinsp;N1\u0026thinsp;+\u0026thinsp;N(e)\u003csup\u003e2\u003c/sup\u003e was used​. In this context, N is the estimated number of animal health workers in Kumasi, n is the sample size to be selected, and e is the margin of error, set at 0.05 for a corresponding 95% confidence level.\u003c/p\u003e \u003cp\u003eAssuming a population of N\u0026thinsp;=\u0026thinsp;500, the calculation was made as follows: n\u0026thinsp;=\u0026thinsp;500/1\u0026thinsp;+\u0026thinsp;500(0.05)\u003csup\u003e2\u003c/sup\u003e=500/2.25\u0026thinsp;=\u0026thinsp;222\u003c/p\u003e \u003cp\u003eThe final sample was proportionately divided between the focus group and the control group, with about 74% (or roughly 170 participants) being animal herders and para-veterinarians, and approximately 26% (or approximately 60 participants) being veterinarians. To be conservative, ensure representation, and account for non-respondents, the smallest calculated size of 222 was increased to 230 participants.\u003c/p\u003e\n\u003ch3\u003eData Collection Instrument and Data\u003c/h3\u003e\n\u003cp\u003eA structured survey, adopted from a study [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] and modified, was used to assess the knowledge, attitude, and practices of veterinarians, para-veterinarians, and animal herders in Kumasi on injection site lesions in small ruminants. The questionnaire was divided into four sections: Demographics (age, sex, education level, years of experience, location); Knowledge (awareness of injection techniques, anatomical Knowledge of drug administration, knowledge of complications); Attitudes (attitudes towards injection practices and meat quality); and Practices (commonly used anatomical injection sites and lesion prevalence and Injection Site Selection).\u003c/p\u003e \u003cp\u003ePre-launch testing was conducted on 12 participants not part of the study sites to test the understanding and useful application. The alpha value obtained was 0.70; this is acceptable according to [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] because Cronbach's alpha values range from 0.70 to 0.90 when the scale is still in development. The study made appropriate improvements.\u003c/p\u003e \u003cp\u003eCumulative data from the Kumasi Abattoir were examined retrospectively for January through August 2025, with a view to identifying prevalence and attributes of injection-site lesions found among slaughtered sheep and goats. All data included cumulative numbers of sheep and goats slaughtered monthly, cumulative numbers of injection-site lesions observed on monthly post-mortems, and regions where injection-site lesions accumulated. Qualified slaughterhouse inspectors were utilised for identifying injection-site lesions by abscess formation, fibrosis, granulomatous lesions, or needle trauma sites.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eSurvey data collected using a structured questionnaire were entered into Microsoft Excel version 19 for cleaning and imported into Statistical Package for Social Science (SPSS) version 27 for analysis. Descriptive statistics were summarised with frequencies, percentages, and means. Comparative analysis between the focus and control groups was conducted using Chi-square tests for categorical variables. Results were clearly presented in tables.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of Injection-Site Lesions\u003c/h2\u003e \u003cp\u003eBetween January and August 2025, there were 43,483 animals slaughtered or processed, and a total of 100 injection-site lesions were found. The highest number of lesions (25) occurred in January, with a prevalence of 0.34%, while the lowest number of lesions (5) was in May, with a prevalence of 0.1% \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\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\u003ePrevalence of Injection-Site lesions in processed meat of small ruminants in the Kumasi Abattoir.\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=\"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\"\u003e \u003cp\u003eMonth (2025)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnimals Slaughtered/Processed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInjection-Site Lesions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCommon-Injection Location of Lesions\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJanuary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (0.34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNeck (58%),\u003c/p\u003e \u003cp\u003eThigh (21%), Shoulder (21%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFebruary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (0.26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (0.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eApril\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (0.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eThigh (88%), Shoulder (12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (0.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eThigh (89%)\u003c/p\u003e \u003cp\u003eNeck (11%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJune\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (0.13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJuly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (0.23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eThigh (100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAugust\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (0.