Delay in initiation of rabies post-exposure vaccination and influencing factors in Gondar zones of Ethiopia
5 affiliations
- 1Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
- 2Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
- 3Department of Veterinary Epidemiology and Public Health, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
- 4School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
- 5Department of Veterinary Epidemiology and Public Health, School of Veterinary Medicine, Bahir Dar University, Bahir Dar, Ethiopia
Abstract
Rabies is a viral zoonotic disease of warm-blooded animals, which is preventable through proper administration of post-exposure prophylaxis (PEP). In controlling rabies, delays in initiating post exposure vaccination (PEV) are a challenge in endemic regions. A study was conducted to assess the delay in initiation of PEV and identify associated factors in Ethiopia. Data was collected by face-to-face interviews from 260 dog bite victims or their guardians between January and June, 2025 using a questionnaire. Post exposure vaccination was considered delayed if it was initiated after 48 hours of the exposure incident. The prevalence of delayed initiation of PEV was calculated as a percentage from the number of individuals who initiated PEV after 48 hours and the total number of individuals exposed to rabies. Factors associated with delay were identified using logistic regression models. The prevalence of delayed in initiation of rabies PEV was 86.1% (224/260); 13.9% (36/260) of participants commenced vaccination within 48 hours of exposure. Severity of bite and ownership of biting animal were factors associated with the outcome. Deep bite (OR = 0.22, 95% CI: 0.07 - 0.66, P = 0.008) and bitten by stray dogs (OR = 0.51, 95% CI = 0.27 - 0.95, P = 0.033) reduced delay in initiation of PEV. Majority of respondents (88.5%) are aware of the existence, the signs (71.5%), the way of transmission (75.4%), and the fatal nature (96.5%) of rabies, and the need for PEV (95.4%). Another majority believe that the cost of the vaccine is fair and PEV is effective (95%), and and costs of the vaccination (76.2%) was not a reason for delay. In conclusion, the study outlined that respondents know many aspects of rabies control and had fewer barriers to uptake the PEV; however, the delay in initiating PEV was high. This underscores that respondents may not be aware of the risk of delay. Therefore, interventions focusing on the risk of delayed PEV initiation are needed. Author summary: Rabies is a viral zoonotic disease that is transmitted to humans mainly through a dog bite. The disease is entirely preventable by vaccinating vectors transmitting the rabies virus and administration of PEV. However, the PEV should be initiated as soon as possible following exposure. In Ethiopia, many people know the existence of rabies, its fatal nature, and the importance of PEV; but, death due to rabies is also high. Therefore, we conducted a questionnaire survey in individuals from the Central, North, and West Gondar Zones of the Amhara Region, Ethiopia, who were exposed to suspected rabid animals (or their guardians when victims were under 18 years of age) and sought rabies PEV at the Gondar Polyclinic,. Delay in initiating PEV was high, but respondents believe that the costs of the vaccination was fair. Delay was higher in victims bitten by owned dogs than those bitten by stray dogs, but victims initiate PEV without delay when they were bitten deep compared to shallow. Respondents knew many aspects of rabies control and had fewer barriers to uptake the PEV; but did not aware the risk of delay. Awareness creation on the risk of delay in initiating the PEV was suggested.
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BibTeX
@article{hailu2026delay,
title = {{Delay in initiation of rabies post-exposure vaccination and influencing factors in Gondar zones of Ethiopia}},
author = {Bezawit Kassaw Hailu and Yitayew Demessie and Asnakew Mulaw Berihun and Abebe Belete Bitew and Sefinew Alemu Mekonnen},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = oct,
doi = {10.1371/journal.pntd.0014729},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014729},
note = {CC BY},
}
RIS
TY - JOUR
TI - Delay in initiation of rabies post-exposure vaccination and influencing factors in Gondar zones of Ethiopia
AU - Bezawit Kassaw Hailu
AU - Yitayew Demessie
AU - Asnakew Mulaw Berihun
AU - Abebe Belete Bitew
AU - Sefinew Alemu Mekonnen
PY - 2026
DA - 2026/10/01
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0014729
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014729
AB - Rabies is a viral zoonotic disease of warm-blooded animals, which is preventable through proper administration of post-exposure prophylaxis (PEP). In controlling rabies, delays in initiating post exposure vaccination (PEV) are a challenge in endemic regions. A study was conducted to assess the delay in initiation of PEV and identify associated factors in Ethiopia. Data was collected by face-to-face interviews from 260 dog bite victims or their guardians between January and June, 2025 using a questionnaire. Post exposure vaccination was considered delayed if it was initiated after 48 hours of the exposure incident. The prevalence of delayed initiation of PEV was calculated as a percentage from the number of individuals who initiated PEV after 48 hours and the total number of individuals exposed to rabies. Factors associated with delay were identified using logistic regression models. The prevalence of delayed in initiation of rabies PEV was 86.1% (224/260); 13.9% (36/260) of participants commenced vaccination within 48 hours of exposure. Severity of bite and ownership of biting animal were factors associated with the outcome. Deep bite (OR = 0.22, 95% CI: 0.07 - 0.66, P = 0.008) and bitten by stray dogs (OR = 0.51, 95% CI = 0.27 - 0.95, P = 0.033) reduced delay in initiation of PEV. Majority of respondents (88.5%) are aware of the existence, the signs (71.5%), the way of transmission (75.4%), and the fatal nature (96.5%) of rabies, and the need for PEV (95.4%). Another majority believe that the cost of the vaccine is fair and PEV is effective (95%), and and costs of the vaccination (76.2%) was not a reason for delay. In conclusion, the study outlined that respondents know many aspects of rabies control and had fewer barriers to uptake the PEV; however, the delay in initiating PEV was high. This underscores that respondents may not be aware of the risk of delay. Therefore, interventions focusing on the risk of delayed PEV initiation are needed. Author summary: Rabies is a viral zoonotic disease that is transmitted to humans mainly through a dog bite. The disease is entirely preventable by vaccinating vectors transmitting the rabies virus and administration of PEV. However, the PEV should be initiated as soon as possible following exposure. In Ethiopia, many people know the existence of rabies, its fatal nature, and the importance of PEV; but, death due to rabies is also high. Therefore, we conducted a questionnaire survey in individuals from the Central, North, and West Gondar Zones of the Amhara Region, Ethiopia, who were exposed to suspected rabid animals (or their guardians when victims were under 18 years of age) and sought rabies PEV at the Gondar Polyclinic,. Delay in initiating PEV was high, but respondents believe that the costs of the vaccination was fair. Delay was higher in victims bitten by owned dogs than those bitten by stray dogs, but victims initiate PEV without delay when they were bitten deep compared to shallow. Respondents knew many aspects of rabies control and had fewer barriers to uptake the PEV; but did not aware the risk of delay. Awareness creation on the risk of delay in initiating the PEV was suggested.
SN - 1935-2735
SN - 1935-2727
ER -