Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers

Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers | bioRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (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];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-M677548'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search New Results Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers View ORCID Profile Kunda Ndashe , View ORCID Profile Geoffrey Mainda , View ORCID Profile Chitwambi Makungu , View ORCID Profile Mark Caudell , View ORCID Profile Katendi Changula , View ORCID Profile Niwael Mtui-Malamsha , View ORCID Profile Tabitha Kimani , View ORCID Profile John Bwalya Muma , View ORCID Profile Masuzyo Nyirenda , Mwaka Sinkala , View ORCID Profile Bernard Mudenda Hang’ombe doi: https://doi.org/10.1101/2025.04.07.647520 Kunda Ndashe 1 Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia , Lusaka, Zambia 2 Food and Agriculture Organisation of the United Nations , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Kunda Ndashe For correspondence: ndashe.kunda{at}gmail.com Geoffrey Mainda 2 Food and Agriculture Organisation of the United Nations , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Geoffrey Mainda Chitwambi Makungu 2 Food and Agriculture Organisation of the United Nations , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Chitwambi Makungu Mark Caudell 3 Food and Agriculture Organisation of the United Nations , Nairobi, Kenya Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mark Caudell Katendi Changula 1 Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Katendi Changula Niwael Mtui-Malamsha 2 Food and Agriculture Organisation of the United Nations , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Niwael Mtui-Malamsha Tabitha Kimani 3 Food and Agriculture Organisation of the United Nations , Nairobi, Kenya Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Tabitha Kimani John Bwalya Muma 4 Department of Disease Control, School of Veterinary Medicine, The University of Zambia , Lusaka, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for John Bwalya Muma Masuzyo Nyirenda 5 Department of Fisheries, Ministry of Fisheries and Livestock , Chilanga, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Masuzyo Nyirenda Mwaka Sinkala 6 Central Veterinary Research Institute, Department of Veterinary Services, Ministry of Fisheries and Livestock , Lusaka P.O. Box 33980, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Bernard Mudenda Hang’ombe 1 Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia , Lusaka, Zambia 7 Copperbelt University , Jambo Drive, P. O Box 21692, Kitwe, Zambia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Bernard Mudenda Hang’ombe Abstract Full Text Info/History Metrics Preview PDF Abstract Aquaculture in Zambia is rapidly growing, contributing significantly to food security and income generation. However, the intensification of fish farming raises concerns about antimicrobial use (AMU) and the emergence of antimicrobial resistance (AMR). This study assessed the knowledge, attitudes, and practices (KAP) of fish farmers regarding AMU and AMR across 25 districts in Zambia’s ten provinces. Data were collected from fish farmers using a structured questionnaire distributed via district fisheries officers and analyzed through descriptive and inferential statistics, including logistic regression. The results revealed significant gaps in knowledge, with only 17.4% of farmers classified as knowledgeable about AMU and AMR. Attitude assessments showed that 60.5% exhibited positive attitudes toward responsible AMU practices, while the remaining 39.5% displayed negative perceptions. In terms of practices, 76.5% adhered to good practices, including consulting veterinary professionals and responsible antibiotic use, whereas 23.5% engaged in poor practices. Key factors influencing KAP outcomes included age, farming experience, and annual production capacity. Farmers aged 30–39 years and those with 1–5 years of experience demonstrated significantly more positive attitudes (p < 0.05), while those with higher production capacities (501–1000 kg) exhibited better practices (p < 0.001). The findings highlight critical knowledge gaps and inconsistent practices regarding AMU and AMR among Zambian fish farmers. Targeted interventions, including education programs, enhanced access to veterinary services, and strengthened regulatory frameworks, are essential to promote responsible AMU, mitigate AMR risks, and ensure the sustainability of aquaculture in Zambia. 1. Introduction Global aquaculture has undergone remarkable growth over the past few decades, emerging as one of the fastest-growing sectors in food production ( FAO, 2020 ). In 2020, total global aquaculture production reached a record 122.6 million tonnes, valued at approximately USD 281.5 billion ( FAO, 2022 ). This expansion has been largely driven by the rising demand for fish protein and the recognition of aquaculture’s critical role in enhancing food security and nutrition worldwide ( FAO, 2022 ). Asia dominates global aquaculture, accounting for nearly 91.6% of global production, with China contributing over 58% of the total ( Verdegem et al ., 2023 ). In contrast, Africa accounts for a smaller share of the global aquaculture output at around 2.0% ( Verdegem et al ., 2023 ). However, the sector is growing steadily in countries like Egypt, Nigeria, and Zambia, which have emerged as key players in the region ( Adeleke et al ., 2020 ). As with the development of any livestock sector, disease outbreaks are an unavoidable challenge, often necessitating the use of antibiotics and other antimicrobials for outbreak management and control ( Newell et al ., 2010 ). This rapid growth has raised concerns about the sustainability of aquaculture practices, particularly in relation to disease management and the widespread use of antibiotics ( FAO, 2020 ). The intensification of aquaculture systems has led to an increase in antimicrobial use (AMU), a common practice to control bacterial diseases and maintain fish health (Bondad Reantaso et al ., 2023). However, the overuse and misuse of