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNeck (64%)\u003c/p\u003e \u003cp\u003eThigh (36%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePrevalence calculated as (number of lesions detected / total animals processed) \u0026times; 100. Primary lesion locations were recorded for cases where anatomical site could be clearly identified during post-mortem inspection.\u003c/p\u003e \u003cp\u003e \u003cem\u003eData source: Kumasi Abattoir monthly inspection records, provided by Chief Meat Inspector, Mr. Carl Max Apolala.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics of respondents\u003c/h2\u003e \u003cp\u003eThe majority of respondents were between age 20 and 29 years old (51.7%) and male-dominated (78.3%). The largest experience group had 1\u0026ndash;5 years of practice (31.7%), while 24.3% had less than one year of experience. Chi-square analysis revealed significant associations between demographic characteristics and KAP scores. The professional category showed highly significant associations with knowledge (p\u0026thinsp;=\u0026thinsp;0.001), attitude (p\u0026thinsp;=\u0026thinsp;0.034), and practice (p\u0026thinsp;=\u0026thinsp;0.001) scores. Similarly, formal training on injection administration was significantly associated with all three KAP domains (p\u0026thinsp;\u0026le;\u0026thinsp;0.026 for all comparisons). Age was significantly associated with knowledge (p\u0026thinsp;=\u0026thinsp;0.038) and attitude (p\u0026thinsp;=\u0026thinsp;0.018) but not practice (p\u0026thinsp;=\u0026thinsp;0.058). Gender and years of experience were not significantly associated with any KAP domain (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. The demographic analysis confirmed that professional category and formal training are strongly associated with all three KAP domains. Younger respondents demonstrated lower knowledge and attitude scores compared to older, more experienced practitioners. However, years of experience alone did not significantly predict KAP performance. Gender showed no significant association with any KAP domain \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. All veterinarians (60) held Doctor of Veterinary Medicine degrees. All para-veterinarians possessed diploma-level certificates in animal health or related fields. Most animal herders (54) completed Senior High School, while 37 attained tertiary education and 26 achieved Junior High School qualifications \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\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\u003eDemographic characteristics of respondents and their associations with KAP domains.\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\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c3\" namest=\"c2\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.058\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 \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.3\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 \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.2\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 \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.2\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 \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.6\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 \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.248\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 \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears of experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.105\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 \u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.7\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 \u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.2\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 \u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.001\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 \u003cp\u003eParaveterinarian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.1\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 \u003cp\u003eAnimal herder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTraining on administering injections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePara-veterinarians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnimal Herders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003eNote: P-values represent Chi-square test results comparing KAP score distributions across demographic categories. p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 (statistically significant).\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eRespondents' Knowledge of injection site\u003c/h2\u003e \u003cp\u003eThe knowledge assessment revealed a clear competency gradient across the three professional groups. Veterinarians demonstrated universal awareness (100%) of all ten ISC types. Para-veterinarians showed high awareness (\u0026gt;\u0026thinsp;80%) for most complications, with the notable exception of improper drug absorption (86.8%) and hardened/thick tissue (81.1%).\u003c/p\u003e \u003cp\u003eAnimal herders demonstrated the most variable knowledge profile. While nearly all could identify obvious clinical signs such as localised pain (98.3%), swelling (97.4%), and lameness (94%), fewer recognised deeper pathological processes such as improper drug absorption (38.5%), tissue necrosis (62.5%), and contamination-related infection (66.7%). Only 57.3% could identify damaged skin/muscle, and 76.0% were aware of abscess formation \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e).