Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.

Background and Aim: Rabies is a fatal zoonosis caused by RNA virus belonging to genus Lyssavirus. Nepal is one of the endemic countries in South Asia for rabies. This study was conducted to better understand the knowledge, attitude, and practice (KAP) of Nepalese community toward rabies across five developmental zones of the country. Materials and Methods: The cross-sectional study was carried out by face-to-face interview using structured questionnaires among 5000 respondents of five cities representing each of the five developmental regions of Nepal by adopting random cluster sampling procedure. The respondents were classified into four categories, including gender, age, education, and social status. The responses for KAP variables were analyzed using descriptive and Chi-square test. Results: The male and younger age respondents with higher education and social status were found more knowledgeable than their counterparts in terms of knowledge variables, including cause of rabies, mode of transmission, clinical signs, treatment, and preventive measures of this fatal disease. Similar findings were observed for attitude and practice variables such as vaccination practice, dog sterilization, health-seeking behavior, first aid practice, and use of first aid materials after dog bites. Some respondents in elderly age group still preferred to use traditional and local methods, which were application of turmeric powder and shrubs to cure dog bites rather than seeking medical facilities. Conclusion: There is a strong need for rabies awareness programs in the community targeting females, school, and college-level students, older age groups, and economically marginalized communities. The awareness materials need to focus on particular topics such as the risk of rabies, modes of transmission, the importance of first aid, health-seeking behavior following dog bite injuries, and practice preventive measures for their pets and community dogs.

Background and Aim: Animal rabies is endemic in Nepal, and it occurs in two forms. Although governmental and non-governmental agencies are working toward the control of rabies by mass dog vaccination and stray dog population management, there is still massive number of rabies incidence reported to the reference veterinary laboratory, Nepal. Therefore, this study aimed to assess animal species, temporal, regional, and agro-ecological distribution patterns of animal rabies in Nepal from 2005 to 2017. Materials and Methods: The epidemiological data on animal rabies from the period of 2005 to 2017 were obtained from the Central Veterinary Laboratory, Tripureshwor, Kathmandu, Nepal. The laboratory-confirmed rabies cases were analyzed according to animal species, temporal, regional (developmental zones), and agro-ecological distributions. In addition, descriptive statistics were used to evaluate the distribution patterns of rabies. Results: From 2005 to 2017, a total of 2771 suspected rabies cases in animals were reported to The Central Veterinary Hospital, Kathmandu. Of which, 1302 were found laboratory-confirmed cases. The rabies cases were most commonly reported and confirmed in dogs followed by other domestic animals. The high occurrences were recorded between 2005 and 2007. However, the incidence was increased during 2016 and 2017. The highest number of rabies cases was recorded in the eastern development zone, and the least number in the central zone at regional level. Likewise, it was highest in the Terai (plain) region and lowest in mountainous areas at agro-ecological zones. The findings also revealed that the occurrences of rabies significantly differed among seasons. Conclusion: Rabies is present in Nepal throughout the year and all seasons with seasonal variation. Among the animal species, dogs are the primary animals affected with rabies followed by cattle and other domestic animals. At the regional level, eastern development zone had the highest incidence and Central development zone recorded the least. Similarly, the Terai region had the highest incidence rates, and the least overall prevalence rate was observed in mountainous regions among agro-ecological zones. Therefore, the government should implement the strict enforcement of mass dog vaccination and dog population management through one health approach to control rabies incidence in the country.