antimicrobials have exacerbated the global challenge of antimicrobial resistance (AMR), a significant health threat that extends beyond human and terrestrial animal populations to aquatic environments ( Nadimpalli et al ., 2018 ; Deori, Sonowal and Das, 2024 ). Aquatic systems can serve as reservoirs for resistant pathogens, which can spread through various pathways, including water systems, food chains, and the environment ( Nnadozie and Odume, 2019 ). It is estimated that the aggregate global human, terrestrial and aquatic food animal antibiotic use in 2030 at 236,757 tons (95% UI 145,525–421,426), of which aquaculture constitutes 5.7% but carries the highest use intensity per kilogram of biomass (164.8 mg kg −1 ) ( Schar et al ., 2020 ). In many low- and middle-income countries (LMICs), including those in Africa, the challenge of AMR is compounded by weak regulatory frameworks, limited access to veterinary services, and insufficient awareness among farmers ( Caudell et al ., 2020 ; Mudenda et al ., 2023 ). While Zambia’s aquaculture sector is experiencing rapid growth, with fish production from aquaculture facilities increasing from 36,105 metric tonnes (MT) in 2018 to 72,000 MT in 2022, the intensification of farming operations has led to disease outbreaks ( Bwalya et al ., 2020 ; Siamujompa et al ., 2023 ). In Zambia, fish farmers have reported frequent disease outbreaks in aquaculture facilities, which pose a significant challenge to fish health and production ( Bwalya et al ., 2020 ; Siamujompa et al ., 2023 ). Despite the occurrence of these outbreaks, previous study reported that farmers do not resort to using antibiotics as a treatment measure ( Ndashe et al ., 2023 ). This is largely due to limited access to veterinary services, and a lack of knowledge about proper antimicrobial use in fish farming ( Ndashe et al ., 2023 ). Instead, farmers often rely on alternative disease management practices, which may not always be effective in controlling infections, potentially exacerbating fish losses and further threatening the sustainability of their operations ( Ndashe et al ., 2023 ). Fish farmers are key actors in the fight against AMR, as their knowledge and practices surrounding antimicrobial use directly impact the development of resistance ( Henriksson et al ., 2018 ). Understanding their perceptions and behaviors is essential for designing interventions that promote prudent antimicrobial use. However, little is known about how Zambian fish farmers manage the risks associated with AMU and AMR. Addressing this gap is critical for developing policies and programs that reduce antimicrobial misuse in aquaculture and help mitigate the spread of resistant pathogens. This study aimed to assess the knowledge, attitudes, and practices (KAP) of fish farmers in Zambia regarding AMU and AMR. By evaluating their awareness and behaviors, this research sought to inform the development of strategies to promote responsible AMU and curb the emergence of resistant pathogens in aquaculture systems. The findings will contribute to the global effort to combat AMR while enhancing the sustainability of fish farming in Zambia. 2. Materials and Methods 2.1. Study Area This study was conducted in 25 districts across Zambia’s ten provinces, selected based on their high aquaculture activity and fish farming population density. At least two districts were chosen from each province, focusing on regions that significantly contribute to aquaculture development. The selected districts included Gwembe, Sinazongwe, and Siavonga in the Southern Province; Kasempa, Mwinilunga, Solwezi, and Mushindano in the North-Western Province; Kaoma in the Western Province; Chitambo, Chibombo, Mkushi, and Chisamba in the Central Province; Chipata and Petauke in the Eastern Province; Mpulungu, Kasama, and Mungwi in the Northern Province; Mansa and Samfya in the Luapula Province; Ndola in the Copperbelt Province; Chinsali in the Muchinga Province; and Chilanga, Chongwe, Kafue, and Rufunsa in the Lusaka Province [ Figure 1 ]. Download figure Open in new tab Figure 1: Map showing the districts included in the study 2.2. Study design and Sample Size Determination A cross-sectional quantitative survey on fish farmers was conducted in different districts of Zambia in September 2024. The sample size was calculated using the Raosoft sample volume calculation method based on a 5% error rate, and 50% response distribution ( Raosoft, 2004 ). As there were no similar types of studies conducted as such in Zambia among fish farmers, we assumed 50% of the respondents would have proper knowledge on AMU, and AMR, added 5% to the sample to address the non-response rate. Thus, a minimum sample size of 170 was necessary for conducting the study. 2.3. Data Collection Tool Data were collected using a structured questionnaire that addressed farmers’ demographics, as well as KAP related to AMU and AMR. Demographic information included farmer age, gender, educational level, work experience, and district location. Questions related to AMU focused on various aspects of aquaculture management, including the type, frequency, source, and storage of antimicrobials, as well as farm management practices concerning school size, fish health, farm biosecurity, clinical signs, and disease occurrence. Knowledge-based questions covered topics such as AMU, antimicrobial withdrawal periods, AMR transmission, and government policies regarding AMU. In the attitudes section, farmers’ perceptions on the safety of AMU and the use of non-prescribed antimicrobials were explored. Finally, practice-related questions sought information on the completion of full courses of AMU, frequency of AMU, and verification of antimicrobial expiration dates. A pre-test of the questionnaire was administered to five farmers, followed by further validation by three experts in AMU and AMR. 2.4. Data Collection The data collection process commenced with virtual meetings with fisheries officers from the selected districts to introduce and familiarize them with the study objectives and the questionnaire. Subsequently, the data collection tool was disseminated to the fisheries officers via WhatsApp. The questionnaire was then distributed to fish farmers through pre-established WhatsApp groups, which were utilized by district fisheries officers for communication with farmers. The questionnaire consisted of two formats: multiple-choice and single-word responses. The survey was administered in English, and responses were electronically recorded using a Google Form ( https://forms.gle/imUmkfkMynxnMrtq8 ), which was accessible for seven days in September 2024. Participation in the study was voluntary, and only farmers who provided informed consent were included in the final dataset. 