Perceptions regarding rabies prevention and control in two different community settings in Vietnam using a Q-sorting approach

Background and Aim: Rabies remains a critical public health threat in Vietnam, particularly in areas where dog-mediated transmission persists. Despite national control strategies, vaccination coverage in dogs remains suboptimal. This study aimed to investigate the perceptions of dog owners toward rabies prevention and control in distinct urban and rural settings of Long An Province, using a Q-sorting methodology to explore sociobehavioral and socioeconomic drivers influencing compliance with vaccination programs. Materials and Methods: A cross-sectional study was conducted among 109 dog owners – 60 from urban Tan An City and 49 from rural Duc Hue District – between March and June 2023. Participants performed Q-sorting with 46 validated statements across four domains: Knowledge, attitudes, practices, and cost perceptions regarding rabies prevention. Principal component analysis was applied separately for each setting to identify latent discourses. Socioeconomic factors were assessed in relation to discourse membership using descriptive and inferential statistics. Results: Two discourses were identified in the urban setting (“Obstructed Adherents” and “Casual Observers”) and three in the rural setting (“Identified Awareness,” “Independent Owners,” and “Close Adherence”). While all participants demonstrated baseline knowledge of rabies severity, barriers such as limited vaccine accessibility and inadequate veterinary support impeded proactive vaccination. Vaccine cost was not perceived as a major deterrent. Educational attainment was significantly associated with proactive health-seeking behavior in the rural setting (p = 0.017). Conclusion: This study elucidates community-specific perceptions that influence rabies prevention behavior. Although awareness of rabies is high, structural limitations – particularly inadequate access to veterinary services – hinder effective control. Tailored community engagement, veterinary outreach, and education campaigns, especially in low-resource settings, are recommended to enhance vaccination uptake and achieve national rabies elimination goals by 2030. Keywords: community perceptions, One Health, Q-sorting, rabies prevention, vaccination barriers, Vietnam.