\u003c/b\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\u003eKnowledge of injection site complications by professional category\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\"\u003e \u003cp\u003eComplications\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarians Aware (n, %)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePara-veterinarians Aware (n, %)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnimal Herders Aware (n, %)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbscess (pus/dirty fluid accumulation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89 (76.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwelling or edema at injection site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e114 (97.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDamaged skin/muscle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (88.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (57.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNerve damage or lameness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (92.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e110 (94%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHardened/thick tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (81.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89 (76.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnaphylactic/allergic reaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52 (98.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98 (83.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocalized pain or discomfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115 (98.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContamination leading to infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (94.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproper drug absorption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (86.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 (38.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInjection site necrosis (tissue death)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (94.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73 (62.5%)\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=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eFrequency of Injection Site Complications\u003c/h2\u003e \u003cp\u003eEach respondent reported at most one ISC linked to either antibiotics or vaccines. Profession totals are: Veterinarians (n\u0026thinsp;=\u0026thinsp;60), Para-veterinarians (n\u0026thinsp;=\u0026thinsp;53), Animal Herders (n\u0026thinsp;=\u0026thinsp;117). A maximum of one ISC was reported by each respondent in the previous year. Thus, frequencies indicate the number of people reporting each ISC rather than the total number of lesions \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\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\u003eFrequency of Injection Site Complications (ISCs) Associated with Antibiotics and Vaccines across Professions\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eISC Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVets (Antibiotics)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVets (Vaccines)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParavets (Antibiotics)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eParavets (Vaccines)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHerders (Antibiotics)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHerders (Vaccines)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTotal (n)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbscess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15 (12.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e45\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwelling/Edema\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e51\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDamaged Skin/Muscle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e24\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNerve Damage/Lameness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (6.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (2.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e19\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHardened/Thick Tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (2.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e16\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnaphylactic Reaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocalized Pain/Discomfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (2.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfection/Contamination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e25\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproper Absorption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (2.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e17\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTissue Necrosis/Death\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e14\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal ISCs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e35 (58.3%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e25(41.7%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e30(56.6%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e23(43.4%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e70(59.8%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e47(40.2%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e230\u003c/b\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 \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCommon Anatomical Injection Sites\u003c/h2\u003e \u003cp\u003eVeterinarians predominantly