2.5. Statistical Analysis In this study, both descriptive and inferential statistical analyses were employed. Following the attainment of the required sample size, data were processed using Microsoft Excel 2013 and subsequently analyzed using Datatab software ( Team, 2022 ). The dataset comprised 43 categorical variables, organized into four sections: 10 demographic and socioeconomic variables, 12 knowledge-related variables, 7 attitude-related variables, and 14 practice-related variables. To assess participants KAP regarding AMU and AMR, a Likert scale was utilized to generate binary dependent variables. Participants who answered at least 7 out of 12 knowledge-based questions correctly were classified as “knowledgeable,” while those answering fewer than 5 were categorized as “not knowledgeable.” Attitudes supporting AMR mitigation were classified as “positive,” while those promoting AMR-contributing behaviors were labeled as “negative.” Practices aimed at reducing AMR were considered “good practice,” while those that increased AMR risk were categorized as “poor practice.” Binary logistic regression was applied to identify significant predictors of KAP. The analysis was conducted in three stages: first, individual associations between predictor variables and KAP outcomes were assessed; second, descriptive crosstab analyses were used to examine relationships; and third, the impact of demographic and socioeconomic variables on KAP outcomes was expressed through odds ratios. 3. Results 3.1. Demographic information The surveyed fish farmers displayed a wide range of demographic and operational characteristics. The largest age groups were 30–39 years (27.72%) and 40–49 years (26.63%), with a male majority (73.37%) [ Table 1 ]. A significant proportion of respondents (65.57%) had received tertiary education, and 84.15% were farm owners. Experience levels varied, with 66.3% having 1–5 years of farming experience, while 22.83% had less than one year of experience [ Table 1 ]. View this table: View inline View popup Table 1: Demographic information of farmers in study area The most commonly reared species were three-spot tilapia (43.22%) and Nile tilapia (30.15%). Ponds were the predominant production system (79.61%), followed by cages (13.11%), tanks (4.85%), and recirculated aquaculture systems (2.43%) [ Table 1 ]. 3.2. Socioeconomic information The primary motivation for fish farming among the surveyed farmers was to generate supplementary income (55.32%), followed by access to free water resources (14.04%) and the perceived ease of farm management (13.62%). Smaller proportions of respondents cited the availability of trained personnel (11.06%) and lower capital requirements (5.96%) as key motivations [ Table 2 ]. View this table: View inline View popup Table 2: Socioeconomic information of farmers in study area Regarding production, 22.83% of farmers reported annual yields ranging from 1,001–5,000 kg, while 19.02% had not yet harvested fish, suggesting they were in the early stages of farming. Smaller production ranges included fewer than 100 kg (5.98%) and 501–1,000 kg (18.48%). A small proportion of farmers (2.17%) reported production levels above 10,000 kg [ Table 2 ]. Fish farming contributed modestly to household incomes, with 35.52% of farmers reporting a contribution of 0–20%, and 24.59% indicating a contribution of 21–40%. Only 6.56% reported contributions of 61–80%, and 3.83% indicated contributions of 81–100%. Additionally, 14.75% of farmers had not yet harvested fish, limiting their ability to assess the financial impact of their operations [ Table 2 ]. 3.3. Knowledge Assessment The knowledge assessment of fish farmers regarding AMU and AMR in aquaculture revealed varying levels of awareness. A majority of farmers (71.89%) were aware of antibiotics, with amoxicillin being the most recognized example (55.68%). However, 27.03% of respondents were uncertain. Veterinarians were identified by 31.89% as the primary authority for prescribing antibiotics, followed by fisheries officers (27.03%), though 32.97% were unsure. Awareness of the risks associated with antibiotics was moderate. Specifically, 47.57% of farmers recognized the potential side effects of antibiotics on fish and the environment, and 55.23% were aware that antibiotics could enter the human body through fish consumption. Additionally, 52.69% understood the concept of antibiotic residues, and 65.05% had heard of antibiotic resistance, with 54.39% acknowledging the potential for pathogen transmission to humans through fish products. Regarding antibiotic resistance, 63.44% of farmers believed it could be mitigated by avoiding antibiotic overuse, while 81.18% recognized the harmful effects of antimicrobial misuse on animal, human, and environmental health. Biosecurity and hygiene were widely regarded as critical, with 76.34% acknowledging the importance of biosecurity measures and 67.74% emphasizing the role of proper hygiene practices in reducing antibiotic resistance. View this table: View inline View popup Table 1: Knowledge assessment of farmers in study area A significant majority of farmers (82.6%) exhibited insufficient knowledge regarding proper antimicrobial use (AMU) and antimicrobial resistance (AMR), with only 17.4% demonstrating adequate understanding [ Figure 2 ]. This finding highlights a considerable knowledge gap, emphasizing the need for targeted educational and awareness initiatives to mitigate AMR risks in aquaculture. Download figure Open in new tab Figure 2. graph showing the percent of farmers Knowledgeable on not in AMU and AMR 3.4. Attitude Assessment The majority