Antimicrobials in Chicken Commercial Feeds in Vietnam: A Three-Year Longitudinal Study Before A Nationwide Ban of Growth Promoters

Abstract Background Antimicrobial growth promoters (AGPs) are included in commercial animal feed rations in many low- and middle-income countries. We measured antimicrobial use (AMU) in commercial feed products consumed by 338 small-scale chicken flocks in the Mekong Delta of Vietnam, before a nation-wide ban on AGPs which is to be phased in over the coming three years. We reviewed the labels of commercial feeds and calculated amounts of antimicrobial active ingredients (AAIs) given to flocks, highlighting those that did not comply with Government regulations.Results Thirty five of 99 different antimicrobial-containing feed products (35.3%) included at least one AAI. Eight different AAIs (avilamycin, bacitracin, chlortetracycline, colistin, enramycin, flavomycin, oxytetracycline, virginamycin) belonging to 5 classes were identified. Brooding feeds contained antimicrobials the most (51.2%), followed by grower (34.6%) and finisher feeds (12.5%). The average amount of AAIs given to flocks per kg of chicken at consumption time was 84.8 (SEM ± 9.3 mg). Quantitatively, chlortetracycline was consumed most (42.2 mg/kg SEM ± 0.34; 50.0% of total use), followed by enramycin (18.4 mg SEM ± 0.03, 21.8%) and bacitracin (16.4 mg SEM ± 0.20, 19.4%). Antimicrobials in commercial feeds were more commonly given to flocks in the earlier part of the production cycle. A total of 10 (9.3%) products were not compliant with existing Vietnamese regulation (06/2016/TT-BNNPTNT) either because they included a non-authorised AAI (4), had AAIs over the permitted limits (4), or both (2).Conclusions and recommendation We found a discrepancy between current legislation and the types and quantities of AGPs found in chicken feeds; this may be a challenge in coming years when the full ban is implemented, and would require that the authorities step up monitoring efforts. Results from this study should encourage discussion about policies on AGPs in low- and middle-income countries.

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Antimicrobials in chicken commercial feeds in Vietnam: a three-year longitudinal study before a nationwide ban of growth promoters

10.21203/rs.3.rs-41284/v1 ◽

2020 ◽

Author(s):

Nguyen Van Cuong ◽

Bach Tuan Kiet ◽

Bo Ve Hien ◽

Bao Dinh Truong ◽

Doan Hoang Phu ◽

...

Keyword(s):

Animal Feed ◽

Mekong Delta ◽

Small Scale ◽

Production Cycle ◽

Growth Promoters ◽

Government Regulations ◽

Middle Income ◽

Middle Income Countries ◽

Commercial Feed ◽

Commercial Feeds

Abstract BackgroundAntimicrobial growth promoters (AGPs) are included in commercial animal feed rations in many low- and middle-income countries (LMICs). We measured antimicrobial use (AMU) in commercial feed products consumed by 338 small-scale chicken flocks in the Mekong Delta of Vietnam, before a nation-wide ban on AGPs which is to be introduced over the coming three years. We reviewed the labels of commercial feeds and calculated amounts of antimicrobial active ingredients (AAIs) given to flocks. We framed these results in the context of overall AMU in chicken production, and highlighted those products that did not comply with Government regulations. ResultsThirty five of 99 different antimicrobial-containing feed products (35.3%) included at least one AAI. Eight different AAIs (avilamycin, bacitracin, chlortetracycline, colistin, enramycin, flavomycin, oxytetracycline, virginamycin) belonging to 5 classes were identified. Brooding feeds contained antimicrobials the most (51.2%), followed by grower (34.6%) and finisher feeds (12.5%). The average amount of AAIs given to flocks per kg of chicken at consumption time was 84.8 (SEM ±9.3mg). Quantitatively, chlortetracycline was consumed most (42.2mg/kg SEM ±0.34; 50.0% of total use), followed by enramycin (18.4mg SEM ±0.03, 21.8%) and bacitracin (16.4mg SEM ±0.20, 19.4%). Antimicrobials in commercial feeds were more commonly given to flocks in the earlier part of the production cycle. A total of 10 (9.3%) products were not compliant with existing Vietnamese regulation (06/2016/TT-BNNPTNT) either because they included a non-authorised AAI (4), had AAIs over the permitted limits (4), or both (2). Conclusions and recommendationSome commercial feed formulations examined included colistin (polymyxin E), a critically important antimicrobial of highest priority for human medicine. A tenth of the formulations examined did not comply with Government regulations. We estimated that consumption of AGPs in feed represented ~10% of total AMU in chicken production. We advocate for restrictions on AMU in chicken production that go beyond phased bans on AGPs. Furthermore, these steps could be bolder and implemented without unnecessary delay. Results from this study should help encourage discussion about policies on AGPs in LMICs.

