A case-control study of risk factors for dog rabies in Northeast Tunisia.

Background: Since 2012, the northeast region of Tunisia has witnessed an increase in dog rabies cases, indicating a concerning emergence of the disease. Previous studies have indicated the widespread nature of rabies in northern Tunisia. However, there remains a lack of comprehensive understanding regarding the associated risk factors. Aim: This study aimed to identify potential risk factors associated with the occurrence of dog rabies in northeast Tunisia through a case-control approach. Methods: A case-control study was conducted, involving a case group ( Results: The final logistic regression model revealed several significant findings. The odds of an unconfined dog being affected by rabies were nearly twice as high as for confined dogs odds ratio [OR = 1.9; 95% confidence intervals (CI): 1.17-3.27]. Furthermore, the odds of rabies occurrence were 25 times higher in areas where rabies cases had been reported within the previous 3 months to 1 year compared to uninfected areas (OR = 25.7; 95% CI: 3.02-219.14). Dogs born at home to the owner's bitch were also found to be at significantly higher risk of rabies (OR = 2.41; 95% CI: 1.14-5.13). Additionally, residing in areas with reported rabies cases in the last 3 months was found to increase the risk of rabies by 2.8 times (OR = 2.8; 95% CI: 1.16-6.77). However, vaccination was associated with a 1.6-fold reduction in the risk of contracting rabies (OR = 0.6; 95% CI: 0.38-0.97). Conclusion: This study provides valuable insights into the risk factors associated with dog rabies in northeast Tunisia. The findings underscore the importance of implementing targeted control measures, such as increased vaccination coverage and enhanced confinement measures, to mitigate the spread of rabies in the region. These findings can inform decision-making processes aimed at improving the effectiveness of national rabies control programs.