used the neck region (88.33%) as their primary injection site, with only 11.67% using the shoulder muscles. When lesions did occur in veterinarian-treated animals, 75% were located in the neck region and 25% in the gluteal muscles. In contrast, para-veterinarians showed a troubling pattern of site selection, with 84.91% primarily using thigh muscles as an inappropriate high-value site, while only 5.66% used the recommended neck region. Correspondingly, 94.34% of lesions in Paraveterinarian-reated animals occurred in the thigh muscles. Animal herders demonstrated similar patterns to para-veterinarians, with 73.49% primarily using thigh muscles and 21.37% using the gluteal area. Only 3.42% reported using the shoulder region, and none reported using the neck. Lesion distribution showcased these practices, with 73.49% of lesions occurring in thigh muscles, 20.51% in the gluteal region, and 6.00% in the shoulder \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\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\u003eCommon Anatomical Injection Sites and Lesion Prevalence by Profession\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMost Frequent Anatomical Injection Sites (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnatomical Distribution of Detected Lesions (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVeterinarians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCervical muscles (Neck) (88.33%), Forelimb muscles (Shoulder) (11.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHindlimb, neck (75.00%), Gluteus muscles (25.00%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePara-veterinarians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHindlimb, muscles (Thigh) (84.91%), Gluteus muscles (9.43%), Cervical muscles (Neck) (5.66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHindlimb muscles (Thigh) (94.34%), Gluteus muscles (5.66%), Forelimb muscles (Shoulder)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnimal Herders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThigh muscles (75.21%), Gluteal area (21.37%), Shoulder region (3.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHindlimb muscles (Thigh) (73.49%), Gluteus muscles (20.51%),\u003c/p\u003e \u003cp\u003eForelimb muscles (Shoulder) (6.00%)\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=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eAnatomical Knowledge of Drug Administration Site\u003c/h2\u003e \u003cp\u003eAll Veterinarians and Para-veterinarians correctly identified the anatomical sites for subcutaneous (SC), intramuscular (IM), and intravenous (IV) injections. However, a smaller percentage of animal herders were knowledgeable about these sites, with only 88.9% knowing what SC, IM, and IV represent. Animal herders also had the lowest percentage of correct responses regarding injecting into the jugular groove for IV injections, at 53.8% \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e\u003cb\u003e)\u003c/b\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\u003eAnatomical Knowledge of Drug Administration Site\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\"\u003e \u003cp\u003eAnatomical Knowledge of Drug Administration Site\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarians (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePara-veterinarians (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnimal Herders (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFully knew what SC, IM, IV represents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInject loose skin for SC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInject around the neck region for IM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInject into the jugular groove for IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.8\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 \u003cstrong\u003eNote\u003c/strong\u003e \u003cp\u003e \u003cem\u003eSC\u0026thinsp;=\u0026thinsp;Subcutaneous; IM\u0026thinsp;=\u0026thinsp;Intramuscular; IV\u0026thinsp;=\u0026thinsp;Intravenous. Percentages represent respondents who correctly identified each anatomical landmark or route.\u003c/em\u003e \u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAttitude Indicators toward Injection Site\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e presents the level of anatomical knowledge related to drug administration sites among veterinarians, para-veterinarians, and animal herders, expressed as percentages. All veterinarians and para-veterinarians (100.0% each) correctly understood what SC, IM, and IV represent, compared with 88.9% of animal herders. The knowledge of the correct sites in the body showed a higher accuracy rate among veterinarians, with 98.3% of them accurately identifying the site for subcutaneous injections as the area of loose skin, as well as the jugular groove for intravenous injections, and all of them (100.0%) accurately identifying the neck area for intramuscular injections. Of the para-veterinarians, 94.3% were accurate in identifying the subcutaneous and intravenous sites, and all of them (100.0%) were accurate in identifying the intramuscular site. However, the animal herders were less accurate in identifying intramuscular (72.6%) and intravenous (53.8%) sites, although all of them (100.0%) were (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitude Indicators toward Injection Site Practices\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\"\u003e \u003cp\u003eAttitude Indicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarians\u003c/p\u003e \u003cp\u003e(n, %)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePara-veterinarians\u003c/p\u003e \u003cp\u003e(n, %)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnimal Herders\u003c/p\u003e \u003cp\u003e(n, %)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupport for aseptic techniques\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e117 (100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImportance of withdrawal period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87 (74.