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Antimicrobial use through consumption of medicated feeds in chicken flocks in the Mekong Delta of Vietnam: A three-year study before a ban on antimicrobial growth promoters

PLoS ONE ◽

10.1371/journal.pone.0250082 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250082

Author(s):

Nguyen Van Cuong ◽

Bach Tuan Kiet ◽

Vo Be Hien ◽

Bao Dinh Truong ◽

Doan Hoang Phu ◽

...

Keyword(s):

Animal Feed ◽

Mekong Delta ◽

Small Scale ◽

Production Cycle ◽

Antimicrobial Use ◽

Growth Promoters ◽

Middle Income ◽

Commercial Feed ◽

Commercial Feeds ◽

Medicated Feeds

Antimicrobials are included in commercial animal feed rations in many low- and middle-income countries (LMICs). We measured antimicrobial use (AMU) in commercial feed products consumed by 338 small-scale chicken flocks in the Mekong Delta of Vietnam, before a gradual nationwide ban on prophylactic use of antimicrobials (including in commercial feeds) to be introduced in the country over the coming five years. We inspected the labels of commercial feeds and calculated amounts of antimicrobial active ingredients (AAIs) given to flocks. We framed these results in the context of overall AMU in chicken production, and highlighted those products that did not comply with Government regulations. Thirty-five of 99 (35.3%) different antimicrobial-containing feed products included at least one AAI. Eight different AAIs (avilamycin, bacitracin, chlortetracycline, colistin, enramycin, flavomycin, oxytetracycline, virginamycin) belonging to five classes were identified. Brooding feeds contained antimicrobials the most (60.0%), followed by grower (40.9%) and finisher feeds (20.0%). Quantitatively, chlortetracycline was consumed most (42.2 mg/kg SEM ±0.34; 50.0% of total use), followed by enramycin (18.4 mg/kg SEM ±0.03, 21.8%), bacitracin (16.4 mg/kg SEM ±0.20, 19.4%) and colistin (6.40 mg/kg SEM ± 4.21;7.6%). Other antimicrobials consumed were virgianamycin, avilamycin, flavomycin and oxytetracycline (each ≤0.50 mg/kg). Antimicrobials in commercial feeds were more commonly given to flocks in the earlier part of the production cycle. A total of 10 (9.3%) products were not compliant with existing Vietnamese regulation (06/2016/TT-BNNPTNT) either because they included a non-authorised AAI (4), had AAIs over the permitted limits (4), or both (2). A number of commercial feed formulations examined included colistin (polymyxin E), a critically important antimicrobial of highest priority for human medicine. These results illustrate the challenges for effective implementation and enforcement of restrictions of antimicrobials in commercial feeds in LMICs. Results from this study should help encourage discussion about policies on medicated feeds in LMICs.

