INTRODUCTION

In Togo, cattle farming plays a strategic socioeconomic role by providing draught power, organic fertilizer, a source of savings, and contributing to food security. However, this sector faces several major animal health threats, both zoonotic and non-zoonotic. African animal trypanosomiasis, for example, remains one of the principal constraints to cattle production [1], with prevalence reaching 37.64% in some areas such as the Mo Plain [2]. Bovine brucellosis has also been reported in the Savannah region [3]. To manage the various diseases affecting cattle, farmers frequently rely on veterinary drugs, particularly antibiotics, often without professional veterinary guidance. Such practices contribute to inappropriate antibiotic use, favor the emergence and spread of resistant bacteria, and increase antimicrobial residues in animal-derived products, thereby posing a significant threat to animal and public health [4–6].

Across Africa, recent reviews and field surveys in the cattle sector have documented low levels of awareness and inadequate practices regarding antibiotic use and resistance [7]. Surveys conducted among cattle farmers in sub-Saharan Africa have reported widespread self-medication, acquisition of antibiotics from unregulated markets, and purchase of veterinary drugs without prescriptions [8]. The predominance of tetracyclines has consistently been documented in cattle production systems [6, 8–11]. In Togo, antimicrobial resistance (AMR) has emerged as an important public health concern. Previous studies have reported antibiotic-resistant bacteria and antimicrobial residues in foods of animal origin at concerning levels [12–16]. Consequently, Togo has adopted a national action plan to combat AMR [17], in accordance with the Global Action Plan on AMR [18].

Several studies investigating knowledge, attitudes, and practices (KAP) related to AMR have been conducted among livestock farmers in Ethiopia, Rwanda, Kenya, and Ghana. In Togo, previous investigations have focused mainly on poultry farmers, pig producers, and animal health professionals [11, 19–21]. However, no published study has specifically evaluated the KAP of cattle farmers regarding antimicrobial use and AMR. This gap is particularly important considering the socioeconomic significance of cattle production and the country’s strategic position along major regional transhumance corridors. Moreover, the Maritime region, characterized by a relatively high density of veterinary pharmacies and increasing land pressure, and the Savannah region, which serves as an important pastoral area with frequent cross-border livestock movements, represent contrasting livestock production contexts that may influence farmers’ perceptions and behaviors regarding antimicrobial use.

Despite growing recognition of AMR as a major One Health challenge, information on cattle farmers’ KAP regarding antimicrobial use and AMR remains scarce in Togo. Existing studies have largely focused on other livestock sectors, such as poultry and pigs, or veterinary professionals, leaving a substantial knowledge gap concerning cattle production systems. Furthermore, comparative evidence evaluating how different ecological, pastoral, and veterinary service contexts affect farmers’ behaviors is lacking. In particular, no previous study has simultaneously assessed and compared cattle farmers from the Maritime and Savannah regions, which differ markedly in livestock management systems, access to veterinary services, and patterns of animal movement. This lack of evidence hampers the development of targeted interventions and evidence-based policies to promote prudent antimicrobial use and mitigate AMR in the cattle sector.

Therefore, this study aimed to comprehensively assess the KAP of cattle farmers regarding antimicrobial use and AMR in the Maritime and Savannah regions of Togo. Specifically, the study evaluated farmers’ understanding of antimicrobials and AMR, examined their attitudes and decision-making processes regarding antibiotic use, and characterized their practices, including self-medication, sources of drug procurement, adherence to treatment durations, and observance of withdrawal periods. In addition, the study identified the antibiotics most commonly used in cattle production, the therapeutic failures perceived by farmers, and the sociodemographic and professional factors associated with variations in knowledge and practices. Ultimately, these findings provide evidence to support policy formulation, awareness campaigns, training programs, and effective interventions to promote prudent antimicrobial use and combat AMR in cattle production systems in Togo.

MATERIALS AND METHODS

Ethical approval

This study involved the voluntary participation of cattle farmers. Therefore, formal approval from an institutional ethics committee was not required. Before each interview, the study’s objectives and significance were clearly explained to all participants, and verbal informed consent was obtained. Respondents were informed that participation was entirely voluntary and that they could withdraw from the study at any stage by discontinuing the interview or declining to answer specific questions. To ensure confidentiality and privacy, no personally identifiable information was disclosed, and all responses were anonymized during data processing and analysis.

Study period and location

The study was conducted between July 22 and September 11, 2025, in the Maritime and Savannah regions of Togo (Figure 1). These two regions were selected because they represent contrasting cattle production environments and veterinary service accessibility. The Savannah region, located in northern Togo, occupies a strategic position along the transhumance and livestock trade routes connecting northern Ghana, south-eastern Burkina Faso, and northern Benin. It is one of the country's major cattle-producing areas, where livestock farming holds an important socioeconomic position.

In contrast, the Maritime region is situated in southern Togo and borders the Atlantic Ocean. The region is characterized by a subequatorial climate with two rainy seasons and two dry seasons. Its landscape consists mainly of coastal plains, lagoons, and marshy areas and is strongly influenced by urbanization, particularly around Lomé. Although agriculture in this region is diversified and includes cassava, maize, sweet potatoes, and vegetable crops, cattle production is less developed due to land pressure, limited grazing resources, and urban expansion. Nevertheless, most veterinary pharmacies in Togo are concentrated in the Maritime region.

