{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:52:21Z","timestamp":1791913941548,"version":"4.3.4"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Rabies is a viral zoonotic disease of warm-blooded animals, which is preventable through proper administration of post-exposure prophylaxis (PEP). In controlling rabies, delays in initiating post exposure vaccination (PEV) are a challenge in endemic regions. A study was conducted to assess the delay in initiation of PEV and identify associated factors in Ethiopia. Data was collected by face-to-face interviews from 260 dog bite victims or their guardians between January and June, 2025 using a questionnaire. Post exposure vaccination was considered delayed if it was initiated after 48 hours of the exposure incident. The prevalence of delayed initiation of PEV was calculated as a percentage from the number of individuals who initiated PEV after 48 hours and the total number of individuals exposed to rabies. Factors associated with delay were identified using logistic regression models. The prevalence of delayed in initiation of rabies PEV was 86.1% (224\/260); 13.9% (36\/260) of participants commenced vaccination within 48 hours of exposure. Severity of bite and ownership of biting animal were factors associated with the outcome. Deep bite (OR = 0.22, 95% CI: 0.07 - 0.66, P\u2009=\u20090.008) and bitten by stray dogs (OR = 0.51, 95% CI\u2009=\u20090.27 - 0.95, P\u2009=\u20090.033) reduced delay in initiation of PEV. Majority of respondents (88.5%) are aware of the existence, the signs (71.5%), the way of transmission (75.4%), and the fatal nature (96.5%) of rabies, and the need for PEV (95.4%). Another majority believe that the cost of the vaccine is fair and PEV is effective (95%), and and costs of the vaccination (76.2%) was not a reason for delay. In conclusion, the study outlined that respondents know many aspects of rabies control and had fewer barriers to uptake the PEV; however, the delay in initiating PEV was high. This underscores that respondents may not be aware of the risk of delay. Therefore, interventions focusing on the risk of delayed PEV initiation are needed.<\/jats:p>","DOI":"10.1371\/journal.pntd.0014729","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:23:46Z","timestamp":1791912226000},"page":"e0014729","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delay in initiation of rabies post-exposure vaccination and influencing factors in Gondar zones of Ethiopia"],"prefix":"10.1371","volume":"20","author":[{"given":"Bezawit Kassaw","family":"Hailu","sequence":"first","affiliation":[{"name":"College of Veterinary Medicine and Animal Sciences, University of Gondar","place":["Gondar, Ethiopia"],"department":["Department of Veterinary Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yitayew","family":"Demessie","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine and Animal Sciences, University of Gondar","place":["Gondar, Ethiopia"],"department":["Department of Veterinary Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asnakew Mulaw","family":"Berihun","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine and Animal Sciences, University of Gondar","place":["Gondar, Ethiopia"],"department":["Department of Veterinary Pathobiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5043-1528","authenticated-orcid":true,"given":"Abebe Belete","family":"Bitew","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine and Animal Sciences, University of Gondar","place":["Gondar, Ethiopia"],"department":["Department of Veterinary Epidemiology and Public Health"]},{"name":"School of Health","place":["Armidale, NSW, Australia"],"department":["Faculty of Medicine and Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5899-3269","authenticated-orcid":true,"given":"Sefinew Alemu","family":"Mekonnen","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, Bahir Dar University","place":["Bahir Dar, Ethiopia"],"department":["Department of Veterinary Epidemiology and Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"pntd.0014729.ref001","article-title":"Taming the zoonosis in tropics: rise of rabies (hondsdolheid) as an endemic disease and its containment in colonial Indonesia, 1870s-1930s","volume":"34","author":"A Wahid","year":"2024","journal-title":"Paramita: Historical Studies Journal"},{"key":"pntd.0014729.ref002","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1080\/01652176.2017.1343516","article-title":"Rabies \u2013 epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: a comprehensive review","volume":"37","author":"R Singh","year":"2017","journal-title":"Veterinary Quarterly"},{"key":"pntd.0014729.ref003","article-title":"Epidemiologic survey around dog bites, Plateau State, Central Nigeria","volume":"2","author":"L Logyang","year":"2023","journal-title":"Clinical Endocrinology and Metabolism"},{"key":"pntd.0014729.ref004","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ijid.2022.10.046","article-title":"Global burden of rabies in 204 countries and territories, from 1990 to 2019: results from the Global Burden of Disease Study 2019","volume":"126","author":"H Gan","year":"2023","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pntd.0014729.ref005","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s44149-023-00078-8","article-title":"Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism","volume":"3","author":"CE Rupprecht","year":"2023","journal-title":"Anim Dis"},{"issue":"5","key":"pntd.0014729.ref006","doi-asserted-by":"crossref","first-page":"671","DOI":"10.4065\/79.5.671","article-title":"Overview, prevention, and treatment of rabies","volume":"79","author":"DG Hankins","year":"2004","journal-title":"Mayo Clin Proc"},{"key":"pntd.0014729.ref007","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g7827","article-title":"The prevention and management of rabies","volume":"350","author":"NS Crowcroft","year":"2015","journal-title":"BMJ"},{"issue":"3","key":"pntd.0014729.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000982","article-title":"Evaluation of cost-effective strategies for rabies post-exposure vaccination in low-income countries","volume":"5","author":"K Hampson","year":"2011","journal-title":"PLoS Negl Trop Dis"},{"issue":"37","key":"pntd.0014729.ref009","doi-asserted-by":"crossref","first-page":"5500","DOI":"10.1016\/j.vaccine.2018.06.061","article-title":"Rabies vaccines: WHO position paper, April 2018 recommendations","volume":"36","author":"WHO","year":"2018","journal-title":"Vaccine"},{"key":"pntd.0014729.ref010","article-title":"On the path to rabies elimination: The need for risk assessments to improve administration of post-exposure prophylaxis","author":"K Rysava","year":"2019","journal-title":"Vaccine"},{"issue":"9","key":"pntd.0014729.ref011","doi-asserted-by":"crossref","first-page":"4751","DOI":"10.4103\/jfmpc.jfmpc_890_20","article-title":"Factors influencing delay in initiating post-exposure prophylaxis for rabies prevention among animal bite victims: A cross sectional study","volume":"9","author":"RT Wani","year":"2020","journal-title":"J Family Med Prim Care"},{"issue":"7","key":"pntd.0014729.ref012","first-page":"735","article-title":"A study to assess the factors influencing delay in initiation of the postexposure prophylaxis among animal bite victims attending anti-rabies clinic of a tertiary care hospital in southern Rajasthan under national rabies control programme","volume":"16","author":"S Shah","year":"2024","journal-title":"International Journal of Pharmaceutical and Clinical Research"},{"issue":"4","key":"pntd.0014729.ref013","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.3390\/ijerph18041736","article-title":"Challenges to the Fight against Rabies-The Landscape of Policy and Prevention Strategies in Africa","volume":"18","author":"AH Haselbeck","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pntd.0014729.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000626","article-title":"The feasibility of canine rabies elimination in Africa: dispelling doubts with data","volume":"4","author":"T Lembo","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014729.ref015","doi-asserted-by":"crossref","first-page":"105459","DOI":"10.1016\/j.actatropica.2020.105459","article-title":"Dog rabies control in West and Central Africa: A review","volume":"224","author":"C Mbilo","year":"2021","journal-title":"Acta Trop"},{"issue":"12","key":"pntd.0014729.ref016","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-048551","article-title":"Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review","volume":"11","author":"PS Nyasulu","year":"2021","journal-title":"BMJ Open"},{"issue":"2","key":"pntd.0014729.