of farmers (76.34%) believe that fish should be treated when clinical signs or mortality occur, while 10.75% disagree and 11.29% are uncertain. Most farmers (83.87%) agree on the importance of seeking veterinary advice prior to using antibiotics, with only 1.61% disagreeing and 13.98% unsure. Additionally, 75.27% support the regulation of antibiotic use by authorities, although 22.58% are uncertain and 1.08% disagree. A strong majority (89.25%) believe that education and public awareness are crucial for reducing antibiotic resistance, and 63.44% recognize the environmental risks associated with antibiotic use, though 28.49% remain uncertain. Furthermore, 78.49% consider antibiotic resistance to be a public health concern, and 81.18% acknowledge their role in mitigating it. These findings indicate a generally positive attitude toward responsible antibiotic use, regulation, and awareness initiatives [ Table 4 ]. View this table: View inline View popup Download powerpoint Table 3: A Logistic Regression Analysis of Influence of Demographic and Farm Characteristics on Farmers’ Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Resistance View this table: View inline View popup Download powerpoint Table 4: Attitude assessment of farmers towards issues of AMU and AMR in the study area The assessment of farmers’ attitudes revealed that 60.5% exhibited a positive attitude toward responsible antibiotic use (AMU) and antimicrobial resistance (AMR), while 39.5% demonstrated a negative attitude. This suggests that a significant proportion of the farming community remains unaware, indifferent, or resistant to proper AMU and AMR practices, highlighting the need for ongoing efforts to enhance awareness and improve attitudes within the sector [ Figure 3 ]. Download figure Open in new tab Figure 3. graph showing the percent of farmers with positive and negative attitude in AMU and AMR 3.5 Practice Assessment The majority of farmers (94.09%) reported not using antibiotics on their fish farms, while 3.23% confirmed antibiotic use, primarily for treatment (2.69%) and less commonly for both treatment and growth promotion (1.62%). Specific antibiotics cited included coarse salt (2.15%), formalin (1.08%), penicillin (0.54%), and amoxicillin (0.54%). Most farmers (84.29%) had never purchased antibiotics, with those who did primarily sourcing them from agrovets (6.44%). Only 9.89% obtained prescriptions from veterinarians, while 43.01% administered antibiotics without adhering to guidelines. Additionally, 50.27% of farmers did not submit fish samples for veterinary testing, and 74.19% reported no antibiotic use. Proper disposal of antibiotic containers was practiced by 6.99% of farmers, while others buried (2.15%) or discarded them in open pits (1.61%). For expired antibiotics, 1.61% burned them, 4.84% discarded them in open pits, and 0.54% shared them with others. When fish exhibited symptoms, 42.47% consulted veterinarians, 12.37% isolated and treated sick fish, and 9.68% treated all fish. These findings indicate limited antibiotic use among farmers, but also reveal significant gaps in proper administration, disposal practices, and veterinary engagement [ Table 5 ]. View this table: View inline View popup Table 5: Assessment of fish farmers in study area in practices towards AMU and AMR The assessment of practice levels revealed that 76.5% of farmers adhere to good practices, including responsible antibiotic use, consultation with veterinary professionals, and efforts to mitigate antimicrobial resistance (AMR) risks. However, 23.5% engage in poor practices, indicating non-compliance with established protocols, which may contribute to the development of AMR. These findings underscore the need for continued education and targeted interventions to promote the widespread adoption of responsible antibiotic use practices [ Figure 4 ]. Download figure Open in new tab Figure 4. graph showing the percent of farmers with good and poor practices in AMU and AMR 3.6. Clinical Signs of Diseased fish observed by farmers The KAP survey identified skin wounds as the most commonly reported clinical sign of fish diseases (47.85%), followed by unusual swimming behavior (43.55%), loss of appetite (37.63%), and gasping for air at the surface (37.10%). Other reported signs included white or cloudy skin spots (26.34%), reddish skin spots (22.04%), whitish gills (18.28%), sunken or protruding eyes (17.74%), and whitish eyes (13.98%). Excessive mucus or slime on the body was the least reported clinical sign (12.37%) [ Figure 5 ]. Download figure Open in new tab Figure 5: Clinical signs of fish reported by farmers in study area 3.7. Influence of Demographic and Operational Factors on Farmers’ Knowledge, Attitudes, and Practices Regarding AMU and AMR Statistical analysis of the KAP regarding AMU and AMR revealed key demographic and operational trends. While age, gender, education, and farm roles showed no significant differences in knowledge, farmers aged over 60 (23.81%) and those with tertiary education (20.17%) exhibited higher knowledge levels. Knowledge was significantly associated with annual production capacity, with farmers producing 501–1000 kg demonstrating better knowledge (p < 0.001). Positive attitudes were more prevalent among farmers aged 30–39 (70.59%) and those with 6–10 years of experience (p = 0.002). Larger producers also exhibited significantly more positive attitudes (p < 0.001). Regarding practices, farmers with larger production capacities (501–1000 kg) and 1–5 years of experience displayed better practices (p-values < 0.001 and 0.039, respectively). While age showed borderline significance (p = 0.097), farmers with higher production capacities were more likely to follow good practices (91.18%). Overall, larger producers and more experienced farmers demonstrated better KAP concerning AMU and AMR, underscoring the need for targeted educational interventions aimed at smaller-scale and less experienced farmers. View this table: View inline View popup Download powerpoint Table 2: Test of the statistical significances of the variations in the respondents’ knowledge of AMU and AMR by their characteristics. 