Study design

A cross-sectional survey was conducted among cattle farmers in the Maritime and Savannah regions to evaluate their KAP regarding antimicrobial use and AMR. The study employed a stratified random sampling approach to ensure adequate representation of cattle production systems in both regions. Site selection was performed under the supervision of veterinary post officers and Fulani community leaders to optimize accessibility and representativeness while minimizing selection bias under prevailing security constraints.

Sample size determination and sampling procedure

The sample size was calculated using Cochran's formula for an infinite population:

n₀ = (z² × p × [1 − p])/E² [22]

where z = 1.96 (95% CI), p = 0.5 to maximize sample size, and E = 0.10 (10% margin of error).

Accordingly,

n₀ = (1.96² × 0.5 × 0.5)/0.10²

= (3.8416 × 0.25)/0.01

= 96.04 ≈ 96.

The finite population correction formula was subsequently applied:

n = n₀/[1 + (n₀/N)].

For the Savannah region (N = 34,962), the calculated sample size was 96, which increased to 106 after incorporating a 10% allowance for non-response. For the Maritime region (N = 1,433), the corrected sample size was approximately 90, increasing to 99 after applying the same non-response adjustment.

Through the active involvement of veterinary post officers and Fulani community leaders, participation rates reached 100% (99/99) in the Maritime region and 91.5% (97/106) in the Savannah region. The slightly lower participation rate in the Savannah region was attributable to herd mobility and the security situation prevailing during the survey period. No respondents refused to participate.

Although KAP surveys are commonly designed with a 5% margin of error, a margin of error of up to 10% is considered acceptable for exploratory studies and hard-to-reach populations. Therefore, a 10% margin of error was adopted in the present study to maintain feasibility while ensuring consistency with the objectives of the investigation.

Data collection

A systematic review of the literature was conducted to guide the development of the questionnaire. The questionnaire comprised both closed-ended and open-ended questions covering farm characteristics, herd size, health management practices, sociodemographic characteristics of farmers, antibiotic use for disease prevention and treatment, sources of antibiotic procurement, attitudes toward antimicrobial use, and practices related to AMR.

The questionnaire was prepared in French and implemented using KoBoToolbox (Harvard Humanitarian Initiative, Cambridge, MA, USA), with geospatial coordinates recorded for each farm, thereby enabling spatial mapping of practices. The instrument was pilot-tested on a small number of farmers, and ambiguities identified by respondents were addressed through iterative modifications to improve clarity.

Interviews were conducted face-to-face, and local languages were used whenever communication difficulties arose with French. Trained investigators recorded responses directly into the KoBoToolbox platform while simultaneously documenting the geospatial coordinates of each farm.

Data collection sites were selected using a stratified random design under the guidance of veterinary post officers and Fulani community leaders. Verification of antibiotic stocks and veterinary drug packaging was performed to validate information provided by farmers. Eligibility criteria included: (i) ownership or management of a cattle farm with at least 10 cattle, (ii) operation of the farm for at least 1 year, and (iii) residence within the targeted study regions.

The combined use of National Agriculture Census data and local knowledge from veterinary officers and Fulani leaders enhanced the spatial representativeness of the sample while reducing potential selection bias. Nevertheless, Kpendjal and Kpendjal-Ouest prefectures could not be visited because of security instability and the displacement of herds toward safer localities during the study period.

Statistical analysis

The raw data were cleaned to eliminate inconsistencies before analysis. Data extracted from KoBoToolbox were transferred to Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Qualitative variables were summarized using absolute and relative frequencies, and the frequencies reported corresponded to the number of respondents for each question. The 95% CI values were calculated using the normal approximation method (Z = 1.96).

Information obtained from open-ended questions about veterinary medicinal products was standardized, and trade names were matched to their corresponding active substances and pharmacological classes based on the published literature [23]. The reported frequencies indicated the number of respondents who cited at least one product in a specific antibiotic class.

Descriptive and bivariate analyses using the Chi-square test were performed using IBM SPSS Statistics version 26 (IBM Corporation, Armonk, NY, USA). Statistical significance was established at p < 0.05. The dependent variables were knowledge level (binary) and practice level (binary), whereas independent variables included region, educational level, farm size, type of production system, and experience in cattle farming.

Farmers' knowledge was evaluated using a composite score based on seven variables (Table 3). Each correct answer received a score of 1, whereas incorrect, incomplete, and "do not know" responses received a score of 0. A total score ≥4 was considered indicative of good knowledge, whereas lower scores were classified as insufficient knowledge.

Similarly, practices were evaluated using nine variables (Table 4). A score ≥5 was considered indicative of satisfactory practices, whereas lower scores were categorized as unsatisfactory practices.

RESULTS

Characteristics of cattle holdings

All 196 farmers surveyed were male (100%), and the majority had no formal education (130/196; 66%). Livestock farming was the main activity for almost half of the farm owners (48%), followed by agriculture (31%) (Table 2). Only 11% of farm managers had received training in cattle farming, including 7.7% with basic training, 2.6% with diploma-level training, and 0.5% with certification training (Figure 2). The majority (81%) of the farms were sedentary, and 69% had existed for more than 10 years. Farms were generally small (fewer than 50 cattle), and only 3% of farms were considered large farms, that is, those with more than 200 cattle (Table 2). The surveyed farming units mainly operated under a sedentary extensive production system (80.93%), with mixed systems combining beef and dairy cattle production being predominant. The breed composition of the herds mainly consisted of local breeds (40.81%) and crossbred animals (58.16%).

