A National Evaluation of One Health, Zoonotic Threats, and Antimicrobial Stewardship among Professional college Students in India

Introduction: The escalating global threats of zoonotic diseases and antimicrobial resistance (AMR) necessitate a robust "One Health" approach. This study aimed to evaluate public awareness, knowledge levels, and behavioural risks associated with the human-animal-environment interface across various states and Union Territories of India to inform future public health interventions.

Methods: A cross-sectional survey was conducted among professional college students using hybrid data collection approaches, comprising both a structured digital questionnaire and manual paper-based forms. The instrument was validated for content and face validity by a panel of experts. A total of 1122 responses from 24 states and 5 Union Territories were collected and analyzed using descriptive and inferential statistics.

Results

The study revealed high theoretical literacy: 72% were familiar with "One Health" and 84.3% identified zoonotic transmission dynamics. AMR awareness reached a near-ubiquitous 95.5%. However, this cognitive awareness was contradicted by significant behavioral risks, exposing a critical "knowledge–practice gap." While awareness of rabies (97.3%) and tuberculosis (95.7%) was near-universal, knowledge of emerging threats like scrub typhus was significantly lower (66.9%). Approximately 30.4% admitted to antibiotic self-administration, and 86.9% engaged with professional guidance only sporadically. Furthermore, socio-cultural practices—such as consuming raw milk (28.5%) and raw meat (1.9%) during religious observances—persisted despite widespread recognition of endemic zoonoses. Digital platforms and peer groups followed by medical and veterinary professionals were identified as primary health information catalysts.

Conclusions

Despite sophisticated conceptual awareness of One Health and AMR among India’s educated youth, significant behavioral inertia remains a critical public health barrier. These findings confirm that theoretical knowledge does not inherently translate to risk mitigation. To bridge this "knowledge–practice gap," future strategies must pivot towards targeted, behavior-centric community engagement. Robust cross-sectoral collaboration between medical and veterinary professionals is essential to transform cognitive understanding into standardized safe practices and grassroots antimicrobial stewardship.