Rabies epidemiology and barriers to prevention: a One Health approach in Central Vietnam (2016–2021)

Background: In the central region of Vietnam, rabies causes the highest number of deaths and there are many barriers to the prevention and control of the disease.Methods: A cross-sectional study was analyzing 49 rabies death cases (2016-2021) and 67 interviews was conducted to describe epidemiological characteristics and explore barriers to rabies prevention and control in Vietnam's central region. Results:The results showed that the death rate from rabies in the Central region was 0.41 cases/100,000 people, the average number of deaths was 7.4 cases/year (5-12 cases).Factors associated with having rabies disease were belonging to the age group 15-59 years old (59.2%), farming occupation (49.0%).Out of those who died, 47 cases (96%) were not vaccinated against rabies, and 2 cases (4.0%) received a partial course of vaccination after the onset of symptoms and thus did not complete the full post-exposure prophylaxis regimen.The most common reasons for non-vaccination were not wanting to be vaccinated (91.8%) and lack of awareness about its importance (8.2%).Barriers to the prevention and control of rabies included lack of specialized human resources, challenges with the management and vaccination of stray dogs, and few people seeking vaccination after exposure.Conclusion: A strengthened One Health approach is essential, prioritizing community education, integrated health-veterinary surveillance, joint outbreak response, and sustainable vaccine access.