Other occupations included civil servants (ministers, teachers, physicians, etc.) and self-employed individuals (traders, geometers, etc.). CI = Confidence interval.

Farmers' knowledge regarding AMR

Of the 196 farmers surveyed, 91.8% did not know how to define an antimicrobial and 87.2% did not know the definition of an antibiotic. Only 8.7% were able to distinguish these two concepts correctly. However, more than half of the respondents (57.7%) were able to name at least two antibiotics without confusing them with other antimicrobials (Table 3). Notably, the AMR awareness rate of 9.7% is among the lowest documented in recent cattle KAP studies in sub-Saharan Africa.

^Note AMR = Antimicrobial resistance.

Farmers' aptitudes and practices regarding AMR

The survey revealed that almost half of cattle farmers (45.4%) sourced veterinary medicines from local markets. The majority had neither a prophylaxis program (95.9%) nor a health record (92.9%). The parenteral route was the most commonly used mode of administration (90.7%), compared with the oral route (63.7%). Regarding treatment duration, 53.6% of farmers stopped treatment when the animals recovered, 38.8% stopped treatment as soon as the cattle's health status improved, and only 7.7% adhered to the recommended duration. The concept of a withdrawal period was unknown to 83.7% of farmers. Among the 16.3% who were aware of it, 2.0% reported not adhering to it. The use of laboratory analyses remained marginal (2.5%), with the principal reasons being a lack of knowledge about laboratory analyses (90.3%) and the distance to diagnostic facilities (7.6%). More than half of the farmers (59.7%) reported treatment failures following antibiotic administration. Faced with these failures, 67.4% changed antibiotics and 53.1% sought assistance from an animal health specialist (Table 4).

The management of animal by-products was mainly based on agricultural practices, with 83.16% of farmers reporting the use of livestock manure for crop production and market gardening. In contrast, carcass management remains a concern: 44.38% of respondents (87/196) reported consuming animal carcasses, whereas 18.36% indicated disposing of them by abandoning them in the natural environment.

Most farmers reported caring for their animals themselves (87/196; 44.4%; 95% CI: 37.6–51.4) and self-supplying antibiotics (85/196; 43.4%; 95% CI: 36.6–50.4). These farmers indicated that they selected antibiotics based on their previous experience with the product, the suspected disease, or advice from another farmer. Private veterinarians were less frequently cited (34.2%) as directly responsible for animal care but were the main prescribers of antibiotics (45.4%). Private technicians were cited at similar frequencies (32.1% for animal care and 29.6% for prescription). Public officers were less represented (18.4% for animal care and 14.3% for prescription). Other categories (farm owners, community animal health workers, and other farmers) remained marginally involved, with frequencies below 10% for animal care (Figure 3). A Chi-square test revealed a statistically significant association between the animal health supervisor and the antibiotic prescriber (χ² = 15.08; degrees of freedom = 6; p = 0.020).

Antibiotic classes used in cattle farms

Among the respondents considered for this question (n = 186), the main antibiotic classes cited were tetracyclines (66.13%), penicillins (39.78%), macrolides (37.10%), and aminoglycosides (17.20%) (Table 5).

Recurrent diseases reported by farmers

The survey results revealed an epidemiological profile dominated by infectious and parasitic diseases. Foot-and-mouth disease (FMD) was the most frequently reported disease, affecting 48.47% of respondents (95% CI: 7.2%). It was followed by Contagious Bovine Pleuropneumonia (CBPP), with 37.24% (95% CI: 6.9%), bovine tuberculosis (25.00%; 95% CI: 6.2%), as well as respiratory disorders and trypanosomiasis, each mentioned by 21.94% of respondents (95% CI: 5.9%) (Figure 4).

Vaccination practices

The survey results indicated that CBPP was the disease most frequently targeted by vaccination, with 97.50% (95% CI: 2.79%) of farmers reporting vaccination against this disease. This was followed by anthrax, reported by 41.67% (95% CI: 8.82%) of respondents, and FMD, cited by only 20.83% (95% CI: 7.27%) despite its high prevalence. Pasteurellosis and Rift Valley fever were rarely targeted by farmers during vaccination campaigns, accounting for 3.33% and 0.83% of responses, respectively (Figure 5).

Purpose of antibiotic use

Among the farmers surveyed, 91.33% reported using antibiotics for presumptive curative treatment. Antibiotic use in cases of high mortality was reported by 27.04% of respondents, whereas 25.00% used antibiotics for both disease prevention and treatment. Strictly preventive use was reported by 21.43%, and 12.24% mentioned using antibiotics to promote animal growth (Table 6).

Reported treatment failures

Among the antibiotics reported by the surveyed farmers to have resulted in treatment failures, oxytetracycline ranked first, being cited by 47 respondents (23.98%; 95% CI: 17.8–30.1). It was followed by tylosin, reported by 23 respondents (11.73%; 95% CI: 7.1–17.7), and penicillin, reported by 16 respondents (8.16%; 95% CI: 4.7–13.6). Finally, gentamicin was mentioned only at very low frequencies (Table 7).

Factors associated with knowledge and practices

The level of satisfactory knowledge among cattle producers (Table 8) showed significant differences across several sociodemographic and structural variables. Knowledge level varied significantly between regions (p = 0.001), with livestock farmers in the Savannah region showing a significantly higher level of satisfactory knowledge (17.5%) than those in the Maritime region (2.0%), a finding warranting further analysis of the pastoral systems involved.