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConcern about meat quality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (90.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60 (51.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness of vaccine-induced lesions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45 (84.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (57.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderstanding of antimicrobial-induced lesions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (94.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75 (64.1%)\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=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eVeterinary Practice Responses\u003c/h2\u003e \u003cp\u003eThe study found that a large proportion of all groups reported using correct injection techniques, maintaining injection site hygiene, and reporting complications. However, animal herders were less likely than Veterinarians and Para-veterinarians to observe animals after injection, dispose of used syringes properly, and use proper injection techniques \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eVeterinary Practice Responses by Group\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\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVeterinarians\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePara-veterinarians\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnimal Herders\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse correct injection techniques\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRotate injection sites\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaintain injection site hygiene\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDispose of used syringes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonitor animals after injection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReport complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90\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"},{"header":"Discussion","content":"\u003cp\u003eThe study examined veterinarians, para-veterinarians, and herders' knowledge, perceptions, and practices regarding injection site issues in small ruminant husbandry in Kumasi. Given that para-veterinarians and herders are not licensed professionals with the authority to inject animals, their direct involvement in injections exposes a gap in veterinary service delivery. The results indicate knowledge gaps across groups, but it is also seen that poor injection practices appear despite knowledge levels. Veterinarians have a comprehensive perspective of potential risks in injection sites because of their strong knowledge in veterinary anatomy, pathology, and pharmacology. On comparing veterinarians with paraprofessionals regarding knowledge in injection site safety and usage of drugs at injection sites, it is seen that they perform better. Para-veterinarians frequently recognise the most common problems, but they may overlook more subtle issues, such as inadequate medication absorption. Other countries, such as Cambodia and Malawi, have shown similar neglect, with minimal practical training in pharmacokinetics. Animal herders know very little about internal issues like tissue necrosis, and they typically focus on symptoms rather than disease mechanisms. It is also worth noting that many herders do not associate the appearance of an abscess with vaccinations.\u003c/p\u003e \u003cp\u003eThe increasing disparity in the awareness of the locations where subcutaneous, intramuscular, and intravenous injections can be carried out can be related to other pastoral systems practised in Africa. It verifies the significance of professional skills in terms of the correct location of injections [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Veterinarians and para-veterinarians usually remember the location of injections effectively; in this case, the herdsmen lack awareness in this area for IM and IV injections. This distinction is reflected in current practice, in which veterinarians primarily inject in the neck, while para-veterinarians and herders inject in the thigh and gluteal regions. These patterns have appeared in Nigeria and northern Ghana, where non-professional staff who inject often inject into the foremost muscle tissues available to them, despite the fact that these tissues are perhaps not the most valuable ones economically. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAlthough there was a general positive attitude toward aseptic techniques, this reflects a shared understanding of basic hygiene. There is an evident gap in knowledge concerning the issues of withdrawal times and beef quality. In fact, only 75% of the animal herders understood the reasons why withdrawal times are important, which explains why a greater proportion of small-scale livestock raisers are not yet informed about residues. