Antimicrobial resistance (AMR) poses a significant threat to global health, driven largely by antibiotic misuse in livestock farming. This pilot study explores cattle farmers’ antibiotic use practices and their implications for environmental and human health in peri-urban area of Ouagadougou. This study aimed to identify risky antibiotic use behaviors among cattle farmers and evaluate their contribution to environmental contamination and AMR dissemination. In April 2023, a survey was conducted among 50 cattle farm owners and managers across four peri-urban area of Ouagadougou, Burkina Faso. Data were collected using structured questionnaires through Kobo Toolbox. Farmers’ practices were categorized as “good” or “poor” based on cumulative scores derived from binary-coded responses. Logistic regression was used to identify associations between practices and AMR risk factors. Among participants, 98% (n = 49) were male, 76% (n = 38) had no formal animal health training, and 96% (n = 48) used antibiotics, primarily tetracyclines. Practices associated with increased AMR risk included reliance on non-veterinary personnel for antibiotic administration and inadequate waste management. Multivariate analysis revealed that traditional farming methods significantly reduced contamination risks (p < 0.05). However, ownership of farms and using antibiotics solely for treatment were linked to higher odds of environmental contamination. Awareness of the implications of antibiotic residues in manure was low, with 82% of farmers uninformed about potential health risks. The study highlights prevalent antibiotic misuse and inadequate biosecurity measures among cattle farmers in Burkina Faso. These practices exacerbate AMR risks, necessitating urgent interventions. Strategies should include farmer education on biosecurity, stricter regulation of antibiotic use, and the promotion of sustainable farming practices. A One Health approach integrating human, animal, and environmental health is critical to addressing AMR challenges.

One Health (OH) is an interdisciplinary framework integrating human, animal, and environmental health to address complex health challenges such as zoonotic diseases and antimicrobial resistance. Despite global adoption, the OH approach in Saudi Arabia lacks comprehensive bibliometric evaluation to reveal trends, collaborations, and research domains. This study aims to provide a bibliometric review of OH research in Saudi Arabia to identify gaps and propose improvements. A systematic bibliometric analysis was conducted on OH-related publications from 2011 to 2024. Data were sourced from seven international databases, including Scopus and PubMed. Studies were filtered using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to include those focusing on OH perspectives within Saudi Arabia. Bibliometric tools like VOSviewer and Biblioshiny were employed to analyze publication trends, citation patterns, and thematic areas. A total of 178 publications were analyzed. The Ministry of Health, King Saud University, and King Abdulaziz University emerged as leading contributors. Key themes identified included zoonotic diseases, environmental health, and antimicrobial resistance. The Saudi Medical Journal and the Saudi Journal of Biological Sciences were primary publication platforms. Citations peaked in 2012, largely due to seminal work on Middle East respiratory syndrome coronavirus. Collaboration patterns showed that domestic partnerships outperformed regional and international collaborations in terms of output, though the latter had higher citation averages. Riyadh was identified as the most productive region. The analysis highlights Saudi Arabia’s growing contributions to OH research, emphasizing the importance of inter-sectoral collaboration. However, challenges remain in aligning research outputs with practical applications, particularly in disease surveillance and public awareness. Strengthening partnerships, enhancing resource allocation, and addressing underrepresented regions are critical for advancing OH implementation.

Zoonotic malaria is an emerging public health challenge in Indonesia, exacerbated by deforestation and increased interaction between humans and non-human primates (NHPs). This study aimed to estimate malaria prevalence in NHPs within the Buton Utara Wildlife Sanctuary (BUWS) and evaluates the potential risk of zoonotic malaria transmission to nearby human populations. Epidemiologic surveys were conducted from 2020 to 2021 in BUWS. Macaca brunnescens, the endemic NHP species, were captured using traps. Blood samples were collected and analyzed through microscopy and molecular techniques to detect Plasmodium species. DNA extraction, mitochondrial DNA barcoding, and polymerase chain reaction were used for species identification and phylogenetic analysis. Human populations residing near BUWS were also screened for malaria via blood smear and DNA analysis. Among the 26 Macaca brunnescens sampled, Plasmodium infections were identified in 50%, including Plasmodium inui, Plasmodium cynomolgi, and Plasmodium simiovale, with one mixed infection. Phylogenetic analyses confirmed the presence of these species. Notably, no Plasmodium knowlesi, a prevalent zoonotic malaria agent in Southeast Asia, was detected. Human malaria screening revealed no zoonotic infections but identified a single case of non-zoonotic malaria linked to travel outside the region. The high prevalence of Plasmodium species in NHPs highlights the potential for zoonotic malaria transmission in BUWS. Although no zoonotic cases were detected among humans, continuous surveillance of NHPs, mosquito vectors, and human populations is essential. Conservation efforts and public health initiatives should focus on mitigating the risks associated with increased human-primate interaction.