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010124","article-title":"Scaling-up the delivery of dog vaccination campaigns against rabies in Tanzania","volume":"16","author":"M Sambo","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"issue":"1842","key":"pntd.0014729.ref018","first-page":"20161211","article-title":"Optimal frequency of rabies vaccination campaigns in Sub-Saharan Africa","volume":"283","author":"AM Bilinski","year":"2016","journal-title":"Proc Biol Sci"},{"issue":"3","key":"pntd.0014729.ref019","article-title":"Epidemiology of suspected rabies cases in Ethiopia: 2018\u20132022","volume":"2","author":"GB Asfaw","year":"2024","journal-title":"One Health Advances"},{"issue":"2","key":"pntd.0014729.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0192313","article-title":"Estimating the burden of rabies in Ethiopia by tracing dog bite victims","volume":"13","author":"TJ Beyene","year":"2018","journal-title":"PLoS One"},{"key":"pntd.0014729.ref021","doi-asserted-by":"crossref","first-page":"6662073","DOI":"10.1155\/2021\/6662073","article-title":"Situation of Rabies in Ethiopia: A Five-Year Retrospective Study of Human Rabies in Addis Ababa and the Surrounding Regions","volume":"2021","author":"M Aklilu","year":"2021","journal-title":"J Trop Med"},{"issue":"2","key":"pntd.0014729.ref022","doi-asserted-by":"crossref","first-page":"22","DOI":"10.12691\/ajphr-12-2-2","article-title":"Endemic Rabies in Ethiopia in the One Health Era","volume":"12","author":"M Pal","year":"2024","journal-title":"AJPHR"},{"issue":"2","key":"pntd.0014729.ref023","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004471","article-title":"Dog Demography, Animal Bite Management and Rabies Knowledge-Attitude and Practices in the Awash Basin, Eastern Ethiopia","volume":"10","author":"R Tschopp","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014729.ref024","first-page":"60","article-title":"Review on rabies, with emphasis on disease control and eradication measures","volume":"4","author":"E Abera","year":"2015","journal-title":"International Journal of Basic and Applied Virology"},{"issue":"2","key":"pntd.0014729.ref025","doi-asserted-by":"crossref","DOI":"10.4314\/evj.v16i2.3","article-title":"Study on knowledge, attitude and dog ownership patterns related to rabies prevention and control in Addis Ababa, Ethiopia","volume":"16","author":"E Yimer","year":"2012","journal-title":"Ethiop Vet J"},{"issue":"2","key":"pntd.0014729.ref026","doi-asserted-by":"crossref","DOI":"10.4314\/ejhd.v24i2.62961","article-title":"The status of rabies in Ethiopia: A retrospective record review","volume":"24","author":"A Deressa","year":"2010","journal-title":"Ethiopian Journal of Health Development"},{"issue":"5","key":"pntd.0014729.ref027","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002216","article-title":"Incidence of rabies in humans and domestic animals and people\u2019s awareness in North Gondar Zone, Ethiopia","volume":"7","author":"WT Jemberu","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014729.ref028","unstructured":"Zemene D. Knowledge, attitude, and practice related to dog bite victims attending at anti-rabies post-exposure vaccine taker in Poly Health Center in Gondar Town, Amhara Region, Northwest Ethiopia. 2024."},{"issue":"4","key":"pntd.0014729.ref029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003709","article-title":"Estimating the global burden of endemic canine rabies","volume":"9","author":"K Hampson","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0014729.ref030","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1186\/s12889-020-09273-5","article-title":"A five-year trend analysis of malaria surveillance data in selected zones of Amhara region, Northwest Ethiopia","volume":"20","author":"D Lankir","year":"2020","journal-title":"BMC Public Health"},{"issue":"3","key":"pntd.0014729.ref031","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003974","article-title":"Dog owners\u2019 intention to control rabies and their willingness to pay for rabies vaccine in Northwestern Ethiopia","volume":"5","author":"F Mengie","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"pntd.0014729.ref032","doi-asserted-by":"crossref","first-page":"100006","DOI":"10.1016\/j.ijidoh.2023.100006","article-title":"Rabies post-exposure prophylaxis delivery to ensure treatment efficacy and increase compliance","volume":"1","author":"D Nadal","year":"2023","journal-title":"IJID One