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] further established that only a few herders were concerned about problems associated with injection sites regarding cattle quality. In contrast, veterinarians and para-veterinarians were generally aware of the economic and health consequences of injection site problems. In addition, studies show that where an instant financial loss is not incurred through trimming or condemnation of carcasses, the animal caretaker is very likely to attach less value to meat quality. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This speaks to the need for education linking injection practices with economic loss.\u003c/p\u003e \u003cp\u003eEven with adequate knowledge and mostly positive attitudes, all three groups-skilled workers included-demonstrate gaps between what they know and do. Some vets fail to change injection sites consistently and don't check on the animals after injections. Time pressure and client expectations have also exposed knowledge-to-practice gaps in antimicrobial therapy in veterinary medicine [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The most significant gaps appear in the animal herder groups, particularly those related to hygiene and postinjection checks, unsafe syringe disposal poses a real risk of spreading zoonoses. Equipment shortages have been noted, alongside a lack of strong government support in Sub-Saharan Africa.\u003c/p\u003e \u003cp\u003eFurthermore, abattoir surveillance revealed a high incidence of injection site lesions, including abscesses, fibrosis, and granulomas. Although illness prevalence does not appear to be significant, routine Meat Hygiene Inspections frequently underreport lesion prevalence, particularly in deep muscle tissue and slaughtered cases at non-commercial slaughter facilities [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e][\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Injection site lesions in the economically valuable muscle in the thighs are especially concerning because studies in Europe and America reveal they are linked to significant economic loss through trimming and carcass degradation [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This is especially relevant in Ghana, where profit margins are low.\u003c/p\u003e \u003cp\u003eThe findings also have practical ramifications for Ghana's livestock business and the country's overall healthcare system. The continuous involvement of para-vets and livestock herders in injection delivery suggests that there is a complementary relationship between veterinary service delivery and enforcement. Even if such changes will be difficult to implement in the short term, it is evident that the message has been given that any intervention approach must include all stakeholders involved in cattle interactions. Antimicrobial resistance stems from knowledge and practice gaps [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Incorrect injection procedures, use of unsuitable injection locations, and a lack of awareness of withdrawal times all contribute to increased drug buildup in meat and intensified animal treatments, all of which drive resistance [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. All of these observations are consistent and emphasize the significance of increased support in the livestock sector [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e "},{"header":"Conclusion and Recommendation","content":"\u003cp\u003eThe findings from this study indicate significant gaps in knowledge, attitude, and practices on injection site issues among veterinarians, para-veterinarians, and cattle herders in Kumasi, Ghana. Competence was highest among veterinarians, while there were significant deficits in anatomical and injection practices for herders. The improper use of injection sites, mainly by unqualified injectors, was consistent with the lesions seen at slaughter. Future research is needed to determine the economic impact of infection site lesions in Ghana, so that there is a greater motivation for intervention. Longitudinal studies could determine which drugs are related with lesions at injection sites and the severity of these lesions, offering more specific causative insight. Intervention research may find cost-effective approaches to reduce infection-site cases among para-veterinarians and cattle herds. It becomes prudent to investigate improved techniques for combining abattoir observation, training, and feedback.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eISC- Injection site complications\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKAP- knowledge, attitudes, and practices\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSPSS- Statistical Package for Social Science\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSC- Subcutaneous\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;IM- Intramuscular\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIV- Intravenous\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and Ethical standards were maintained: verbal consent was given by all participants after study details were explained, participation was voluntary, and withdrawal was allowed at any time. Identifiable data were removed to ensure confidentiality. All data were anonymised and securely stored. Also, the study received a joint ethical approval from the Review Board of Kwame Nkrumah University of Science and Technology.\u003c/p\u003e\n\u003cp\u003eThe study recognises that only veterinarians are licensed to administer injections in Ghana. Data on para-veterinarian and herder practices were collected to understand real-life treatment behaviours in the field, not to validate or endorse unlicensed procedures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData used in this study are available on request from the corresponding\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eauthor.