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Older People, Mobility and Transport in Low- and Middle-Income Countries: A Review of the Research

Sustainability ◽

10.3390/su11216157 ◽

2019 ◽

Vol 11 (21) ◽

pp. 6157 ◽

Cited By ~ 4

Author(s):

Mark Gorman ◽

Sion Jones ◽

Jeffrey Turner

Keyword(s):

Older People ◽

Low Income ◽

Well Being ◽

The State ◽

Small Scale ◽

Knowledge Gaps ◽

Middle Income ◽

Middle Income Countries ◽

The Impact ◽

Low And Middle Income

Older populations are rising globally, which in high-income countries has helped to generate a growing literature on the impact of ageing on travel requirements and transport policy. This article aims to provide an initial assessment of the state of knowledge on the impact on transportation policy and usage of the increasing numbers of older people in low- and middle-income countries (LAMICs), through a review of the literature relating to older people and transportation. As both the academic and policy/practice-related literature specifically addressing ageing and transport in LAMICs is limited, the study looks beyond transportation to assess the state of knowledge regarding the ways in which older people’s mobility is affected by issues, such as health, well-being, social (dis)engagement and gender. We find significant knowledge gaps, resulting in an evidence base to support the implementation of policy is lacking. Most research in low-income countries (LICs) is either broad quantitative analysis based on national survey data or small-scale qualitative studies. We conclude that, although study of the differing contexts of ageing in LAMICs as they relate to older people’s mobilities and transport use has barely begun, institutions which both make and influence policymaking recognise the existence of significant knowledge gaps. This should provide the context in which research agendas can be established.

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Awareness and utilization of personal protective equipment among small-scale welders in Cross River State, Nigeria: a descriptive cross-sectional study

Babcock University Medical Journal (BUMJ) ◽

10.38029/bumj.v4i1.56 ◽

2021 ◽

Vol 4 (1) ◽

pp. 1-7

Author(s):

Ekpereonne Esu ◽

Utibeabasi Ekanem

Keyword(s):

Personal Protective Equipment ◽

Small Scale ◽

Protective Equipment ◽

Cross Sectional ◽

Rapid Urbanization ◽

Middle Income ◽

Cross River ◽

Cross River State ◽

Middle Income Countries ◽

Low And Middle Income

Objective: Rapid urbanization and industrialization in the many low- and middle-income countries means that there is a growing demand for the welding industry. Previous studies in Nigeria, and other low- and middle-income countries have reported a significant discrepancy between awareness and consistent and appropriate use of personal protective equipment (PPE). This study assessed the awareness and utilization of PPE among small-scale welders in Calabar South, Cross River State, Nigeria. Methods: This study was conducted in Calabar South Local Government Area using a descriptive cross-sectional design. Data collection was with an interviewer-administered semi-structured questionnaire, and an observation checklist was used to monitor the use of PPE among small-scale welders. Results: One hundred and sixteen small-scale welders were surveyed with a mean age of 34.9 ±9.1 years. Almost 90% of respondents had completed at least primary education. Eighty-one respondents (69.8%) were aware of PPE. Three-quarters of respondents (61/81) knew PPE protected the user from injury. The most frequently identified type of welding PPE among the respondents aware of PPE, were safety goggles (38.3%), hand gloves (25.9%), safety boots (19.8%), and coveralls (9.9%). 83.6% had access to PPE at work. However, only 14.4% reported using PPE consistently. Observation revealed that the PPE most frequently used, sunglasses, were not the recommended welding goggles. Conclusion: The low utilization of PPE calls for stricter enforcement of occupational health and safety regulations among welders in the informal sector, including implementing PPE awareness programs.

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Small-scale commercial chicken production: A risky business for farmers in the Mekong Delta of Vietnam

10.1101/2020.11.02.364281 ◽

2020 ◽

Author(s):

Truong Dinh Bao ◽

Nguyen Van Cuong ◽

Hoang Doan Phu ◽

Nguyen Thi Thuy Dung ◽

Bach Tuan Kiet ◽

...