3.8. Determinants of Farmers’ Knowledge, Attitudes, and Practices Toward AMU and AMR: Insights from Logistic Regression Analysis Logistic regression analysis identified key factors influencing farmers’ KAP regarding AMU and AMR. Age was a significant determinant, with farmers aged 30–39 being more likely to exhibit positive attitudes (OR = 2.88, p = 0.045), while those aged 40–49 demonstrated better practices (OR = 3.92, p = 0.027). Experience also played a crucial role, as farmers with 1–5 years of experience displayed significantly better attitudes (OR = 2.46, p = 0.013) and practices (OR = 2.62, p = 0.017) compared to less experienced farmers. Annual production capacity strongly influenced KAP outcomes, with farmers producing 201– 500 kg being much more likely to adopt good practices (OR = 108.0, p = 0.002; OR = 93.0, p< 0.001), indicating better access to resources and training. Interestingly, farm workers were more knowledgeable than farm owners (OR = 0.19, p = 0.047), likely due to their direct involvement in daily farm operations. However, gender and education level were not significantly associated with KAP. 4. Discussion The study provides crucial insights into the demographic and operational characteristics of fish farmers in Zambia, alongside their KAP regarding AMU and AMR. These findings highlight the significant gaps in awareness and responsible practices, particularly concerning the use of antibiotics in aquaculture. When compared to similar studies conducted globally, it is evident that the challenges Zambia faces in addressing AMU and AMR are not unique, but reflective of trends observed across aquaculture systems in many developing countries (Bondad Reantaso et al ., 2023; Caputo et al ., 2023 ). The demographic profile of fish farmers in this study reveals a diverse range of ages, educational backgrounds, and levels of experience. The majority of respondents were middle-aged, with most having attained tertiary education, suggesting that aquaculture is attracting educated individuals. However, despite this high level of formal education, many farmers still exhibit limited knowledge of AMU and AMR, a trend that has been observed globally ( Jia et al ., 2017 ; Pham-Duc et al ., 2019 ; Chowdhury et al ., 2022 ; Dandi et al ., 2024 ). In countries such as Bangladesh and Vietnam, where aquaculture plays a significant role in the economy, studies have found that even farmers with formal education often lack specific training on antibiotic use and biosecurity ( Pham-Duc et al ., 2019 ; Chowdhury et al ., 2022 ). This emphasizes that general education alone is insufficient to equip farmers with the necessary skills and knowledge to manage AMU and AMR responsibly. The lack of significant difference in knowledge based on educational background in this study suggests that while formal education is important, it is specialized training that truly influences AMU and AMR awareness. The finding that farmers with larger production capacities had better knowledge and practices supports this argument, as they likely have more access to technical training, veterinary services, and resources that improve their management practices. This is consistent with findings from Ghanat, where larger commercial fish farms tend to follow better AMU practices due to their capacity to engage professional support and access to advanced aquaculture systems ( Dandi et al ., 2024 ). The knowledge assessment in this study paints a concerning picture, with only 17.4% of farmers considered knowledgeable about AMU and AMR. While 71.79% were aware of what antibiotics are, fewer had a clear understanding of antimicrobial resistance, its causes, and its consequences for both fish farming and human health. A comparison with studies from Southeast Asia, such as those by Pham-Duc et al. (2019) , shows similar trends where farmers recognize the term “antibiotics” but have limited understanding of their responsible use, and the long-term impacts of overuse on public health and environmental ecosystems ( Pham-Duc et al ., 2019 ). The widespread knowledge gap observed in Zambia aligns with the situation in other developing nations, where aquaculture systems are expanding rapidly, but regulatory frameworks and education have not kept pace. For example, in Vietnam, Strom et al. (2019) reported that while many fish farmers were aware of antibiotic use, they lacked understanding of how antibiotic resistance develops and spreads through aquaculture systems ( Ström et al ., 2019 ). This points to a global need for more targeted education and training programs focused specifically on AMU and AMR in aquaculture, rather than general agricultural practices. The majority of farmers (60.5%) exhibited a positive attitude toward responsible AMU and AMR practices, indicating an openness to adopting better practices if given the right information and support. This aligns with findings from studies in countries such as Thailand and India, where farmers generally expressed positive attitudes toward seeking veterinary advice and following recommended treatments, but often lacked access to reliable services and faced economic constraints that limited their ability to implement best practices ( Baoprasertkul, Somsiri and Boonyawiwat, 2012 ; Kumaran et al ., 2012). A key observation in this study is the significant role of experience in shaping attitudes. Farmers with 1–5 years of experience were more likely to have positive attitudes towards AMU and AMR compared to less experienced counterparts. This suggests that practical exposure to the challenges of fish farming, including disease management, may foster a greater appreciation for the importance of responsible antibiotic use. It also highlights the need for ongoing support for new entrants into the industry, to ensure they develop positive practices early in their farming careers. The findings on farmers’ practices regarding AMU in Zambia reveal a stark contrast between awareness and action. Despite a strong recognition of the importance of veterinary guidance (with 83.87% agreeing on the need for veterinary consultation), only 15.05% of farmers adhered to dosing guidelines, and most did not submit diseased fish samples to