The manager's level of education also significantly influenced knowledge level (p < 0.001); educated farmers (middle school, high school, or university) had better knowledge than uneducated farmers (3.8%). Farm age also had a significant effect (p = 0.039), with farms older than 10 years showing a higher level of satisfactory knowledge (13.2%) than newer farms. Similarly, farm size influenced knowledge level (p = 0.015); farmers with herds of fewer than 50 cattle appeared to be better informed (16.1%) than those with larger herds. In contrast, neither the type of production system (nomadic, semi-sedentary, or sedentary) nor training in cattle farming showed a statistically significant association with knowledge level (p > 0.05).

The levels of satisfactory aptitudes and practices among cattle farmers (Table 9) showed significant variation across certain socioeconomic and structural characteristics. Region significantly influenced aptitudes and practices (p = 0.029); farmers in the Savannah region exhibited higher levels of satisfactory practices (34.0%) than those in the Maritime region (20.2%). The manager's level of education was also a determining factor (p = 0.024), with farmers who had reached high school (71.4%) or university level (50.0%) demonstrating better aptitudes and practices than uneducated farmers (24.2%).

Similarly, the type of production system significantly influenced these parameters (p = 0.040), with semi-sedentary farmers exhibiting better practices (41.4%) than sedentary farmers (25.9%). Training in cattle farming appeared to be an important factor (p = 0.012), as farmers who had received specific training showed a much higher level of satisfactory practices (52.9%) than those without training (24.6%). In contrast, neither farm age (p = 0.090) nor herd size (p = 0.373) showed a significant association with aptitudes and practices.

DISCUSSION

Characteristics of cattle holdings

The present study showed a marked male predominance among respondents, reflecting the traditional sociocultural structure of cattle farming in Togo and the surrounding subregion, where the activity is still predominantly practiced by men. This finding is consistent with reports from Nigeria [4], Ethiopia [24], and Cameroon [25], where more than 90% of surveyed pastoralists were male. Women, when involved in livestock production, are generally engaged in secondary management activities, such as basic animal care and feeding, or are more active in small-ruminant and poultry production systems [26].

KAP regarding AMR

This study provides the first in-depth assessment of AMR-related KAP among cattle farmers in Togo, thereby filling an important knowledge gap in a country where previous studies have primarily focused on poultry, pigs, and human health actors. The assessment of farmers' knowledge revealed a generally low level of awareness of key concepts related to antimicrobials and their use. Only 8.2% of respondents correctly defined the term "antimicrobial," whereas 12.8% correctly defined "antibiotic." Similarly, only 8.7% reported knowing the difference between these two concepts. In contrast, a relatively higher proportion of farmers (57.7%) cited at least two antibiotics, reflecting a degree of familiarity with products commonly used in cattle farming. These findings are consistent with numerous studies conducted in sub-Saharan Africa that have documented limited awareness among livestock farmers of the challenges associated with antibiotic use and AMR. Recent reviews and surveys have similarly reported low levels of knowledge and poor practices contributing to AMR across Africa [7]. In East and West Africa, surveys investigating antibiotic use among livestock producers have described similar behaviors, including self-medication, frequent use of oxytetracyclines, and procurement of antibiotics from unregulated markets or pharmacies without prescriptions [8].

The results of our survey revealed critical deficiencies in the attitudes and practices of cattle farmers in Togo, exposing them to an increased risk of AMR. These observations are consistent with findings from recent studies conducted in West Africa and highlight the regional dimensions of this issue. The finding that 59.7% of farmers reported treatment failures after antibiotic use is consistent with the widespread irrational use of antibiotics in the region. These therapeutic failures may be attributable to poor practices, particularly premature discontinuation of treatment after clinical improvement (53.6% of farmers), underdosing or overdosing, and self-medication without a precise diagnosis. In addition, the quality of veterinary products cannot be excluded as a possible cause of treatment failure. Counterfeit and substandard veterinary medicines have been documented in informal markets in West Africa and Togo [19, 21]. In the present study, 45.4% of farmers obtained antibiotics from local markets, creating a context associated with a high risk of poor product quality. Inadequate storage conditions, including exposure to heat and humidity, may compromise antibiotic efficacy, particularly that of tetracyclines, which are susceptible to thermal degradation. Tetracycline resistance is widely documented in livestock systems in sub-Saharan Africa and represents a plausible explanation for treatment failures regardless of individual management practices [11, 27–30]. Furthermore, the lack of diagnostic confirmation before treatment may lead to inappropriate antibiotic use or antibiotic administration for non-bacterial diseases, including viral and parasitic infections, thereby resulting in apparent therapeutic failures.

The low level of awareness regarding AMR observed in this study, particularly the lack of knowledge concerning withdrawal periods among 83.7% of respondents, represents a recurrent issue in West Africa. For example, in central Burkina Faso, 82% of pastoralists were reported to be unaware of the health risks associated with antibiotic residues in manure [31]. Similarly, among mobile pastoralists in Nigeria, awareness regarding antimicrobial use and AMR was generally poor, with 90.3% reporting inadequate adherence to withdrawal periods and 96.0% administering antibiotics without expert consultation [32]. Collectively, these findings suggest that awareness campaigns have not yet reached a substantial proportion of pastoral communities in the subregion. These observations are particularly concerning in light of the well-established role of inadequate withdrawal periods in the selection and dissemination of AMR [33]. Furthermore, the consumption of animal carcasses (44.38%) and their disposal in the environment (18.36%) documented in this study may contribute to the environmental dissemination of resistant microorganisms and further exacerbate AMR in West Africa.