Antimicrobial resistance (AMR) has emerged as one of the most critical global health challenges and poses significant threats to human, animal, and environmental health. Indonesia, like many other developing nations, is facing widespread AMR because of the overuse and misuse of antibiotics in humans, livestock, aquaculture, and agriculture. The interconnected nature of AMR requires a holistic approach to understand its prevalence, pathways, and impact. A One Health perspective, which integrates human, animal, and environmental health, is vital for comprehensively and effectively addressing AMR. This study is significant because it provides a detailed analysis of AMR in Indonesia and identifies critical resistance patterns across various bacterial species and antibiotics. This study highlights reservoirs of resistance, such as wastewater and food-producing animals, which serve as major pathways for the spread of resistant genes. Furthermore, this study examines the policy landscape in Indonesia, emphasizing the need for data-driven interventions and multi-sectoral collaboration. This study offers insights into AMR’s economic, health, and social implications and aligns with global and national AMR mitigation frameworks. The primary aim of this study was to evaluate the current state of AMR in Indonesia, focusing on the environmental, animal, and human health sectors. The One Health approach identifies key resistance patterns, transmission pathways, and contributing factors. In addition, the study proposes a research roadmap to guide future initiatives, emphasizing the development of rapid diagnostics, therapeutic innovations, and improved surveillance systems to combat the growing threat of AMR in Indonesia.

Proteus mirabilis, an opportunistic pathogen of the Enterobacteriaceae family, is frequently implicated in wound infections and exhibits significant antibiotic resistance, particularly through the production of extended-spectrum beta-lactamase (ESBL). This study aimed to determine the occurrence and antibiotic susceptibility of ESBL-producing and non-ESBL P. mirabilis isolates in wound infections at Zainoel Abidin General Hospital, Banda Aceh, Indonesia. A cross-sectional study was conducted on wound specimens collected between January 2021 and March 2024. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK® 2 Compact system. Statistical analyses were conducted using Chi-square or Fisher statistical analyses significance set at p ≤ 0.05. A total of 153 P. mirabilis isolates were identified, of which 60 (39.22%) were ESBL-producing and 93 (60.78%) were non-ESBL-producing. The highest occurrence was observed in male patients (55% ESBL and 54.84% non-ESBL) and in patients older than 55 years (48.33% ESBL and 38.71% non-ESBL). Antibiotic susceptibility testing revealed that ESBL-producing isolates were highly susceptible to cefoperazone/sulbactam (98.67%), meropenem (98.33%), amikacin (96.67%), and piperacillin/tazobactam (91.67%). Non-ESBL isolates exhibited the highest susceptibility to amikacin (97.85%), cefoperazone/sulbactam (96.77%), piperacillin/tazobactam (91.67%), and ceftazidime (90.32%). Notably, ESBL-producing isolates exhibited resistance to amoxicillin (0%), ampicillin (1.67%), cefotaxime (8.33%), and levofloxacin (10%). The high occurrence of ESBL-producing P. mirabilis, particularly in elderly patients, underscores the need for routine ESBL screening and targeted antibiotic therapy. The observed differences in antibiotic susceptibility between ESBL and non-ESBL isolates highlight the importance of early detection for appropriate antibiotic selection in wound infection management. Continued surveillance and antimicrobial stewardship are crucial in mitigating the impact of antibiotic-resistant P. mirabilis in clinical settings.