laboratories for diagnosis. This gap between belief and practice is a common issue in aquaculture. Similar studies in India have shown that while farmers understand the need for proper antibiotic use, they often fail to comply with best practices due to logistical, financial, or accessibility issues ( Patil et al ., 2022 ). The predominant use of ponds as the main production system (79.61%) and the low adoption of more intensive systems, such as recirculating aquaculture systems (2.43%), may contribute to the challenges of AMU management. Pond-based systems tend to have lower levels of biosecurity, which can lead to higher disease outbreaks and the consequent increased use of antibiotics. This is a trend observed in other regions as well, where intensive systems are associated with better biosecurity and lower dependency on antibiotics (Flores et al ., 2015; Bera et al ., 2018 ). Biosecurity measures, such as proper disposal of antibiotic containers and isolation of sick fish, were poorly practiced, with only a small proportion of farmers following these protocols. This is concerning given the global emphasis on biosecurity as a key strategy to reduce the spread of AMR in aquaculture. Studies from developed countries, such as Norway and Scotland, where biosecurity protocols are strictly enforced, show much lower levels of antibiotic use due to better disease prevention practices ( Lillehaug, Santi and Østvik, 2015 ; Murray and Gubbins, 2016 ; Subasinghe et al ., 2023 ). One of the most striking findings in this study is that 94.09% of farmers reported not using antibiotics on their farms, while those who did primarily used them for treatment rather than growth promotion. While this may initially appear positive, it raises questions about the underreporting of antibiotic use or the potential use of unregulated, non-approved products. In countries like Zambia, where regulatory oversight is still developing, there is often a lack of accurate data on antibiotic use, as informal markets and the lack of proper record-keeping make monitoring difficult. Similar challenges have been noted in studies from Bangladesh and Kenya, where unregulated antibiotic use is common due to weak enforcement of regulations ( Chowdhury et al ., 2022 ; Kariuki et al ., 2023 ; Kisoo et al ., 2023 ). Farmers’ reliance on agrovets and chemists for antibiotic procurement, rather than veterinarians or official channels, suggests a lack of proper regulation and monitoring. The low rate of veterinary prescriptions (8.99%) indicates a need for stronger regulation and oversight by authorities such as the Zambia Medicines Regulatory Authority (ZAMRA) and the Veterinary Council of Zambia (VCZ). Similar regulatory challenges are faced in Southeast Asia and parts of South America, where unregulated antibiotic markets contribute to widespread misuse and the acceleration of AMR ( Chi et al ., 2017 ; Miranda, Godoy and Lee, 2018 ; Chowdhury et al ., 2022 ). This study underscores the need for comprehensive, multi-faceted interventions to address AMU and AMR in Zambia’s aquaculture sector. Key strategies should include strengthening regulatory frameworks to monitor antibiotic use, enhancing access to veterinary services, and promoting biosecurity practices at the farm level. Additionally, targeted education and training programs are essential to bridge the knowledge gaps among farmers, especially those with less experience or smaller production capacities. Drawing lessons from countries such as Norway and Scotland, which have successfully reduced antibiotic use through strict regulation, robust disease monitoring, and effective biosecurity measures, Zambia could adopt similar approaches. Moreover, collaboration between government bodies, academic institutions, and the private sector could facilitate the development of a sustainable aquaculture industry that prioritizes responsible AMU and mitigates the risk of AMR. 5. Conclusion The findings from this study highlight significant gaps in farmers’ knowledge, attitudes, and practices regarding AMU and AMR in Zambia’s aquaculture sector. While there is a generally positive attitude towards responsible antibiotic use, actual practices fall short, particularly in terms of adherence to biosecurity protocols and proper antibiotic use. The challenges observed in Zambia are reflective of broader trends in developing countries, where rapid aquaculture expansion has outpaced regulatory and educational efforts. Targeted interventions focusing on farmer education, regulatory enforcement, and improved access to veterinary services are crucial to promoting responsible AMU and curbing the spread of AMR. 7. Author’s contribution KN, GM and CM conceptualized and designed the study. KN, MN coordinated data collection. KN performed data analysis, and drafted the manuscript. MC, GM, and JMB provided technical support and contributed to result interpretation. CC, MS1, MS2, and TK provided input and reviewed the manuscript. BMH and NMM supervised the study and reviewed the manuscript. All authors approved the final manuscript. 8. Competing Interests The authors declare that there are no conflicts of interest associated with this study. 6. Acknowledgements We would like to express our sincere gratitude to the fish farmers in the study areas for their cooperation and support as they were crucial for the successful completion of this research. We also extend our heartfelt appreciation to the Food and Agriculture Organization (FAO) Zambia for their financial and logistical support. Additionally, we are grateful for the facilitation provided by the Ministry of Fisheries and Livestock through the Department of Fisheries whose assistance was essential in ensuring the smooth execution of this study. Reference ↵ Adeleke , B. , Robertson-Andersson , D. , Moodley , G. and Taylor , S. , 2020 . Aquaculture in Africa: A comparative review of Egypt, Nigeria, and Uganda vis-a-vis South Africa . Reviews in Fisheries Science & Aquaculture , 29 ( 2 ), pp. 167 – 197 . Available at : doi: 10.1080/23308249.2020.1795615 OpenUrl CrossRef ↵ Baoprasertkul , P. , Somsiri , T. and Boonyawiwat , V. , 2012 . Use of veterinary medicines in Thai aquaculture: