QUALITATIVE COMPARISON OF FACTORS INVOLVED IN SPREAD OF ANTIMICROBIAL RESISTANCE BETWEEN PAKISTAN AND ITALY WITH FOCUS ON KNOWLEDGE, ATTITUDE, AND PERCEPTION OF MILK CONSUMERS AND DAIRY BREEDERS.

The research involved three different studies. The first study aimed to address the difference in knowledge, attitude, and perception (KAP) of Italian and Pakistani milk consumers towards antimicrobial resistance (AMR) and the possibility of antibiotic residues presence in milk under the maximum acceptable limits established by the respective country laws. A questionnaire was developed in English, then translated into Urdu and Italian languages and finally distributed among people using social media. The collected data was analyzed using Principal Component Analysis and Cluster Analysis based on milk purchasing and buying habits. The results demonstrated that Italian consumers were more attentive to milk quality attributes, had relatively more awareness of AMR and possibility of antibiotic residues presence in milk, and showed more concerns over the presence of antibiotics in milk. Pakistani milk consumers were more influenced by their buying habits, had lesser awareness of AMR, possibility of antibiotic residues in milk, and showed lesser concerns over the presence of antibiotic residues in milk. The differences among the two sets of populations were due to socioeconomic and sociodemographic factors. Italian milk consumers were more aware towards government responsibility and the authority role in AMR control and management. On the other hand, the lack of education seemed to be the major factor in the lack of awareness of AMR among Pakistani milk consumers. The second study explored the KAP of dairy farmers in Pakistan. The questionnaire developed in English language was translated into the local language of Urdu and disseminated among the dairy farmers in Pakistan. The collected responses were analyzed using Chi-Square and bivariate correlation statistical analysis techniques. The results demonstrated that there is poor understanding and awareness of AMR, antibiotic residues in milk, and showed poor concerns over the presence of antibiotic residues in milk among Pakistani dairy breeders/farmers. However, a significant number of dairy farmers were willing to reduce the antibiotic consumption on farms. The most prevalent health disorders on farms were mastitis and metabolic health disorders. Education and negligence of responsible authorities were found to be the key factors for poor AMR and health conditions on the farms. The third study aimed to find the sensitivity/resistivity of common antibiotics used both in dairy livestock with milk as a possible vector of spreading AMR in Pakistan. The data was collected from one of the busiest Civil Veterinary Hospitals, District Livestock and Veterinary Diagnostic laboratories, milk collection plant and human diagnostic laboratories. The data was collected to check the antibiotics used in mastitis, the results of sensitivity/ resistivity of antibiotics used in mastitis treatment, presence of antibiotics and their residues in milk, and sensitivity/resistivity of antibiotics used in human population during the year 2021-22. After analyzing the collected data using Chi Square and bivariate correlation statistical tests, it was found that the beta-lactams are the most used antibiotics in mastitis treatment, showed most resistivity in mastitis infections, were most detected in milk collected and were also most resistant in human population. The results indicate that AMR is being transferred through milk in the dairy chain in Pakistan.