CARDIOVASCULAR RISK SCREENING SERVICES IN SUDANESE COMMUNITY PHARMACIES

Objectives: The objective of this study was to investigate the Sudanese community pharmacists' knowledge and practice of cardiovascular disease risk assessment services.Methods: The study was conducted as a non-interventional, descriptive, cross sectional community-pharmacy based survey.Results: The Response rate was 91%. The obese and the elderly received the highest ratings for cardiovascular disease risk assessment. Hypertension, type 1 and type 2 diabetes mellitus and ages >55 and 36-55 years were mostly targeted for screening. Variable responses were reported regarding the type of fasting lipid profile that is screened. One third of the participants claimed to have screening evaluation forms. Most participants had the appropriate equipment for screening but only a few had cholesterol measures. Only 27% reported the use of cardiovascular risk charts or calculator for the evaluation. Overwhelming majority had no documentation records and the most available reference was the BNF.Conclusion: The current knowledge and practice of cardiovascular disease risk assessment is poor and need fundamental development. Community pharmacy practice in the Sudan is still product oriented. These services were provided by respondents on voluntary bases without full knowledge or appropriate training on proper assessment and evaluation of the risks that they measured. This needs to change if pharmacy's potential is to be reached. Collaboration between health authorities and universities is essential to acknowledge the new roles of the pharmacist and provide the appropriate knowledge and training needed to promote and implement the change process that is required

Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance

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