preprint · medRxiv
Rabies causes approximately 59,000 human deaths globally each year, with Africa accounting for over a third of this total. In Uganda, national dog vaccination rates hover around 10%, falling well short of protective levels. An investigation in Butaleja Town Council examined factors governing whether dog owners vaccinate their animals. While over half of surveyed owners had vaccinated at least one dog, overall dog vaccination coverage reached under half of the local canine population, falling short of the 70% threshold required to interrupt viral transmission. Uptake was strongly linked to owner characteristics and service access. Older individuals, households with higher incomes or formal education, and owners attending community education were far more likely to vaccinate. Direct access to veterinary clinics and the receipt of vaccination reminders also positively influenced uptake, highlighting critical practical barriers in rural disease control.
Controlling rabies at the animal source is vital for preventing fatal human infections and reducing healthcare burdens from bite exposures. Demonstrating that partial household vaccination leaves communities vulnerable helps public health and veterinary agencies design more effective interventions. The findings show that achieving international elimination targets depends heavily on expanding local veterinary service access, targeted educational outreach, and practical reminder mechanisms for underserved pet owners.
The research highlights clear opportunities for veterinary health organisations, public health agencies, and digital service developers. The findings support applied implementation rather than early-stage discovery, indicating near-term use for community-level veterinary delivery models and automated communication tools, such as mobile reminder systems. Veterinary pharmaceutical distributors and service providers could use this data to optimise distribution channels and design targeted outreach campaigns for lower-income, younger, and rural dog owners.
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ABSTRACT Rabies remains a major zoonotic public health threat, associated with approximately 59,000 annual deaths globally, with Africa bearing 36% of this burden. In Uganda, an estimated 36 human deaths and 1.8 million dog bite exposures occur annually, yet national dog vaccination coverage remains critically low at approximately 10%. This study investigated factors associated with rabies vaccination uptake among dog owners in Butaleja Town Council, Eastern Uganda, a high-risk setting. A cross-sectional survey was conducted among 173 dog owners between May 18 and June 28, 2024, using semi-structured questionnaires. The primary outcome was vaccination uptake (≥1 dose in the past year). Modified Poisson regression with robust variance estimated adjusted prevalence ratios for all socio-demographic, veterinary system, health system, dog-related, and knowledge factors. Among 173 dog owners, 57.2% vaccinated at least one dog, corresponding to 54.6% (166/304) of all dogs vaccinated. Factors associated with vaccination uptake included older age (21–40 years: aPR 1.43, 95% CI: 1.15–1.71; 41–60 years: aPR 1.53, 95% CI: 1.22–1.82; ≥61 years: aPR 1.56, 95% CI: 1.33–2.23), higher education (primary: aPR 1.20, 95% CI: 1.00–1.45; secondary: aPR 1.55, 95% CI: 1.20–2.00), higher income, access to veterinary clinics (aPR 2.50, 95% CI: 1.52–3.75), and participation in community education sessions (aPR 1.71, 95% CI: 1.34–2.15). While household-level uptake showed moderate engagement, the resulting dog population vaccination coverage of 48.4% remained substantially below the 70% World Health Organization threshold required for herd immunity. Achieving the “Zero by 30” elimination dog-bite mediated Rabies target in this setting requires targeted interventions addressing the identified associated factors including; enhanced community education, improved veterinary service accessibility, reminder systems, and strategies to convert partial household vaccination into complete coverage particularly among younger, less educated, and lower-income dog owners. Author Summary Rabies remains a neglected tropical disease that claims approximately 59,000 lives annually, predominantly in Africa and Asia. While mass dog vaccination is the most effective control strategy, many communities struggle to reach the 70% coverage needed to mitigate rabies transmission. This study investigated why dog owners in a high-risk Ugandan community do or do not vaccinate their animals. We surveyed 173 dog owners and found an important gap; while 57% of owners had vaccinated at least one dog, only 48% of all dogs were actually vaccinated far below the global target. This distinction matters because it shows that even owners who participate in vaccination programs often leave some dogs unprotected, undermining efforts to achieve herd immunity. Several factors were associated with vaccination. Owners with better access to veterinary clinics, knowledge of where to get vaccines, and participation in community education were more likely to vaccinate. Receiving vaccination reminders also made a significant difference. Conversely, limited awareness, poor service accessibility, and socioeconomic challenges prevented many from vaccinating their dogs. These findings point to practical solutions: improving communication about vaccination locations, sending reminders, and strengthening community education could help more families fully vaccinate all their dogs. For Uganda and similar settings, addressing these barriers is essential to reach the global goal of eliminating rabies deaths by 2030.
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DOI: 10.64898/2026.08.14.26360440
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