Canine rabies and risk of dog aggression in the city of Santa Cruz. A temporal-spatial perspective

Canine rabies and dog attacks represent a significant challenge to public health, particularly in endemic regions such as Santa Cruz de la Sierra, Bolivia. This study analyzed factors associated with dog bites and canine rabies cases in the city between 2019 and 2022, using georeferencing tools to identify key epidemiological patterns and provide relevant information for control strategies. In 2022, a total of 2900 animal attack cases were recorded, 81.6 % of which were caused by dogs. The victims were predominantly men (54 %) and adults aged 20 to 64 years (47 %). Most attacks occurred on the lower limbs (44.6 %) and were caused by known dogs (77.2 %). Additionally, the circumstances of the attacks varied, with accidental incidents being the most common. However, attacks without apparent cause were more likely when the aggressor was an unknown dog (OR 1.88, p < .001). Spatial analysis, conducted using the Kernel density method, identified clusters of attacks around the health centers included in the study, while canine rabies cases were concentrated in peri-urban areas of the city, particularly in the eastern regions. Of the 855 suspected canine rabies cases analyzed during the study period, 1.5 % (n=13) tested positive, primarily in unvaccinated male mixed-breed dogs. The proportion of positive cases decreased progressively since 2019, reflecting progress in vaccination campaigns and canine population control. This study highlights the need for comprehensive public health strategies, including mass vaccination programs, educational campaigns, and the promotion of responsible pet ownership. It also underscores the importance of improving epidemiological surveillance and access to medical services to reduce rabies transmission and respond more effectively to dog bites. The findings provide essential evidence for designing targeted interventions for vulnerable communities in endemic areas.