Post-COVID-19 Rabies Surveillance and Risk Factors in Rural Eastern Cape, South Africa: A One Health Perspective

Area of Science:

• Veterinary Public Health
• Zoonotic Disease Surveillance
• One Health Framework

Background:

• Rabies is a neglected zoonotic disease in South Africa, especially in rural areas.
• Weak surveillance, behavioral gaps, and poor One Health coordination hinder control efforts.

Purpose of the Study:

• To assess rabies surveillance, behavioral risk factors, and system responsiveness in two rural Eastern Cape communities.
• To evaluate post-pandemic resilience within a One Health framework.

Main Methods:

• A cross-sectional, community-based pilot study involved 109 residents using structured questionnaires.
• Data collected on demographics, rabies awareness, vaccination practices, and service disruptions.
• Descriptive, bivariate, and multivariate analyses, alongside machine learning models, were used to identify risk predictors and develop a Surveillance Gap Index (SGI).

Main Results:

• 88% of participants were aware of rabies, but only 35% attended awareness campaigns.
• Dog-bite exposure affected 51% of households, with higher risk in males (aOR = 4.33).
• High post-pandemic vaccination coverage (85.7%) was maintained despite COVID-19 disruptions; education was linked to pet vaccination (aOR = 1.78).

Conclusions:

• Integrating behavioral insights and predictive analytics into One Health strategies can enhance rabies surveillance.
• This approach supports progress toward eliminating human rabies by 2030.