The epidemiological profile observed in this study, characterized by the predominance of infectious and parasitic diseases, may be partly explained by the survey's timing, which was conducted during the rainy season (July–September 2025). This period is associated with elevated infectious and parasitic pressures in Togo; therefore, the reported diseases and the practices reported by farmers may reflect seasonal dynamics.

The predominant use of tetracyclines, followed by penicillins and macrolides, observed in the present study has also been reported in cattle production systems elsewhere in Africa [6, 8, 9, 34]. This pattern likely reflects the commercial availability of these molecules, their relatively low cost, and their long-standing use in veterinary medicine in rural areas. The observation that oxytetracycline was the molecule most frequently associated with therapeutic failures is consistent with other field reports in which livestock owners and veterinarians perceived a decline in tetracycline efficacy. However, these therapeutic failures may also be attributable to several inappropriate practices, particularly procurement from local markets, inadequate diagnosis, improper storage conditions, and poor compliance with dosage recommendations.

Although CBPP was the disease most frequently targeted by vaccination (97.5%), overall vaccination coverage for other important diseases, such as FMD (20.8%) and anthrax (41.7%), remained low. These findings differ from those reported by Hirwa in Rwanda, where most participants reported vaccination against lumpy skin disease (33%), followed by Rift Valley fever (24%) and FMD (15%) [35]. The prioritization of CBPP vaccination by nearly all farmers (97.5%), despite the high frequency of FMD, may be explained by the more frequent CBPP vaccination campaigns compared with those for other diseases. This vaccination deficit reflects both irregular access to public veterinary services and a misconception among farmers, who often consider vaccination to be secondary to curative treatment [24]. Furthermore, the almost universal absence of prophylaxis programs (95.9%) and health records (92.8%) highlights weaknesses in treatment traceability and the limited integration of good health management practices into cattle production systems in Togo.

This insufficient vaccination coverage contributes to the recurrence of diseases on farms, particularly FMD (48.5%), CBPP (37.2%), and bovine tuberculosis (25%). These highly morbid diseases represent major drivers of antibiotic use in extensive livestock systems. Similar trends have been documented in Togo and elsewhere in West Africa, including Mali and Ghana, where CBPP and respiratory diseases constitute major reasons for antibiotic administration in cattle [9, 36]. These findings reflect the persistence of endemic transboundary diseases that are inadequately controlled by vaccination programs, thereby promoting the empirical and repeated use of antibiotics by livestock farmers.

The patterns of antibiotic access and therapeutic decisions observed in the present study, particularly self-prescription, acquisition of antibiotics from local markets, limited use of laboratory analyses, inadequate adherence to treatment duration, and poor knowledge regarding withdrawal periods, are recognized factors contributing to the selection and dissemination of AMR. Comparable surveys have shown that insufficient regulatory control, easy access to antibiotics, and the cost of diagnostic procedures contribute to these practices across the region [37]. The potential consequences are twofold: (i) an increased risk of emergence and spread of resistant strains within farms, with possible repercussions for human health through the food chain and human-animal interactions; and (ii) increased exposure to antibiotic residues in meat and milk. These concerns have been emphasized by regional reviews and analyses on antibiotic use in livestock production in Africa [37].

The study also revealed that 44.4% of farmers personally managed their animals’ health, whereas 43.4% personally prescribed antibiotics. Private veterinarians (34.2%) and technicians (32.1%) were consulted only occasionally. This profile is characteristic of a poorly structured veterinary system in which self-medication predominates [6]. Similar proportions have been reported in Nigeria [4] and Kenya [5], where more than 60% of farmers purchase and administer antibiotics without veterinary consultation. This behavior is facilitated by unrestricted access to veterinary medicines and by the perception of empirical competence acquired through experience [38]. The statistically significant association observed between the animal health manager and the antibiotic prescriber (χ² = 15.08; p = 0.020) indicates that health management practices are closely linked to self-medication behaviors.

Most farmers (90.7%) administered antibiotics parenterally, followed by oral administration (63.7%). This predominance may be associated with the presentation of commonly used antibiotics, which are often packaged in 50 mL injectable vials. It may also reflect farmers' perceptions of rapid therapeutic effects and habits acquired from technicians and veterinarians [39]. Nevertheless, only 7.7% of farmers complied with the recommended treatment duration, whereas most discontinued treatment once clinical improvement was observed. These practices, combined with the widespread lack of awareness of withdrawal periods (83.7%), promote the emergence of AMR [18, 40] and pose a major risk to food safety through antibiotic residues in meat and milk.

Factors associated with knowledge and practices

Several socioeconomic and structural determinants identified in the present study, including education level, region, farm age, herd size, and previous training, were associated with better knowledge and practices. These findings are consistent with previous reports indicating that formal education and livestock training are protective factors favoring safer antimicrobial-related behaviors, whereas limited access to veterinary services and reliance on informal advice encourage self-medication and inappropriate antibiotic use. Similar associations have been reported in studies conducted in East and West Africa [7].