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was carried out without any financial support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAugustine Teye, Bismark Gyasi, Albright Stephen Effah Ameyaw:\u003c/strong\u003e conceptualisation or design of the work, methodology, data collection, and data analysis, writing \u0026ndash; original draft. \u003cstrong\u003ePrince Nana Takyi,\u003c/strong\u003e \u003cstrong\u003eAlisa Elise Wepere Luguterah:\u0026nbsp;\u003c/strong\u003emethodology, investigation, manuscript writing, review, and editing. \u003cstrong\u003eTony Opoku-Agyemang,\u003c/strong\u003e \u003cstrong\u003eRaphael Deladem Folitse, Benjamin Obukowho Emikpe\u003c/strong\u003e: conceptualisation or design of the work, methodology, manuscript writing, review and editing, project administration, supervision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to\u0026nbsp;the respondents for participating in this study. We also thank Chief Meat Inspector, Mr. Carl Max Apolala for his contribution.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJatfa JW, Adenkola AY, Victor I, Kisani A, Adamu SS, Onyeyili PA. Retrospctive studies of small ruminant diseases diagnosed at the Veterinary Teaching Hospital, University of Agriculture, Makurdi, Nigeria. Tropical Veterinarian. 2015;33(3-4):95-100. https://www.ajol.info/index.php/tv/article/view/160179 \u003c/li\u003e\n\u003cli\u003eAdams F, Ohene-Yankyera K, Aidoo R, Wongnaa CA. Economic benefits of livestock management in Ghana. Agricultural and Food Economics. 2021 May 10;9(1):17. https://link.springer.com/article/10.1186/s40100-021-00191-7 \u003c/li\u003e\n\u003cli\u003ePlummer PJ, Schleining JA. Assessment and management of pain in small ruminants and camelids. Veterinary Clinics: Food Animal Practice. 2013 Mar 1;29(1):185-208 https://www.vetfood.theclinics.com/article/S0749-0720(12)00092-8/abstract . \u003c/li\u003e\n\u003cli\u003eHayes L, Britton S, Weerasinghe G, Woodgate RG, Hernandez-Jover M. Insights into the knowledge, practices and training needs of veterinarians working with smallholder livestock producers in Australia. Preventive Veterinary Medicine. 2018 Jun1;154:54-62. https://www.sciencedirect.com/science/article/pii/S0167587718300424 \u003c/li\u003e\n\u003cli\u003eStewart JL, Shipley CF. Management of reproductive diseases in male small ruminants. Veterinary Clinics: Food Animal Practice. 2021 Mar 1;37(1):105-23. https://www.vetfood.theclinics.com/article/S0749-0720(20)30077-3/abstract \u003c/li\u003e\n\u003cli\u003eLi W, Yin Y, Wang F, Miao S. Beef quality assurance injection sites and techniques. Journal of Agricultural Science. 2012 Jan 1;4(1):91.\u003c/li\u003e\n\u003cli\u003eCresswell E, Remnant J, Butterworth A, Wapenaar W. Injection‐site lesion prevalence and potential risk factors in UK beef cattle. Veterinary Record. 2017 Jan;180(3):70-. https://bvajournals.onlinelibrary.wiley.com/doi/abs/10.1136/vr.103778 \u003c/li\u003e\n\u003cli\u003eKermode M, Muani V. Injection practices in the formal \u0026amp; informal healthcare sectors in rural north India. Indian Journal of Medical Research. 2006 Nov 1;124(5):513-20. https://journals.lww.com/ijmr/abstract/2006/24050/injection_practices_in_the_formal___informal.9.aspx \u003c/li\u003e\n\u003cli\u003eHall LE, Reilly B, Blackie N. Surveying UK sheep farmers\u0026rsquo; vaccination techniques and the impact of vaccination training. Veterinary Record. 2022 Aug;191(4):no-. https://bvajournals.onlinelibrary.wiley.com/doi/abs/10.1002/vetr.1798 \u003c/li\u003e\n\u003cli\u003eArvidsson A, Fischer K, Hansen K, Sternberg-Lewerin S, Chenais E. Diverging discourses: animal health challenges and veterinary care in northern Uganda. Frontiers in Veterinary Science. 2022 Mar 10;9:773903. https://www.frontiersin.org/articles/10.3389/fvets.2022.773903/full \u003c/li\u003e\n\u003cli\u003eMockshell J, Ilukor J, Birner R. Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?. Tropical animal health and production. 2014 Feb;46(2):475-80. https://link.springer.com/article/10.1007/s11250-013-0518-9 \u003c/li\u003e\n\u003cli\u003eNuvey FS, Mensah GI, Zinsstag J, Hattendorf J, Fink G, Bonfoh B, Addo KK. Management of diseases in a ruminant livestock production system: a participatory appraisal of the performance of veterinary services delivery, and utilization in Ghana. BMC Veterinary Research. 2023 Nov 15;19(1):237. https://link.springer.com/article/10.1186/s12917-023-03793-z \u003c/li\u003e\n\u003cli\u003eTurkson PK, Naandam J. Assessment of veterinary needs of ruminant livestock owners in Ghana. Preventive veterinary medicine. 2003 Nov 12;61(3):185-94. https://www.sciencedirect.com/science/article/pii/S0167587703002149 \u003c/li\u003e\n\u003cli\u003eWeaver J, Leon E, Edan M, D\u0026apos;Alessio F. Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports. Revue scientifique et technique (International Office of Epizootics). 2012 Aug 1;31(2):631-45. https://europepmc.org/article/med/23413738 \u003c/li\u003e\n\u003cli\u003eKuiseu J, ZINSOU FE, Olounlade PA, ALOWANOU GE, Adenile AD, Dansou CC, Hounzangbe-Adote S, Babayemi OJ, Edorh PA. Prevalence, effects and alternative control methods of Haemonchus contortus in small ruminants: a review. Journal of Veterinary Medicine and Animal Health. 