Keyword(s):

Mekong Delta ◽

Rural Livelihoods ◽

Small Scale ◽

Flock Size ◽

Labor Costs ◽

Middle Income ◽

Middle Income Countries ◽

Native Chicken ◽

Limited Experience ◽

Commercial Chicken

ABSTRACTSmall-scale farming of meat chicken flocks using local native breeds contributes to the economy of many rural livelihoods in Vietnam and many other low- and middle-income countries (LMICs). These systems are also the target of high levels of antimicrobial use (AMU); however little is known about the profitability and sustainability of such systems. Since small scale farms are commercial enterprises, this knowledge is essential in order to develop successful strategies aimed at curbing excessive AMU. Using longitudinal data from 203 randomly selected small-scale (100-2,000 chickens) native chicken flocks raised in 102 farms in Dong Thap province (Mekong Delta, Vietnam), we investigated the financial and economic parameters of such systems and the main constraints to their sustainability. Feed accounted for the largest financial cost (flock median 49.5% [Inter-quartile range (IQR) 41.5-61.8%]) of total costs, followed by day-old-chicks (DOCs) (median 30.3% [IQR 23.2-38.4%]), non-antimicrobial health-supporting products (median 7.1% [IQR 4.7-10.5%]), vaccines (median 3.1% [IQR 2.2-4.8%]), equipment (median 1.9% [IQR 0.0-4.9%]) and antimicrobials (median 1.9% [IQR 0.7-3.6%]). Excluding labor costs, farmers achieved a positive return on investment (ROI) from 120 (59.1%) flocks, the remainder generated a loss (median ROI 124% [IQR 36-206%]). Higher ROI was associated with higher flock size and low mortality. There was no statistical association between use of medicated feed and flock mortality or chicken bodyweight. The median daily income per person dedicated to raising chickens was 202,100 VND, lower than alternative rural labour activities in the Mekong Delta. In a large proportion of farms (33.4%), farmers decided to stop raising chickens after completing one cycle. Farmers who dropped off chicken production purchased more expensive feed (in 1,000 VND per kg) (11.1 [10.6-11.5] vs. 10.8 [10.4-11.3] for farms that continued production (p=0.039) and experienced higher chicken mortality (28.5% [12.0-79.0%] vs. 16 [7.5-33.0%] (p=0.004). The turnover of farmers raising chickens in such systems represents a challenge in targeting messages on appropriate AMU and on chicken health. In order to ensure sustainability of small-scale commercial systems, advisory services need to be available as farmer initiate new flocks, and support them in the early stages to help overcome their limited experience and skills. This targeted approach would support profitability whilst reducing risk of emergence of AMR and other disease problems from these systems.

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The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

BMC Cancer ◽

10.1186/s12885-021-08809-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Désirée Schliemann ◽

Kogila Ramanathan ◽

Nicholas Matovu ◽

Ciaran O’Neill ◽

Frank Kee ◽

...

Keyword(s):

Colorectal Cancer ◽

Scoping Review ◽

Small Scale ◽

Screening Methods ◽

Recruitment Strategies ◽

Middle Income ◽

Crc Screening ◽

Middle Income Countries ◽

Screening Cost ◽

Low And Middle Income

Abstract Background Low- and middle-income countries (LMICs) experienced increasing rates of colorectal cancer (CRC) incidence in the last decade and lower 5-year survival rates compared to high-income countries (HICs) where the implementation of screening and treatment services have advanced. This review scoped and mapped the literature regarding the content, implementation and uptake of CRC screening interventions as well as opportunities and challenges for the implementation of CRC screening interventions in LMICs. Methods We systematically followed a five-step scoping review framework to identify and review relevant literature about CRC screening in LMICs, written in the English language before February 2020. We searched Medline, Embase, Web of Science and Google Scholar for studies targeting the general, asymptomatic, at-risk adult population. The TIDieR tool and an implementation checklist were used to extract data from empirical studies; and we extracted data-informed insights from policy reviews and commentaries. Results CRC screening interventions (n = 24 studies) were implemented in nine middle-income countries. Population-based screening programmes (n = 11) as well as small-scale screening interventions (n = 13) utilised various recruitment strategies. Interventions that recruited participants face-to-face (alone or in combination with other recruitment strategies) (10/15), opportunistic clinic-based screening interventions (5/6) and educational interventions combined with screening (3/4), seemed to be the strategies that consistently achieved an uptake of > 65% in LMICs. FOBT/FIT and colonoscopy uptake ranged between 14 and 100%. The most commonly reported implementation indicator was ‘uptake/reach’. There was an absence of detail regarding implementation indicators and there is a need to improve reporting practice in order to disseminate learning about how to implement programmes. Conclusion Opportunities and challenges for the implementation of CRC screening programmes were related to the reporting of CRC cases and screening, cost-effective screening methods, knowledge about CRC and screening, staff resources and training, infrastructure of the health care system, financial resources, public health campaigns, policy commitment from governments, patient navigation, planning of screening programmes and quality assurance.