Correlation analyses demonstrated that region, herd size, and livestock training significantly influenced farmers' KAP. The superior knowledge and practices observed among farmers in the Savannah region, despite the lower density of veterinary pharmacies, represent a novel finding that may reflect the influence of intergenerational pastoral knowledge among Fulani, Moba, and Gourma communities and the frequency of cross-border vaccination campaigns, a phenomenon rarely quantified in previous KAP studies. Alternatively, these differences may be explained by greater proximity to community veterinary services and repeated cross-border vaccination activities [41].

These findings are in agreement with those reported by Gemeda et al. [6], who identified education and training as major predictors of antimicrobial use practices in Ethiopia. Likewise, Caudell et al. [5] demonstrated that trained farmers were more likely to use antibiotics under veterinary supervision and to comply with recommended treatment durations [5]. Collectively, these observations confirm the importance of education level and regional disparities in shaping the adoption of good practices and understanding concepts related to prudent antibiotic use among cattle farmers in Togo. Consequently, strengthening continuing education and promoting good veterinary practices represent important strategies for limiting AMR in livestock production systems. Targeted training programs for less-educated farmers, regulation of antibiotic sales in local markets, and establishment of treatment traceability systems appear essential for Togo.

The findings of the present study are aligned with the strategic priorities of Togo's National Action Plan against AMR (2019–2023) [17] by identifying specific deficiencies and providing baseline information for the cattle sector. Moreover, these findings contribute to the limited body of cattle-specific evidence available in West Africa and underscore the limitations of uniform AMR control strategies in highly heterogeneous livestock production systems.

Limitations

This study has several limitations. First, the results were based largely on farmers' self-reported information, and no objective instruments were available to assess respondents' honesty or recall. Nevertheless, interviewer training and the inclusion of cross-checking questions helped reduce this potential source of bias.

Second, as in most questionnaire-based surveys, social desirability bias may have occurred, with respondents potentially overestimating or underestimating their antibiotic use practices. We also acknowledge the potential bias arising from the lack of veterinary records to verify farmers' information. However, several mitigation measures were implemented, including prior training of investigators to maintain neutrality, incorporation of cross-checking questions, and on-site verification of antibiotic stocks and veterinary product packaging to validate farmers' responses.

Another limitation of the study is the relatively high margin of error (10%) used for sample size determination, which may reduce the precision of estimates compared with surveys designed using the more conventional 5% margin of error. Despite these limitations, the study provides valuable baseline information on KAP regarding AMR among cattle farmers in Togo and serves as an important foundation for future investigations and intervention programs.

CONCLUSION

This study provides the first comprehensive evaluation of KAP on antimicrobial use and AMR among cattle farmers in Togo and establishes an important baseline for the cattle sector within the One Health framework. The findings revealed alarmingly low awareness of AMR among farmers, with only 9.7% reporting knowledge of AMR and 16.3% being aware of withdrawal periods. Inappropriate practices were widespread, including self-medication, procurement of antibiotics from informal markets, poor adherence to treatment duration and dosage recommendations, limited use of diagnostic services, and inadequate record-keeping. Tetracyclines were the most frequently used antibiotic class and oxytetracycline was the antibiotic most commonly associated with treatment failures. FMD and CBPP were the most frequently reported diseases, whereas vaccination efforts were largely concentrated on CBPP. Furthermore, farmers from the Savannah region, as well as those with higher educational levels and previous livestock training, demonstrated significantly better knowledge and practices.

From a practical perspective, these findings highlight the urgent need to strengthen veterinary extension services, improve farmers' awareness regarding prudent antimicrobial use, regulate the sale of veterinary drugs in informal markets, and establish treatment traceability systems. Targeted training programs, particularly for farmers with limited education, and the promotion of good veterinary practices are likely to contribute substantially to reducing inappropriate antimicrobial use and limiting the emergence and spread of AMR in cattle production systems.

A major strength of this study lies in its comparative approach involving two contrasting livestock production systems and its focus on an underrepresented cattle sector in West Africa. The integration of field verification of antibiotic stocks and veterinary product packaging also enhanced the reliability of the information collected.

Future studies should incorporate longitudinal designs, microbiological and residue analyses, and molecular characterization of resistant pathogens to better understand the epidemiology of AMR at the livestock-human-environment interface. Further investigations involving additional regions and production systems are also warranted to support the development of evidence-based national surveillance and intervention programs.

Overall, this study demonstrates that substantial gaps remain in cattle farmers' knowledge and practices regarding antimicrobial use and AMR in Togo. Addressing these deficiencies through education, strengthened veterinary services, and effective regulatory measures will be essential for promoting sustainable livestock production and safeguarding animal, human, and environmental health.

DATA AVAILABILITY

The supplementary data can be made available from the corresponding author upon reasonable request.

GENERATIVE AI DECLARATION

The authors declare that generative artificial intelligence tools were used solely to improve language, grammar, and readability during manuscript preparation. All scientific content, data analysis, interpretation of results, and conclusions were developed and verified by the authors. The authors take full responsibility for the accuracy, integrity, and originality of the work presented, and no AI tool was listed as an author.

AUTHORS’ CONTRIBUTIONS

YAK: Conceptualization, methodology, investigation, data collection, data analysis, visualization, original draft preparation, and manuscript review and editing. AKK: Methodology, visualization, and manuscript review and editing. ET: Supervision, conceptualization, methodology, and manuscript review and editing. All authors have read and approved the final version of the manuscript.

COMPETING INTERESTS

The authors declare that they have no competing interests.