2021 Apr 30;13(2):84-97. https://academicjournals.org/journal/JVMAH/article-full-text/DDDF70166663 \u003c/li\u003e\n\u003cli\u003eOluigbo CU, Ngozi EC, Ohaegbu PM. Determination of sample sizes in research using Taro Yamane formula: An overview. InProceedings of the 1st Annual Faculty of Science International Conference, Niger Delta University 2024 Jan (Vol. 1, pp. 76-84). \u003c/li\u003e\n\u003cli\u003eDeVellis RF. Scale development: Theory and applications. Thousand Oaks. 2003.\u003c/li\u003e\n\u003cli\u003eMatache A, Nenciu F, Vanghele NA, Nae G. Impact evaluation of using antibiotics in animal husbandry practices-Review. Technium. 2023 Oct 1;14. https://search.ebscohost.com/login.aspx?direct=true\u0026amp;profile=ehost\u0026amp;scope=site\u0026amp;authtype=crawler\u0026amp;jrnl=2668778X\u0026amp;AN=172925454\u0026amp;h=jEAn8BybPwywhnyjO3slmvYOLl0qVHaZyH0Gv7MvbfCgBwySJlkbepzEhXEK5WWMAYI0W0EahVhQaYs2EdRmmQ%3D%3D\u0026amp;crl=c \u003c/li\u003e\n\u003cli\u003eFortan\u0026eacute; N. Antimicrobial resistance: preventive approaches to the rescue? Professional expertise and business model of French \u0026ldquo;industrial\u0026rdquo; veterinarians. Review of Agricultural, Food and Environmental Studies. 2021 Jun;102(2):213-38. https://link.springer.com/article/10.1007/s41130-019-00098-4 \u003c/li\u003e\n\u003cli\u003eCaudell MA, Dorado-Garcia A, Eckford S, Creese C, Byarugaba DK, Afakye K, Chansa-Kabali T, Fasina FO, Kabali E, Kiambi S, Kimani T. Towards a bottom-up understanding of antimicrobial use and resistance on the farm: A knowledge, attitudes, and practices survey across livestock systems in five African countries. PloS one. 2020 Jan 24;15(1):e0220274. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220274\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"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":"Injection site complications, Injection techniques, Ghana, Small ruminants, Veterinarians","lastPublishedDoi":"10.21203/rs.3.rs-8659048/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8659048/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eInjection site complications (ISCs) are an under-recognised challenge in small ruminant production in Ghana. Poor injection practices can result in tissue damage, abscess formation, drug residues, and carcass condemnation, posing economic and public health risks. Although veterinarians are legally authorised to administer injections, para-veterinarians and herders frequently perform these procedures in practice. The knowledge, attitudes, and practices (KAP) of animal health providers regarding injection site complications were assessed in the study.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA comparative cross-sectional approach was adopted using structured questionnaire techniques and abattoir record reviews in a retrospective design. A stratified random sample of 230 respondents was used in the survey of veterinarians, para-veterinarians, and herders in the Kumasi region of Ghana. Abattoir records between January and August of the year 2025 were retrospectively analysed for the prevalence of injection site lesions. Descriptive statistical and chi-squared tests were employed in the evaluation of the results.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eHerders scored lower in their knowledge of injection site anatomy than veterinarians (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). While the latter primarily preferred the neck region in performing intramuscular injections, herders preferred the thighs or rump region; the latter was associated with increased lesions in the abattoir examination of the slaughtered animals. Abattoir examination revealed a significant prevalence of injection site abscesses, fibrosis, and granulomas.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThere is a significant gap in knowledge and injection practices of herders in particular, which could be associated with the observed injection site lesions in the abattoir examination of the slaughtered animals.\u003c/p\u003e","manuscriptTitle":"Assessment of Knowledge, Attitudes, and Practices Related to Injection Site Complications Among Animal Health Providers in Small Ruminants in Kumasi, Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-04 11:55:35","doi":"10.21203/rs.3.rs-8659048/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-03T09:06:15+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-02T07:56:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"315205660997281145433494214247050515265","date":"2026-04-02T04:54:40+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-17T14:55:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"321350369632654363780804301259729974957","date":"2026-02-10T07:42:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"139081817840194469999087744863289347284","date":"2026-02-09T09:44:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"224001049624833487191996286050046517349","date":"2026-02-05T08:43:16+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-02T13:11:04+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-02T13:07:27+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-02T08:24:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-31T14:48:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Veterinary Research","date":"2026-01-31T14:26:24+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":"d600783c-9a07-41fb-94d5-5e8ac34e81ad","owner":[],"postedDate":"February 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-17T06:53:14+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-04 11:55:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8659048","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8659048","identity":"rs-8659048","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}