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Reducing Antimicrobial Usage in Small-Scale Chicken Farms in Vietnam: A 3-Year Intervention Study

Frontiers in Veterinary Science ◽

10.3389/fvets.2020.612993 ◽

2021 ◽

Vol 7 ◽

Author(s):

Doan Hoang Phu ◽

Nguyen Van Cuong ◽

Dinh Bao Truong ◽

Bach Tuan Kiet ◽

Vo Be Hien ◽

...

Keyword(s):

Intervention Study ◽

Production Systems ◽

Mekong Delta ◽

Farming Systems ◽

Small Scale ◽

Scale Production ◽

Middle Income ◽

Intervention Phase ◽

Middle Income Countries ◽

Before And After

Indiscriminate antimicrobial use (AMU) in animal production is a driver of antimicrobial resistance globally. There is a need to define sustainable interventions to reduce AMU in small-scale production systems, which currently represent the most widespread farming systems in South East Asia and many low- and middle-income countries. We conducted a before-and-after intervention study on a random sample of small-scale chicken farms in the Mekong Delta of Vietnam from 2016 to 2019. The study included a baseline followed by an intervention phase where farmers were provided with regular veterinary advice on flock health and husbandry, as well as antimicrobial replacement products. Of 102 recruited farms (raising >100 chickens per flock cycle), thirty-five (34.2%) entered the intervention phase, whilst the rest stopped raising chickens, mainly due to suboptimal flock performance. Through the implementation of our intervention, chicken flocks reduced levels of AMU by 66% [adjusted hazard ratio (HR) = 0.34; p = 0.002) from a baseline of 343.4 Animal Daily Doses per 1,000 chicken-days and decreased weekly mortality by 40% (adjusted HR = 0.60; p = 0.005) from a baseline mortality of 1.60 per 100 birds. Chicken bodyweight increased by 100 g (p = 0.002) in intervention flocks. Our findings demonstrate that the provision of veterinary advice can achieve substantial reductions in AMU in small-scale production systems without compromising flock health and productivity.

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Promoting Food Safety in Local Value Chains: The Case of Vegetables in Vietnam

Sustainability ◽

10.3390/su13126902 ◽

2021 ◽

Vol 13 (12) ◽

pp. 6902

Author(s):

Laura Enthoven ◽

Goedele Van den Broeck

Keyword(s):

Food Safety ◽

Third Party ◽

Value Chains ◽

Small Scale ◽

Local Market ◽

Control Mechanisms ◽

Middle Income ◽

Safety Issues ◽

Middle Income Countries ◽

Low And Middle Income

Background: Food quality and safety concerns in low- and middle-income countries are often addressed using stringent standards and formal contracts between farmers and buyers. Many studies have investigated the welfare implications of these control mechanisms for small-scale farmers in modern value chains, including exports and supermarkets. Conversely, few studies have focused on the potential of certification and contracts to tackle food safety issues within local traditional value chains. Methods: This study uses a discrete choice experiment to explore the preferences of vegetable farmers (n = 301) in northern Vietnam for different types of certification schemes–including third-party certification and participatory guarantee systems–and contracts. Results: Farmers are willing to accept a 49% lower price per kilogram for their vegetables to enter into a contract with a buyer, provided that pesticide use restrictions are feasible and the buyer is fully committed and trustworthy. However, they are strongly averse to organic farming, as they would require a 40% premium per kilogram to produce organically. They would also request a 21% premium to accept selling to an unknown buyer. Farmers highly value contracts that entail large purchase quantities, long duration and pesticide provision. Although the estimated willingness-to-accept values may seem very large, they make sense in the context of highly perishable produce. Conclusion: Our findings urge both policy makers and researchers to not only focus on modern value chains but also on local traditional value chains to tackle food safety issues in low- and middle-income countries, as we show that farmers are willing to produce safe vegetables for the local market when trading with buyers under beneficial conditions.