PUBLISHER’S NOTE

Veterinary World remains neutral with regard to jurisdictional claims in the published institutional affiliations.

ACKNOWLEDGMENTS

The authors express their gratitude to the Directorate of Veterinary Services and its staff for their support in logistics and human resources. The authors thank the participating farmers, heads of veterinary posts, and Fulani community leaders for their cooperation. The authors are also grateful to FAO for funding this research through Pandemic Fund project (GCP/TOG/026/PAF).

REFERENCES

1. Hendrickx G, Napala A, Dao B, Batawui K, Bastiaensen P, De Deken R. The area-wide epidemiology of bovine trypanosomosis and its impact on mixed farming in subhumid West Africa; a case study in Togo. Vet Parasitol 1999;84(1-2):13-31. [Google Scholar]
2. Talaki E, Dao B, Dayo G, Alfa E, N’Feide T. Trypanosomoses animales dans la Plaine de Mô au Togo. Int J Biol Chem Sci 2015;8(6):2462. [Google Scholar]
3. Bawa A, Hellow G, Yempabou D, Bedekelabou AP, Ousmane Hamid AM, Alambedji RB. Prévalence de la brucellose bovine et pratiques à risque de contamination des acteurs de la filière lait dans les préfectures de l’Oti et de l’Oti-Sud (région des Savanes) au Togo. Rev Afr Santé Prod Anim 2025;2:75-87. [Google Scholar]
4. Alhaji NB, Isola TO. Antimicrobial usage by pastoralists in food animals in North-central Nigeria: the associated socio-cultural drivers for antimicrobials misuse and public health implications. One Health 2018;6:41-7. [Google Scholar]
5. Caudell MA, Dorado-Garcia A, Eckford S, Creese C, Byarugaba DK, Afakye K. 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;15(1):e0220274. [Google Scholar]
6. Gemeda BA, Amenu K, Magnusson U, Dohoo I, Hallenberg GS, Alemayehu G. Antimicrobial use in extensive smallholder livestock farming systems in Ethiopia: knowledge, attitudes, and practices of livestock keepers. Front Vet Sci 2020;7:55. [Google Scholar]
7. Atalay YA, Abebe Gelaw K. Prevalence of knowledge, attitudes, and practices regarding antimicrobial resistance in Africa: a systematic review and meta-analysis. Front Microbiol 2024;15:1345145. [Google Scholar]
8. Azabo R, Dulle F, Mshana SE, Matee M, Kimera S. Antimicrobial use in cattle and poultry production on occurrence of multidrug resistant Escherichia coli. A systematic review with focus on sub-Saharan Africa. Front Vet Sci 2022;9:1000457. [Google Scholar]
9. Akansale R, Adzitey F, Teye GA. Knowledge of farmers in antibiotic usage and investigation of antibiotic residues in meats in Sunyani Municipality, Ghana. J Food Saf Hyg 2021. [Google Scholar]
10. Azabo RR, Mshana SE, Matee MI, Kimera SI. Antimicrobial resistance pattern of Escherichia coli isolates from small scale dairy cattle in Dar es Salaam, Tanzania. Animals 2022;12(14):1853. [Google Scholar]
11. Bedekelabou AP, Oyetola WD, Dingam Riguenodji A, Bada Alambedji R. Antibiotic resistance in food producing animals in West Africa French speaking countries: a systematic review. Afr J Microbiol Res 2021;15(1):47-61. [Google Scholar]
12. Godonou AM, Lack F, Gbeasor-Komlanvi FA, Konlani L, Dossim S, Ameyapoh YA. High faecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) among hospitalized patients at Sylvanus Olympio Teaching Hospital, Lomé, Togo in 2019;23(1):40-8. [Google Scholar]
13. Lack F, Tsogbalé A, Dossim S, Dagnra A, Salou M. Faecal carriage of multi-drug resistant Enterobacteriaceae in hospitalized children at University Teaching Hospital Sylvanus Olympio of Lomé, Togo. Afr J Clin Exp Microbiol 2022;23(1):49-56. [Google Scholar]
14. Katawa G, Sadji A, Toudji GA, Touglo K, Tchadié PE, Ritter M. Description of antimicrobial resistance patterns at the National Institute of Hygiene in Lome, Togo. Jpn J Infect Dis 2023;76(2):91-100. [Google Scholar]
15. Atrah YS, Doumegno KJ, Dossim S, Talaki E, Ameyapoh Y, Salou M. Antibiotic resistance patterns of Escherichia coli strains isolated from pig (Sus scrofa domesticus) casings in Lomé, Togo. J Bacteriol Res 2024;16:21-7. [Google Scholar]
16. Gambogou B, Gnamey AJE, Mensah RT, Diabangouaya DC, Kangni-Doussou M, Ameyapoh YA. Impact of antibiotics residues on food microbiological quality in Togo: cases of chicken meat and eggs. Res Sq 2020. [Google Scholar]
17. Comité d’experts sur la résistance aux antibiotiques, OMS Togo. Plan d’action national de lutte contre la résistance aux antimicrobiens au Togo 2019. [Google Scholar]
18. World Health Organization. Plan d’action mondial pour combattre la résistance aux antimicrobiens 2016. [Google Scholar]
19. Bedekelabou AP, Oyetola DW, Coulibaly ZL, Akinsola O, Bada-Alambedji R. First assessment of the knowledge, attitudes, and practices of health actors in Togo and Ivory Coast in regard to antibiotic resistance. Int J One Health 2022;8(2):108-23. [Google Scholar]
