Knowledge, attitudes, and practices on rational antimicrobial use and antimicrobial resistance in Namibia: an online cross-sectional survey.

Background: Antimicrobial resistance (AMR) is a growing global health threat, particularly in low- and middle-income countries. Understanding public knowledge, attitudes, and practices (KAP) regarding antimicrobial use (AMU) and AMR is essential for designing effective interventions. Through this cross-sectional study, we aimed to assess the KAP related to rational AMU and AMR among Namibian adults using an online, self-administered survey. Methods: We distributed an online questionnaire between 1 September and 17 November 2024, targeting Namibian adults aged 18 years and older, who had lived in Namibia for at least six months, were willing to participate, and were English literate. We analysed associations between sociodemographic factors and KAP scores using descriptive statistics and χ Results: Most of the 541 respondents were female (70%), aged 25-34 (40.5%) and had a tertiary education (91.9%). Good knowledge, attitudes, and practices were observed in 64.3%, 79.7%, and 74.9% of participants, respectively. Higher KAP scores were associated with education, employment, urban residence, and access to water, sanitation, and hygiene infrastructure. Misconceptions persisted across all groups, however, particularly regarding AMU in healthy animals and personal AMR risk. Conclusions: While surveyed participants demonstrated generally good KAP, gaps remain. Our findings support the need for targeted AMR education campaigns and policy interventions, which need to be supported by a better understanding of the KAP of Namibian adults regarding AMU and AMR.