Legionnaires’ disease (LD), caused by the Gram-negative bacterium Legionella pneumophila, has emerged as a significant public health concern due to its rising incidence and high morbidity and mortality rates. This review comprehensively examines the etiology, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prevention of LD. The bacterium thrives in aquatic environments, often within biofilms and protozoan hosts, contributing to its resilience and widespread distribution in natural and man-made water systems. Transmission primarily occurs through the inhalation of contaminated aerosols, with immunocompromised individuals, the elderly, and smokers being at heightened risk. Clinically, LD presents as a severe pneumonia with systemic involvement, and its diagnosis often relies on culture, urinary antigen tests, and molecular methods. The treatment landscape is dominated by macrolides and fluoroquinolones, with emerging research into alternative therapies to combat antimicrobial resistance. Effective public health strategies, including rigorous water management practices and infection control measures, are vital in mitigating the risk of outbreaks. This review aims to enhance clinical awareness and inform public health initiatives by elucidating the complex interplay between bacterial virulence, host factors, and environmental conditions that contribute to LD transmission and persistence. A better understanding of these dynamics is crucial for developing robust prevention and control strategies, ultimately reducing the global burden of this potentially life-threatening disease.

Rabies remains a significant public health issue in Indonesia, particularly in the Maluku Province, where eight out of 11 regencies, including Ambon City, face persistent challenges with rabies transmission. Ambon City has shown fluctuating trends in rabies-transmitting animal bite cases, contributing notably to the province’s overall burden. This study aimed to analyze the distribution of these bite cases in Ambon City from 2020 to 2023, utilizing descriptive epidemiological and spatial autocorrelation analyses to identify clustering patterns and spatial relationships among districts. A quantitative, descriptive epidemiological study was conducted using secondary data on rabies-transmitting animal bite cases in Ambon City between 2020 and 2023. Data analysis included tables, bar charts, and choropleth maps using Quantum Geographic Information System software. Spatial autocorrelation was evaluated using GeoDa software through Moran’s I and Local Indicators of Spatial Autocorrelation (LISA) tests. The highest number of bite cases occurred in 2023, with 1,359 cases and an incidence rate (IR) of 3.79/1,000 residents. Nusaniwe District recorded the most cases (1,256), while Leitimur Selatan had the highest IR, peaking at 11.39/1,000 residents in 2023. Moran’s I test indicated a negative spatial autocorrelation, with a value approaching 0, suggesting dispersed rather than clustered patterns of rabies transmission. The LISA analysis showed significant local correlations only in 2020 and 2021. Rabies-transmitting animal bite cases in Ambon City are increasing annually, exacerbated by low vaccine and serum administration rates and persistent positive Lyssa cases. Despite the broad distribution of cases, specific districts demonstrate higher transmission potential. The study emphasizes the need to enhance vaccine distribution, increase public awareness, and improve dog control and vaccination efforts to curb rabies transmission effectively.

Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacterium capable of long-term environmental persistence. In Indonesia, anthrax has been reported in 22 provinces, with East Java, Central Java, and Yogyakarta identified as persistent endemic regions. Understanding the phenotypic and genetic characteristics of local B. anthracis isolates is critical for informing targeted control strategies under the One Health framework. This study aimed to characterize the phenotypic and genotypic profiles of B. anthracis isolates collected between 1990 and 2021 from three anthrax-endemic provinces in Java, Indonesia, and to identify potential environmental and epidemiological risk factors influencing transmission. A total of 28 isolates obtained from environmental and animal sources across 12 districts were examined using conventional phenotypic methods and confirmed by multiplex polymerase chain reaction (PCR) targeting Ba813, lef (pXO1), and capC (pXO2) genes. Laboratory data were interpreted alongside epidemiological and environmental information within a One Health framework. All isolates displayed classical phenotypic traits of B. anthracis: Gram-positive morphology, non-hemolytic, non-motile, capsule formation, and sensitivity to penicillin, tetracycline, and ciprofloxacin. PCR results confirmed the presence of both chromosomal and plasmid virulence markers. Notably, consistent traits across isolates indicated genetic homogeneity among circulating strains. Risk factors contributing to anthrax persistence included inadequate vaccination coverage, livestock movement through trade routes, the slaughter of infected animals, poor carcass disposal, environmental spore survival, and traditional practices such as “Purak” slaughter. This study provides novel insights into the virulence and genetic stability of B. anthracis in three Indonesian provinces. The findings emphasize the need for integrated control measures that include enhanced surveillance, public education, vaccination campaigns, and environmental decontamination. A robust One Health approach is essential for the sustainable management and eventual eradication of anthrax in endemic regions.