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A Systematic Framework for Collecting Site-Specific Sampling and Survey Data to Support Analyses of Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094676 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4676

Author(s):

Katherine von Stackelberg ◽

Pamela R.D. Williams ◽

Ernesto Sánchez-Triana

Keyword(s):

Health Outcomes ◽

Health Impact ◽

Adverse Outcomes ◽

Health Impacts ◽

Small Scale ◽

Economic Activities ◽

Middle Income ◽

Middle Income Countries ◽

Populations At Risk ◽

Low And Middle Income

The rise of small-scale and localized economic activities in low- and middle-income countries (LMICs) has led to increased exposures to contaminants associated with these processes and the potential for resulting adverse health effects in exposed communities. Risk assessment is the process of building models to predict the probability of adverse outcomes based on concentration-response functions and exposure scenarios for individual contaminants, while epidemiology uses statistical methods to explore associations between potential exposures and observed health outcomes. Neither approach by itself is practical or sufficient for evaluating the magnitude of exposures and health impacts associated with land-based pollution in LMICs. Here we propose a more pragmatic framework for designing representative studies, including uniform sampling guidelines and household surveys, that draws from both methodologies to better support community health impact analyses associated with land-based pollution sources in LMICs. Our primary goal is to explicitly link environmental contamination from land-based pollution associated with specific localized economic activities to community exposures and health outcomes at the household level. The proposed framework was applied to the following three types of industries that are now widespread in many LMICs: artisanal scale gold mining (ASGM), used lead-acid battery recycling (ULAB), and small tanning facilities. For each activity, we develop a generalized conceptual site model (CSM) that describes qualitative linkages from chemical releases or discharges, environmental fate and transport mechanisms, exposure pathways and routes, populations at risk, and health outcomes. This upfront information, which is often overlooked, is essential for delineating the contaminant zone of influence in a community and identifying relevant households for study. We also recommend cost-effective methods for use in LMICs related to environmental sampling, biological monitoring, survey questionnaires, and health outcome measurements at contaminated and unexposed reference sites. Future study designs based on this framework will facilitate consistent, comparable, and standardized community exposure, risk, and health impact assessments for land-based pollution in LMICs. The results of these studies can also support economic burden analyses and risk management decision-making around site cleanup, risk mitigation, and public health education.

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Closed-Loop Biodigesters on Small-Scale Farms in Low- and Middle-Income Countries: A Review

Water ◽

10.3390/w13192744 ◽

2021 ◽

Vol 13 (19) ◽

pp. 2744

Author(s):

Isha Kulkarni ◽

Joachim Werner Zang ◽

Wilson M. Leandro ◽

Priti Parikh ◽

Ilan Adler ◽

...

Keyword(s):

Case Studies ◽

Closed Loop ◽

Low Cost ◽

Future Research ◽

Sociocultural Factors ◽

Small Scale ◽

Middle Income ◽

Farming Communities ◽

Middle Income Countries ◽

Low And Middle Income

Anaerobic digestion (AD) systems are prominent in low- and middle-income countries (LMICs), although their implementation within organic farms to enhance resource efficiency and “close the loop” has been limited. This paper thus reviewed existing literature on the potential of AD technologies as part of closed-loop rural family farming communities in LMICs. Data from eleven existing case studies matching this criterion was then collated to understand practical considerations of implementing and maintaining viable AD systems for small farmers. The case studies analyzed indicate that most, if not all, of the biogas produced in the AD process is used for household purposes such as cooking, lighting and heating. The AD systems are either based on the fixed biogas dome or the floating drum design, although the tubular flexible balloon model is mentioned as a low-cost alternative. Future research opportunities in this topic include studying the applicability of recommendations offered across different geographies, consideration of long-term sustainability and impact of biodigester technology, and sociocultural factors such as community ownership and indigenous practices.

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