current status . Improving biosecurity through prudent and responsible use of veterinary medicines in aquatic food production , 83 . (Accessed: 9 October 2024 ). ↵ Bera , K.K. , Karmakar , S. , Jana , P. , Das , S. , Purkait , S. , Pal , S. and Haque , R. , 2018 . Biosecurity in aquaculture: an overview . Aqua International , 18 ( 12 ), pp. 42 – 46 . OpenUrl BondadlJReantaso , M.G. , MacKinnon , B. , Karunasagar , I. , Fridman , S. , AldaylJSanz , V. , Brun , E. , Le Groumellec , M. , Li , A. , Surachetpong , W. , Karunasagar , I. and Hao , B. , 2023 . Review of alternatives to antibiotic use in aquaculture . Reviews in Aquaculture , 15 ( 4 ), pp. 1421 – 1451 . Available at : doi: 10.1111/raq.12786 . OpenUrl CrossRef ↵ Bwalya , P. , Simukoko , C. , Hang’ombe , B.M. , Støre , S.C. , Støre , P. , Gamil , A.A. , Evensen , Ø. and Mutoloki , S. , 2020 . Characterization of streptococcus-like bacteria from diseased Oreochromis niloticus farmed on Lake Kariba in Zambia . Aquaculture , 523 , p. 735185 . Available at : doi: 10.1016/j.aquaculture.2020.735185 . OpenUrl CrossRef ↵ Caputo , A. , BondadlJReantaso , M.G. , Karunasagar , I. , Hao , B. , Gaunt , P. , VernerlJJeffreys , D. , Fridman , S. and DoradolJGarcia , A. , 2023 . Antimicrobial resistance in aquaculture: A global analysis of literature and national action plans . Reviews in Aquaculture , 15 ( 2 ), pp. 568 – 578 . Available at : doi: 10.1111/raq.12741 . OpenUrl CrossRef ↵ Caudell , M.A. , Dorado-Garcia , A. , Eckford , S. , Creese , C. , Byarugaba , D.K. , Afakye , K. , Chansa-Kabali , T. , Fasina , F.O. , Kabali , E. , Kiambi , S. and Kimani , T. , 2020 . 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 , 15 ( 1 ), p. e0220274 . Available at : doi: 10.1371/journal.pone.0220274 . OpenUrl CrossRef ↵ Chi , T.T.K. , Clausen , J.H. , Van , P.T. , Tersbøl , B. and Dalsgaard , A. , 2017 . Use practices of antimicrobials and other compounds by shrimp and fish farmers in Northern Vietnam . Aquaculture Reports , 7 , pp. 40 – 47 . Available at : doi: 10.1016/j.aqrep.2017.05.003 . OpenUrl CrossRef ↵ Chowdhury , S. , Rheman , S. , Debnath , N. , Delamare-Deboutteville , J. , Akhtar , Z. , Ghosh , S. , Parveen , S. , Islam , K. , Islam , M.A. , Rashid , M.M. and Khan , Z.H. , 2022 . Antibiotics usage practices in aquaculture in Bangladesh and their associated factors . One Health , 15 , p. 100445 . Available at : doi: 10.1016/j.onehlt.2022.100445 OpenUrl CrossRef PubMed ↵ Dandi , S.O. , Abarike , E.D. , Abobi , S.M. , Doke , D.A. , Lyche , J.L. , Addo , S. , Edziyie , R.E. , Obiakara-Amaechi , A.I. , Øystein , E. , Mutoloki , S. and Cudjoe , K.S. , 2024 . Knowledge, attitudes, and practices of antibiotic use among small-, medium-, and large-scale fish farmers of the Stratum II of the Volta Lake of Ghana . Antibiotics , 13 ( 7 ), p. 582 . Available at : doi: 10.3390/antibiotics13070582 . OpenUrl CrossRef PubMed ↵ Deori , C. , Sonowal , T. and Das , M. , 2024 . Antimicrobial resistance: a looming threat to public health and global well-being . Indian Journal of Community and Family Medicine , 10 ( 1 ), pp. 18 – 25 . Available at : DOI: 10.4103/ijcfm.ijcfm_1_24 OpenUrl CrossRef ↵ FAO ( 2020 ) ‘ Understanding antimicrobial resistance in aquaculture’ , Asian Fisheries Sci , 33 , pp. 27 – 32 . OpenUrl ↵ FAO ( 2022 ) The State of World Fisheries and Aquaculture 2022: Towards Blue Transformation . Rome, Italy : FAO (The State of World Fisheries and Aquaculture (SOFIA), 2022 ). Available at : doi: 10.4060/cc0461en . OpenUrl CrossRef Flores , R.C. , Corpuz , M.N.C. , Tungol , F.E. , Villafuerte , A.A. and Antonio , A.S. , Assessment of Aquaculture Biosecurity Measures in Bataan, Philippines . ↵ Henriksson , P.J. , Rico , A. , Troell , M. , Klinger , D.H. , Buschmann , A.H. , Saksida , S. , Chadag , M.V. and Zhang , W. , 2018 . Unpacking factors influencing antimicrobial use in global aquaculture and their implication for management: a review from a systems perspective . Sustainability Science , 13 , pp. 1105 – 1120 . Available at : doi: 10.1007/s11625-017-0511-8 . OpenUrl CrossRef PubMed ↵ Jia , B. , St-Hilaire , S. , Singh , K. and Gardner , I.A. , 2017 . Biosecurity knowledge, attitudes and practices of farmers culturing yellow catfish (Pelteobagrus fulvidraco) in Guangdong and Zhejiang provinces, China . Aquaculture , 471 , pp. 146 – 156 . Available at : doi: 10.1016/j.aquaculture.2017.01.016 OpenUrl CrossRef ↵ Kariuki , J.W. , Jacobs , J. , Ngogang , M.P. and Howland , O. , 2023 . Antibiotic use by poultry farmers in Kiambu County, Kenya: exploring practices and drivers of potential overuse . Antimicrobial Resistance & Infection Control , 12 ( 1 ), p. 3 . Available at : doi: 10.1186/s13756-022-01202-y OpenUrl CrossRef PubMed Kisoo , L. et al. ( 2023 ) ‘Practices and drivers for antibiotic use in cattle production systems in Kenya’ , One Health , 17 , pp. 100646 . Available at : doi: 10.1016/j.onehlt.2023.100646 OpenUrl CrossRef PubMed ↵ Kisoo , L. , Muloi , D.M. , Oguta , W. , Ronoh , D. , Kirwa , L. , Akoko , J. , Fèvre , E.M. , Moodley , A. and Wambua , L. , 2023 . Practices and drivers for antibiotic use in cattle production systems in Kenya . One Health , 17 , p. 100646 . Available at : doi: 10.1080/1389224X.2012.670442 . OpenUrl CrossRef PubMed ↵ Lillehaug , A. , Santi , N. and Østvik , A. , 2015 . Practical biosecurity in Atlantic salmon production . Journal of Applied Aquaculture , 27 ( 3 ), pp. 249 – 262 . Available at : doi: 10.1080/10454438.2015.1066174 . OpenUrl CrossRef ↵ Miranda , C.D. , Godoy , F.A. and Lee , M.R. , 2018 . Current status of the use of antibiotics and the antimicrobial resistance in the Chilean salmon farms . Frontiers in microbiology , 9 , p. 1284 . Available at : doi: 10.3389/fmicb.2018.01284 OpenUrl CrossRef PubMed ↵ Mudenda , S. , Chabalenge , B. , Daka , V. , Mfune , R.L. , Salachi , K.I. , Mohamed , S. , Mufwambi , W. , Kasanga , M. and Matafwali , S.K. , 2023 . Global strategies to combat antimicrobial resistance: a one health perspective . Pharmacology & Pharmacy , 14 ( 8 ), pp. 271 – 328 .. Available at : DOI: 10.4236/pp.2023.148020 OpenUrl CrossRef ↵ Murray , A.G. and Gubbins , M. , 2016 . Spatial management measures for