## 2 Results
### Knowledge Assessment  
Only a small proportion (30.2%; 106/351) of participants knew that antimicrobial resistance is predicted to account for more deaths than cancer in the coming 30 years, and a similar proportion disagreed with the statement (26.8%; 94/351). The remaining 43.0% (151/351) reported to neither agree nor disagree or left the statement open. The level of knowledge of this AMR burden was higher in participants from LMICs (48.6%; 34/70) than those from HICs (25.6%; 72/281) (\(p<0.001\)). More than half of all participants (67.2%; 236/351) correctly answered that antimicrobials cannot be used for viral infections, and a small proportion believed that antimicrobials are effective against viruses (18.6%; 65/351). Most participants (81.8%; 287/351) were well-informed that antimicrobial misuse and abuse in animal husbandry can negatively affect human health, which again differed significantly between LMIC participants (92.9%; 65/70) and HIC participants (79.0%; 222/281) (\(p<0.05\)). Most participants (78.9%; 277/351) were aware that emerging resistant organisms from other countries or continents can become a problem in their own country. Fewer participants (69.8%; 245/351) knew that it is not easy to discover and produce new antimicrobials, and nearly one-third (29.9%; 105/351) neither agreed nor disagreed with this statement. The role of hygiene in tackling AMR was acknowledged by half (54.4%; 191/351) of all participants, with higher scores seen in LMIC (75.7%; 53/70) than HIC participants (49.1%; 138/281; \(p<0.001\)). A detailed overview of the proportional distribution of all answer options per statement can be found in Supplementary File 3. A bar plot of the proportion of participants with the right answers, stratified between LMICs and HICs, can be seen in Figure 2.  
A participant was considered to have a \"good score\" with an overall score of at least 7.0 out of 10 and a \"fair score\" when the overall score was at least 5.0 out of 10. The proportion with good knowledge scores declined as the education level decreased (54.8% of master/doctoral level, 41.3% of bachelor level, 22.5% in lower education graduates). Education level was significantly associated with both good and fair knowledge scores (\(p<0.05\)) (see Supplementary File 4). Upon multivariate analysis, the association between education level and good and fair scores remained significant but only between master/PhD holders and high school graduates (adjusted OR (aOR) of 0.25 for good scores (95% CI: 0.11-0.57) and 0.16 (0.07-0.37) for fair scores). Good and fair knowledge scores were positively correlated with having a scientific background (aOR 0.49 (0.31-0.79) for good scores and 0.34 (0.19-0.56) for fair scores). Furthermore, good knowledge scores were significantly associated with age (40-60 years vs. <40 years, aOR 2.21 (1.11-4.04)) and country of nationality (Spanish vs. Dutch, aOR 0.44 (0.23-0.86)) (see Table 3). \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **All Participants** & **HICs** & **LMICs** & **Significance a** \\ \hline \multicolumn{4}{c}{**Personal knowledge**} \\ Means \(\pm\) standard deviation & 5.95 \(\pm\) 2.82 & 5.81 \(\pm\) 2.79 & 6.43 \(\pm\) 3.57 & 0.053 \\ Median [inter quartile range] & 6.43 [3.57] & 6.55 [2.87] & 7.14 [3.57] & 0.044 * \\ \hline \multicolumn{4}{c}{**Personal attitude and perception (AP)**} \\ Means \(\pm\) standard deviation & 6.99 \(\pm\) 2.55 & 7.31 \(\pm\) 2.38 & 5.70 \(\pm\) 2.80 & \textless{}0.001 *** \\ Median [inter quartile range] & 7.50 [2.50] & 7.50 [2.50] & 5.83 [4.58] & \textless{}0.001 *** \\ \hline \multicolumn{4}{c}{**Political KAP**} \\ Means \(\pm\) standard deviation & 2.88 \(\pm\) 2.21 & 2.84 \(\pm\) 2.16 & 3.04 \(\pm\) 2.14 & 0.529 \\ Median [inter quartile range] & 2.31 [3.08] & 2.31 [3.08] & 2.69 [3.37] & 0.676 \\ \hline \hline \end{tabular}  
* Significance is determined by the two-sample \(t\)-test for the comparison between the means and by the Mann-Whitney U-test for the comparison of the median. Significance: **
* \(p<0.001\), and  
\end{table}