Leprosy, caused by Mycobacterium leprae, remains a significant public health challenge in Indonesia, especially in provinces like Maluku where elimination targets have not been met. Low community awareness and stigma surrounding the disease contribute to delayed diagnosis and hinder effective control efforts. This study assessed the level of awareness about leprosy and its associated factors among residents of East Seram District, Maluku Province. A cross-sectional household health survey was conducted between September and December 2023, covering 253 respondents aged 18–65 years residing on the mainland of East Seram Island. Data were collected using structured interviews adapted from validated health surveys. The main outcome variable was awareness of leprosy, measured through knowledge-based questions. Respondents were categorized as having high awareness if their score exceeded 76%. Logistic regression analyses were employed to identify factors associated with high awareness. Only 10.3% of respondents demonstrated a high level of awareness about leprosy. Higher odds of awareness were significantly associated with university education (odds ratio [OR] = 57.86; 95% confidence interval [CI]: 5.75–582.24; p = 0.001), being unmarried (OR = 6.33; 95% CI: 1.56–25.71; p = 0.010), and previous contact with health workers (OR = 6.38; 95% CI: 1.04–39.00; p = 0.045). Respondents with lower educational attainment, those who were married, and those who had never accessed health services were more likely to have low awareness levels. Community awareness of leprosy in East Seram District is alarmingly low. Targeted health education campaigns are imperative, especially among populations with limited formal education, those who are married, and those without prior exposure to healthcare services. Expanding health promotion efforts through community-based strategies and improving access to health workers are essential for enhancing awareness and advancing leprosy control initiatives in Maluku Province.

Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a zoonotic pathogen implicated in severe infections in humans and aquatic animals, particularly fish. Recent outbreaks of GBS sequence type 283 in Southeast Asia, associated with raw fish consumption, have raised public health concerns. Despite growing evidence of zoonotic transmission, comparative studies investigating virulence factor homology across hosts remain limited. This study focuses on the fibrinogen-binding protein A (FbsA), a critical virulence determinant in GBS pathogenesis. This study aimed to conduct a novel computational One Health analysis comparing the FbsA protein from fish- and human-derived GBS strains to elucidate their structural and functional similarities and explore their interaction with human fibrinogen (Fg). Amino acid sequences of FbsA from fish and human GBS isolates were retrieved from the National Center for Biotechnology Information database. Sequence alignment was performed using the MUSCLE algorithm in Molecular Evolutionary Genetics Analysis (MEGA) software. Three-dimensional structures were predicted through ColabFold and validated using Ramachandran plots. Residue profiling and structural visualization were conducted in PyMOL. Molecular docking between FbsA and Aα (G), Bβ (H), and γ (I) chains of human Fg was performed using ClusPro, followed by interaction analysis using LigPlot+. Sequence alignment revealed 100% identity between fish and human-derived FbsA, indicating a conserved evolutionary relationship. The refined FbsA structure demonstrated α-helices and random coils with six repetitive regions. Molecular docking confirmed robust binding between FbsA and the D fragment of human Fg, involving key critical residues within the repetitive region (residues 45th–60th). Notably, interaction sites also included the β119–129 regions, overlapping with the plasmin cleavage site, potentially contributing to endocarditis and septicemia pathogenesis. The structural and functional equivalence of fish- and human-derived FbsA underscores the zoonotic risk of GBS transmission. These findings offer a compelling foundation for targeted vaccine development and preventative strategies to mitigate GBS infections across species boundaries.

