Barriers to Canine Rabies Vaccination in Nigeria: Implications for Rabies Elimination by 2030

Introduction: Mass dog rabies vaccination is the most effective strategy for preventing human rabies and interrupting transmission. However, achieving high vaccination coverage in dog populations remains challenging in many low- and middle-income countries (LMICs), due to multiple barriers. In Nigeria, Africa's most populous country, rabies remains a major public health burden, with domestic dogs as the primary reservoir. Efforts to scale up canine rabies vaccination are limited by the lack of a coordinated national programme and challenges related to affordability, service availability, infrastructure, and owner awareness. Methods: We conducted a cross-sectional study of dog-owning households in three Nigerian states and the Federal Capital Territory (FCT) and developed a probabilistic model to uncover contextual factors associated with perceived barriers to canine rabies vaccination among owners of unvaccinated dogs. Results: Posterior distributions of our model estimates indicate that respondents reporting not knowing how to vaccinate their dogs against rabies were more likely to have tertiary education, prior awareness of rabies, use dogs for security purposes, urban residence, and residence in areas with higher household poverty. In contrast, respondents reporting knowledge of rabies transmission via bites from rabid dogs, access to local veterinary services, good road networks, and ownership of partially confined dogs were less likely to perceive this barrier. Respondents who were students, had attained tertiary education, resided in urban areas, and were in the FCT and Anambra State were more likely to perceive the rabies vaccine as too costly. Conversely, respondents from medium-sized households, those who relied on traditional care in the event of a dog bite, and owners of partially confined dogs were also more likely to perceive the rabies vaccine as too costly. Finally, respondents who had heard about rabies and those with tertiary education were less likely to perceive the rabies vaccine as unimportant. Conclusions: Our study identified key barriers to canine rabies vaccination in Nigeria, including lack of knowledge, perceived high cost, and low perceived importance. These were influenced by socioeconomic factors, place of residence, and dog ownership practices, while rabies awareness, veterinary access, good road infrastructure, and partial confinement reduced these perceptions. These findings highlight the need for targeted, context-specific strategies to improve affordability, access, and infrastructure, particularly among disadvantaged households.

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