20. Tcheou PB, Bedekelabou AP, Adjei-Mensah B, Kpomasse CC, Talaki E, Salou M. Antibiotic use and residue detection in guinea fowl eggs in rural Togo: an assessment of practices and risks. Vet Anim Sci 2025;28:100448. [Google Scholar]
21. Tcheou PB, Bedekelabou AP, Talaki E, Salou M. Veterinary medicines in Togo: legislation and distribution channels for antibiotics used in poultry. Int J Biol Chem Sci 2024;18(2):507-23. [Google Scholar]
22. Sapra RL. How to calculate an adequate sample size? In: How to practice academic medicine and publish from developing countries? Singapore: Springer Nature Singapore; 2022. [Google Scholar]
23. Gustin P. Répertoire commenté des medicaments a usage vétérinaire 2022. [Google Scholar]
24. Tufa TB, Regassa F, Amenu K, Stegeman JA, Hogeveen H. Livestock producers’ knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia. Front Vet Sci 2023;10:1167847. [Google Scholar]
25. Makamte M, Takemegni M, Djuikoue I, Tiani R, Assob J. Connaissances, attitudes - pratiques du personnel de la filière bovine sur la prévention des zoonoses dans l’abattoir de la ville de Douala, Cameroun. J Funct Vent Pulmonol 2021. [Google Scholar]
26. Dimon E, Toukourou Y, Diogo RVC, Kinkpe L, Assogba BCG, Seidou AA. Women’s contributions to livestock in West Africa. J Anim Health Prod 2025;13(1):1-11. [Google Scholar]
27. Bedekelabou AP, Talaki E, Dolou M, Diouf A, Bada Alambedji R. Antibiotic resistance of enterobacteria (Escherichia coli, Klebsiella spp. and Salmonella spp.) isolated from healthy poultry and pig farms in peri-urban area of Lome, Togo. Afr J Microbiol Res 2020;14(12):657-66. [Google Scholar]
28. Hunduma D, Amenu K, Desta H, Grace D, Agga GE, Kerro Dego O. Prevalence and antimicrobial resistance of Escherichia coli O157:H7 and Salmonella, and the prevalence of Staphylococcus aureus in dairy cattle and camels under pastoral production system. Antibiotics 2023;13(1):26. [Google Scholar]
29. Manishimwe R, Moncada PM, Bugarel M, Scott HM, Loneragan GH. Antibiotic resistance among Escherichia coli and Salmonella isolated from dairy cattle feces in Texas. PLoS One 2021;16(5):e0242390. [Google Scholar]
30. Stevens A, Kaboré Y, Perrier-Gros-Claude JD, Millemann Y, Brisabois A, Catteau M. Prevalence and antibiotic resistance of Salmonella isolated from beef sampled from the slaughterhouse and from retailers in Dakar (Senegal). Int J Food Microbiol 2006;110(2):178-86. [Google Scholar]
31. Soma D, Diarra FBJ, Bonkoungou IJO, Somda NS, Bako E, Nikiema MEM. Assessing antibiotic use practices on central Burkina Faso cattle farms and the associated risks to environmental and human health contamination: a pilot study. Int J One Health 2025. [Google Scholar]
32. Mohammed I, Alhaji N, Adeiza A, Aliyu M, Bakare A, Odetokun I. Antimicrobial use and resistance among mobile pastoralists in Nigeria: knowledge, practices, risk perceptions and drivers for transboundary dissemination. AJVS 2025. [Google Scholar]
33. Mume JA. Review on antibiotic residues in food of animal origin: economic and public health impacts. Appl J Hyg 2023;3(4):99-108. [Google Scholar]
34. Bedekelabou AP, Teko-agbo A, Penoukou E, Niang E, Gbati OB. Dépistage des résidus de quelques antibactériens dans le lait et les œufs produits dans les régions de Dakar et de Thiès au Sénégal. Rev Mar Sci Agron Vét 2021;9:191-6. [Google Scholar]
35. Hirwa EM, Mujawamariya G, Shimelash N, Shyaka A. Evaluation of cattle farmers’ knowledge, attitudes, and practices regarding antimicrobial use and antimicrobial resistance in Rwanda. PLoS One 2024;19(4):e0300742. [Google Scholar]
36. Djabangou P. Etats des lieux de l’élevage des bovins laitiers dans la région maritime au sud Togo 2021. [Google Scholar]
37. Odey TOJ, Tanimowo WO, Afolabi KO, Jahid IK, Reuben RC. Antimicrobial use and resistance in food animal production: food safety and associated concerns in Sub-Saharan Africa. Int Microbiol 2023;27(1):1-23. [Google Scholar]
38. The FAO action plan on antimicrobial resistance 2016. [Google Scholar]
39. Tadesse T, Nura D, Asrat M, Khan J, Gizaw O. Assessment of knowledge, attitudes, and practices of livestock farmers regarding antimicrobial use, resistance, and residues in selected zones of Oromia region, Ethiopia. Discov Food 2025;5(1):60. [Google Scholar]
40. O’Neill J. Antimicrobial resistance: tackling a crisis for the health and wealth of nations 2014. [Google Scholar]
41. Corniaux C. Actualisation des données sur le commerce du bétail au Togo: circuits, marchés et consommation de viande bovine 2012. [Google Scholar]