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Author: search.filters.author.Mshelbwala, Philip PStart date: 2000

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    Insights into canine rabies vaccination Disparities in Sierra Leone: A cross-sectional household study
    (Public Library of Science, 2024-07-19) Mshelbwala, Philip P
    Annually, Sierra Leone records an estimated 301 human fatalities due to rabies. Canine vaccination is crucial for rabies prevention and control efforts. However, considerable variability exists in vaccination rates. Reasons for this variation remain unclear. We conducted a cross-sectional study across 2,558 dog-owning households (HHs) to provide insights into factors influencing canine vaccination for targeted prevention and control towards elimination by 2030. First, we described dog ownership practices, then built a probabilistic model to understand factors associated with dog vaccination, and finally used a spatial scan statistic to identify spatial clusters where vaccination rates were low. Our results indicated that only 14% (358/2,558) of participating HHs had fully vaccinated their dogs against rabies. The probability of dog vaccination increased when comparing civil servants to private workers/artisans, with an Odds Ratio(OR) of 1.14 (95% credible interval (Crl) of 0.82-1.56), residing in locations with a veterinary establishment vs. none (OR = 6.43, 95% Crl (4.97-8.35), providing care to dogs vs. allowing dogs to roam freely (OR = 2.38, 95% Crl(1.80-3.17) and owning a single dog vs multiple dogs (OR = 1.20, 95 Crl (0.92-1.56). Conversely, there was a decrease in the estimated probability of vaccination when comparing dog owners located in rural vs. urban areas (OR = 0.58, CrI 95% (0.43-0.78). Latent understanding, a measure of overall understanding of rabies virus, which we estimated using participant education levels and responses to questions about rabies epidemiology, was also an important predictor of vaccination probability (OR = 1.44, 95% Crl (1.04-2.07). The spatial analysis identified high-risk clusters for low vaccination in the cities of Moyamba, with a radius of 40 km, a relative risk (RR) of 1.10, and Bo, with a radius of 19.9 km with RR of 1.11. These data do not support Sierra Leone reaching the 2030 goal of human rabies elimination caused by dogs. Our study highlights a critical need for public outreach and education, improved vaccination rates, increased accessibility to veterinary services, and targeted interventions in Bo and Moyamba to support rabies prevention and control efforts.
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    Factors associated with perceived barriers to canine rabies vaccination among owners of unvaccinated dogs in Sierra Leone
    (Elsevier BV, 2025-09-27) Mshelbwala, Philip P
    Dog vaccination is the most effective method for preventing rabies virus transmission and human deaths. However, in Sierra Leone, vaccination rates remain low, and the reasons for non-vaccination are not well understood. We analysed 2023 household survey data using a hierarchical Bayesian multinomial regression to provide insight into perceived barriers to canine rabies vaccination among owners of unvaccinated dogs. Our results indicated that of the 2558 dog-owning households interviewed, only 14 % (358) reported having fully vaccinated their dogs. Of the 2200 respondents with unvaccinated dogs, most (71.6 %) didn't know how to access rabies vaccination services, 17.6 % cited cost, and 10.8 % believed it was unimportant. Posterior distribution of our model showed that urban residents had 91 % lower odds of believing rabies vaccination was unimportant compared to rural residents (OR = 0.11, 95 % CrI: 0.02-0.34). Similarly, individuals with tertiary education had 28 % lower odds of believing rabies vaccination was unimportant (OR = 0.72, 95 % CrI: 0.31-1.59), though this effect is uncertain despite an 80 % probability of being protective. Respondents in areas without veterinary services were more likely to cite cost as a barrier. Students were significantly less likely than civil servants to consider rabies vaccination unimportant (OR = 0.41, 95 % CrI: 0.17-0.95). In contrast, owners of free-roaming dogs were significantly twice as likely to believe that rabies vaccination was unimportant (OR = 2.41, 95 % CrI: 1.15-5.59). Those with partially confined dogs were significantly more likely to report not knowing how to access rabies vaccination services (OR = 1.99, 95 % CrI: 1.39-2.86). Compared to households citing cost, those in the Eastern Province were significantly less likely to report that the vaccine is unimportant. Respondents in the Western Area were significantly less likely to report cost as a barrier. In contrast, households in the Eastern were more likely to report cost as a barrier. These findings suggest that barriers to dog vaccination in Sierra Leone are shaped by a combination of informational, socioeconomic, and geographic factors. Improving public awareness, especially in rural areas, and expanding access to veterinary services could help address key obstacles. Tailored outreach strategies that consider education levels, occupation types, and local infrastructure are recommended to enhance vaccination uptake and support rabies prevention efforts.