The global rise of antimicrobial resistance (AMR), particularly multidrug-resistant Escherichia coli (MDR E. coli), poses a significant threat to public health, animal health, and environmental safety. Traditional antibiotics are increasingly ineffective, necessitating alternative approaches such as immunotherapy. Hyperimmune serum represents a potential solution to combat MDR pathogens by providing immediate passive immunity. The present study aimed to produce and evaluate hyperimmune serum against MDR E. coli isolated from animal products in Bali and Nusa Tenggara, Indonesia, as a novel immunotherapeutic strategy against AMR. Five MDR E. coli isolates resistant to eight antibiotics were obtained from the Quality Testing and Certification Center for Animal Products in Bogor, Indonesia. Isolates originated from Bali, West Nusa Tenggara, and East Nusa Tenggara. Bacterial isolates were cultured in Yeast Tris (YT) broth medium supplemented with antibiotics. Bacterial proteins were extracted, solubilized, and emulsified with Freund’s complete and incomplete adjuvants. A 2-year-old horse was immunized with prepared antigens through intramuscular injections over 6 weeks, followed by intravenous administration. Serum was collected pre- and post-immunization. Confirmation of the hyperimmune serum’s specificity and neutralizing capability was performed using an in vitro agar plate test. Successful growth of MDR E. coli isolates was confirmed in antibiotic-supplemented media, whereas no growth was observed in the antibiotic-sensitive native control. Hyperimmune serum obtained post-immunization exhibited strong in vitro specificity, recognized homologous MDR E. coli isolates, and formed significant neutralization zones (5–6 mm) around agar diffusion disks. Pre-immunization serum showed no reactivity, demonstrating effective production of specific antibodies. The neutralization zones were slightly smaller than those achieved with chloramphenicol control, indicating effective but slightly reduced bactericidal activity. The study successfully demonstrated that hyperimmune serum generated from MDR E. coli isolates from animal products has specific neutralizing activity against homologous MDR bacterial strains. These findings support the potential application of hyperimmune sera as an immunotherapeutic tool to mitigate AMR-related infections. Further research is necessary to standardize Immunoglobulin G concentrations, determine optimal immunization protocols, and evaluate clinical efficacy in vivo. The hyperimmune serum preparation represents a promising advancement for tackling MDR bacterial infections and contributes substantially to One Health strategies aimed at reducing the public health threat posed by AMR.

Rabies remains a critical public health threat in Vietnam, particularly in areas where dog-mediated transmission persists. Despite national control strategies, vaccination coverage in dogs remains suboptimal. This study aimed to investigate the perceptions of dog owners toward rabies prevention and control in distinct urban and rural settings of Long An Province, using a Q-sorting methodology to explore sociobehavioral and socioeconomic drivers influencing compliance with vaccination programs. A cross-sectional study was conducted among 109 dog owners – 60 from urban Tan An City and 49 from rural Duc Hue District – between March and June 2023. Participants performed Q-sorting with 46 validated statements across four domains: Knowledge, attitudes, practices, and cost perceptions regarding rabies prevention. Principal component analysis was applied separately for each setting to identify latent discourses. Socioeconomic factors were assessed in relation to discourse membership using descriptive and inferential statistics. Two discourses were identified in the urban setting (“Obstructed Adherents” and “Casual Observers”) and three in the rural setting (“Identified Awareness,” “Independent Owners,” and “Close Adherence”). While all participants demonstrated baseline knowledge of rabies severity, barriers such as limited vaccine accessibility and inadequate veterinary support impeded proactive vaccination. Vaccine cost was not perceived as a major deterrent. Educational attainment was significantly associated with proactive health-seeking behavior in the rural setting (p = 0.017). This study elucidates community-specific perceptions that influence rabies prevention behavior. Although awareness of rabies is high, structural limitations – particularly inadequate access to veterinary services – hinder effective control. Tailored community engagement, veterinary outreach, and education campaigns, especially in low-resource settings, are recommended to enhance vaccination uptake and achieve national rabies elimination goals by 2030.

Malaria control programs in Indonesia heavily rely on insecticide-based interventions such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). However, the effectiveness of these strategies is increasingly compromised by the emergence of insecticide resistance, particularly in high-transmission regions like Papua Province. The mechanisms underlying pyrethroid resistance in local vector populations remain inadequately characterized. This study aimed to assess the permethrin resistance status and characterize the frequency of L1014F/S knockdown resistance (kdr) alleles in Anopheles punctulatus group mosquitoes in Keerom, Papua, to inform region-specific malaria vector control strategies. An entomological and molecular investigation was conducted in five villages across three districts of Keerom Regency. Larval and adult Anopheles mosquitoes were collected through standard World Health Organization techniques. Insecticide susceptibility was evaluated using 0.75% permethrin bioassays. Molecular identification and detection of kdr mutations (L1014F/S) were performed using species-specific polymerase chain reaction and sequencing protocols. Allele frequencies were analyzed using Hardy–Weinberg equilibrium models, and statistical comparisons were made using one-way analysis of variance. Among 163 mosquitoes tested, permethrin resistance was confirmed across all districts, with mortality rates ranging from 50% to 68.66%. Molecular analyses identified Anopheles koliensis, A. punctulatus, and A. peditaeniatus. High frequencies of the L1014S mutation were detected in A. koliensis (0.87) and A. punctulatus (0.66), whereas A. peditaeniatus exhibited only wild-type alleles. No L1014F mutations were observed. The high prevalence of homozygous resistant genotypes indicates intense selection pressure, potentially linked to LLIN and agricultural insecticide use. This study provides the first molecular evidence of widespread permethrin resistance mediated by L1014S mutations in the A. punctulatus group in Papua. These findings underscore the urgent need for enhanced resistance monitoring and the integration of alternative insecticides and non-chemical vector control methods to sustain malaria control efforts in the region.