disease mitigation as practiced in Scottish aquaculture . Marine Policy , 70 , pp. 93 – 100 . Available at : doi: 10.1016/j.marpol.2016.04.052 OpenUrl CrossRef ↵ Nadimpalli , M. , Delarocque-Astagneau , E. , Love , D.C. , Price , L.B. , Huynh , B.T. , Collard , J.M. , Lay , K.S. , Borand , L. , Ndir , A. , Walsh , T.R. and Guillemot , D. , 2018 . Combating global antibiotic resistance: emerging one health concerns in lower-and middle-income countries . Clinical infectious diseases , 66 ( 6 ), pp. 963 – 969 . Available at : DOI: 10.1093/cid/cix879 OpenUrl CrossRef PubMed ↵ Ndashe , K. , Hang’ombe , B.M. , Changula , K. , Yabe , J. , Samutela , M.T. , Songe , M.M. , Kefi , A.S. , Njobvu Chilufya , L. and Sukkel , M. , 2023 . An Assessment of the risk factors associated with disease outbreaks across tilapia farms in Central and Southern Zambia . Fishes , 8 ( 1 ), p. 49 . Available at : doi: 10.3390/fishes8010049 . OpenUrl CrossRef ↵ Newell , D.G. , Koopmans , M. , Verhoef , L. , Duizer , E. , Aidara-Kane , A. , Sprong , H. , Opsteegh , M. , Langelaar , M. , Threfall , J. , Scheutz , F. and van der Giessen , J. , 2010 . Food-borne diseases—the challenges of 20 years ago still persist while new ones continue to emerge . International journal of food microbiology , 139 , pp. S3 – S15 . Available at : doi: 10.1016/j.ijfoodmicro.2010.01.021 OpenUrl CrossRef PubMed ↵ Nnadozie , C.F. and Odume , O.N. , 2019 . Freshwater environments as reservoirs of antibiotic resistant bacteria and their role in the dissemination of antibiotic resistance genes . Environmental pollution , 254 , p. 113067 . Available at : doi: 10.1016/j.envpol.2019.113067 OpenUrl CrossRef PubMed ↵ Patil , P.K. , Mishra , S.S. , Pradhan , P.K. , Manna , S.K. , Abraham , J.T. , Solanki , H.G. , Shahi , N. , Swain , P. , Sahoo , S.N. , Avunje , S. and Sharma , K.S. , 2022 . Usage pattern of chemicals, biologicals and veterinary medicinal products in Indian aquaculture . Reviews in Aquaculture , 14 ( 4 ), pp. 2038 – 2063 . Available at : doi: 10.1111/raq.12688 . OpenUrl CrossRef ↵ Pham-Duc , P. , Cook , M.A. , Cong-Hong , H. , Nguyen-Thuy , H. , Padungtod , P. , Nguyen-Thi , H. and Dang-Xuan , S. , 2019 . Knowledge, attitudes and practices of livestock and aquaculture producers regarding antimicrobial use and resistance in Vietnam . Plos one , 14 ( 9 ), p. e0223115 .. Available at : doi: 10.1371/journal.pone.0223115 OpenUrl CrossRef PubMed ↵ Raosoft , I. ( 2004 ) ‘Raosoft sample size calculator’, Raosoft, Inc., Seattle Available at : ( http://www.raosoft.com/samplesize.html ) ↵ Schar , D. , Klein , E.Y. , Laxminarayan , R. , Gilbert , M. and Van Boeckel , T.P. , 2020 . Global trends in antimicrobial use in aquaculture . Scientific reports , 10 ( 1 ), p. 21878 . Available at : doi: 10.1038/s41598-020-78849-3 . OpenUrl CrossRef ↵ Siamujompa , M. , Ndashe , K. , Zulu , F.C. , Chitala , C. , Songe , M.M. , Changula , K. , Moonga , L. , Kabwali , E.S. , Reichley , S. and Hang’ombe , B.M. , 2023 . An investigation of bacterial pathogens associated with diseased Nile tilapia in small-scale cage culture farms on Lake Kariba, Siavonga, Zambia . Fishes , 8 ( 9 ), p. 452 .. Available at : doi: 10.3390/fishes8090452 OpenUrl CrossRef ↵ Ström , G.H. , Björklund , H. , Barnes , A.C. , Da , C.T. , Nhi , N.H.Y. , Lan , T.T. , Magnusson , U. , Norman Haldén , A. and Boqvist , S. , 2019 . Antibiotic use by smalllJscale farmers for freshwater aquaculture in the Upper Mekong Delta, Vietnam . Journal of aquatic animal health , 31 ( 3 ), pp. 290 – 298 . Available at : doi: 10.1002/aah.10084 . OpenUrl CrossRef PubMed ↵ Subasinghe , R. , AldaylJSanz , V. , BondadlJReantaso , M.G. , Jie , H. , Shinn , A.P. and Sorgeloos , P. , 2023 . Biosecurity: Reducing the burden of disease . Journal of the World Aquaculture Society , 54 ( 2 ), pp. 397 – 426 .. Available at : doi: 10.1111/jwas.12966 . OpenUrl CrossRef ↵ Team , Data . ( 2022 ) ‘Skalenniveau’. DATAtab . Available at: https://datatab.net/statistics-calculator/descriptive-statistics ↵ Verdegem , M. , Buschmann , A.H. , Latt , U.W. , Dalsgaard , A.J. and Lovatelli , A. , 2023 . The contribution of aquaculture systems to global aquaculture production . Journal of the World Aquaculture Society , 54 ( 2 ), pp. 206 – 250 . Available at : doi: 10.1111/jwas.12963 . OpenUrl CrossRef View the discussion thread. Back to top Previous Next Posted April 09, 2025. Download PDF Email Thank you for your interest in spreading the word about bioRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers Message Subject (Your Name) has forwarded a page to you from bioRxiv Message Body (Your Name) thought you would like to see this page from the bioRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers Kunda Ndashe , Geoffrey Mainda , Chitwambi Makungu , Mark Caudell , Katendi Changula , Niwael Mtui-Malamsha , Tabitha Kimani , John Bwalya Muma , Masuzyo Nyirenda , Mwaka Sinkala , Bernard Mudenda Hang’ombe bioRxiv 2025.04.07.647520; doi: https://doi.org/10.1101/2025.04.07.647520 Share This Article: Copy Citation Tools Antibiotic Use and Resistance in Zambia’s Aquaculture Sector: Assessing Knowledge, Attitudes, and Practices Among Fish Farmers Kunda Ndashe , Geoffrey Mainda , Chitwambi Makungu , Mark Caudell , Katendi Changula , Niwael Mtui-Malamsha , Tabitha Kimani , John Bwalya Muma , Masuzyo Nyirenda , Mwaka Sinkala , Bernard Mudenda Hang’ombe bioRxiv 2025.04.07.647520; doi: https://doi.org/10.1101/2025.04.07.647520 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Scientific Communication and Education Subject Areas All Articles Animal Behavior and Cognition (7618) Biochemistry (17637) Bioengineering (13864) Bioinformatics (41853) Biophysics (21403) Cancer Biology (18540) Cell Biology (25429) Clinical Trials (138) Developmental Biology (13356) Ecology (19862) Epidemiology (2067) Evolutionary Biology (24287) Genetics (15585) Genomics (22464) Immunology (17701) Microbiology (40300) Molecular Biology (17142) Neuroscience (88440) Paleontology (666) Pathology (2825) Pharmacology and Toxicology (4814) Physiology (7633) Plant Biology (15107) Scientific Communication and Education (2042) Synthetic Biology (4285) Systems Biology (9809) Zoology (2268)