Zoonotic malaria caused by Plasmodium knowlesi presents a growing public health challenge in Southeast Asia. Host genetic factors, particularly polymorphisms in the Duffy antigen/receptor for chemokines (DARC), may influence susceptibility to zoonotic transmission. Indonesia’s vast ethnic and ecological diversity offers a unique context to explore the genetic interface between human and non-human primate (NHP) hosts and zoonotic malaria. This study aimed to investigate the genetic diversity of the DARC gene in sympatric human and NHP populations across Indonesia and its potential role in modulating susceptibility to zoonotic malaria. A cross-sectional survey was conducted in Sabang (Aceh), Palangkaraya (Central Kalimantan), and North Buton (Southeast Sulawesi). Dried blood spots were collected from 68 NHPs and 363 humans. DARC promoter and coding regions were amplified through polymerase chain reaction, sequenced, and analyzed using bioinformatic tools. Phylogenetic analyses and allele-specific comparisons were performed to assess cross-species genetic similarity and regional variation in DARC alleles. No −46T>C promoter single-nucleotide polymorphism associated with Duffy negativity was found in either humans or NHPs. Three genotypic forms – FYA, FYB, and FYA/FYB – were observed in human populations, with FYA being predominant in Kalimantan and Sulawesi. Notably, individuals with the FYA allele in Aceh, a region with high P. knowlesi incidence, were less likely to have an infection, suggesting a potential protective role. All NHPs carried the FY*B allele. Comparative analyses revealed high DARC sequence homology between humans and NHPs, particularly Macaca fascicularis and Macaca brunnescens, implicating molecular compatibility in zoonotic transmission dynamics. This is the first comprehensive study to assess DARC gene polymorphisms in both human and NHP populations in Indonesia within the context of zoonotic malaria. The findings underscore the significance of host genetic variation in mediating susceptibility to P. knowlesi and highlight regional allele profiles as potential markers for risk stratification. These insights provide a genomic framework to inform surveillance and control strategies in malaria-endemic regions vulnerable to zoonotic transmission.

Rabies remains a critical public health concern in Indonesia, particularly in high-risk provinces, such as East Nusa Tenggara. Despite governmental efforts under the One Health framework, gaps persist in vaccination coverage, public awareness, and intersectoral coordination. This study aims to assess community knowledge, attitudes, and practices (KAP) regarding rabies and evaluate rabies control strategies in Belu and Malaka regencies, incorporating both community and policymaker perspectives. A mixed-methods approach was adopted, integrating quantitative surveys and qualitative interviews. Structured questionnaires assessed KAP levels among 225 respondents across two regencies, while logistic regression identified sociodemographic predictors of adequate rabies knowledge. Qualitative data, obtained through in-depth interviews and focus group discussions, were thematically analyzed using the context, input, process, and product evaluation model to explore stakeholder coordination, community engagement, and systemic challenges. Female respondents and those aged >50 years exhibited significantly higher knowledge of rabies (adjusted odds ratios [AOR] for males = 0.321, p = 0.003; AOR for ≤30 years = 0.390, p = 0.032). Vaccination coverage among domestic animals remained suboptimal (~50%), below the national target of ≥75%. Weak but significant positive correlations were observed between knowledge and both attitude (r = 0.144, p = 0.03) and practice (r = 0.211, p = 0.001). Qualitative findings revealed the fragmented implementation of One Health, insufficient vaccine supply, limited veterinary personnel, and poor integration of traditional knowledge into health communication strategies. This study underscores the importance of tailored health education, particularly for younger and male populations, and highlights the potential of community-driven interventions to improve rabies control. Integrating traditional cultural expressions with modern outreach, strengthening intersectoral collaboration, and improving logistical support are essential for sustainable control. The use of technology (e.g., WhatsApp-based reporting) and community task forces demonstrated promise in enhancing responsiveness. Future programs should prioritize culturally adaptive strategies and expand the operational scope of One Health to mitigate rabies in endemic regions.