Health"},{"issue":"3","key":"pntd.0014729.ref033","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/tbed.12463","article-title":"Towards Canine Rabies Elimination in South-Eastern Tanzania: Assessment of Health Economic Data","volume":"64","author":"B Hatch","year":"2017","journal-title":"Transbound Emerg Dis"},{"key":"pntd.0014729.ref034","first-page":"91","article-title":"Overview of rabies in and around Addis Ababa, in animals examined in Ehnri Zoonoses Laboratory between, 2003 and 2009","volume":"14","author":"A Ali","year":"2010","journal-title":"Ethio Vet J"},{"key":"pntd.0014729.ref035","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.prevetmed.2016.01.029","article-title":"Intention of dog owners to participate in rabies control measures in Flores Island, Indonesia","volume":"126","author":"E Wera","year":"2016","journal-title":"Prev Vet Med"},{"key":"pntd.0014729.ref036","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.prevetmed.2013.02.009","article-title":"Examining dog owners\u2019 beliefs regarding rabies vaccination during government-funded vaccine clinics in Grenada to improve vaccine coverage rates","volume":"110","author":"D Thomas","year":"2013","journal-title":"Prev Vet Med"},{"issue":"12","key":"pntd.0014729.ref037","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1111\/jpc.12948","article-title":"Dog bites to the upper extremity in children","volume":"51","author":"J Speirs","year":"2015","journal-title":"J Paediatr Child Health"},{"issue":"6","key":"pntd.0014729.ref038","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1093\/trstmh\/trae002","article-title":"Prevalence of delayed initiation of rabies postexposure prophylaxis and factors influencing it among animal bite victims from Eastern Uttar Pradesh, India","volume":"118","author":"IA Khan","year":"2024","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"7","key":"pntd.0014729.ref039","article-title":"Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants","volume":"11","author":"Q Liu","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"pntd.0014729.ref040","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3961\/jpmph.17.027","article-title":"Epidemiology of Animal Bites and Factors Associated With Delays in Initiating Post-exposure Prophylaxis for Rabies Prevention Among Animal Bite Cases: A Population-based Study","volume":"50","author":"F Esmaeilzadeh","year":"2017","journal-title":"J Prev Med Public Health"},{"key":"pntd.0014729.ref041","doi-asserted-by":"crossref","first-page":"102873","DOI":"10.1016\/j.tmaid.2025.102873","article-title":"Delayed and incomplete rabies post-exposure prophylaxis among international travelers: A seven-year retrospective study at an emergency center in eastern Thailand","volume":"67","author":"N Singkam","year":"2025","journal-title":"Travel Med Infect Dis"},{"key":"pntd.0014729.ref042","doi-asserted-by":"crossref","first-page":"49","DOI":"10.12688\/aasopenres.13311.1","article-title":"Delays in initiating rabies post-exposure prophylaxis among dog bite victims in Wakiso and Kampala districts, Uganda","volume":"4","author":"S Kisaka","year":"2022","journal-title":"AAS Open Res"},{"key":"pntd.0014729.ref043","doi-asserted-by":"crossref","first-page":"6419104","DOI":"10.1155\/2020\/6419104","article-title":"Pattern of Animal Bites and Delays in Initiating Rabies Postexposure Prophylaxis among Clients Receiving Care in Korle-Bu Teaching Hospital","volume":"2020","author":"JA Addai","year":"2020","journal-title":"J Trop Med"},{"issue":"10","key":"pntd.0014729.ref044","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.3390\/medicina59101744","article-title":"Psychological and Social Aspects of Vaccination Hesitancy-Implications for Travel Medicine in the Aftermath of the COVID-19 Crisis: A Narrative Review","volume":"59","author":"C Milionis","year":"2023","journal-title":"Medicina (Kaunas)"},{"issue":"1","key":"pntd.0014729.ref045","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12889-020-8145-7","article-title":"Assessment of knowledge, attitude and practice towards rabies and associated factors among household heads in Mekelle city, Ethiopia","volume":"20","author":"WG Hagos","year":"2020","journal-title":"BMC Public Health"},{"issue":"10","key":"pntd.0014729.ref046","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012551","article-title":"General public knowledge, attitudes, and practices about rabies and associated factors in Gomma district of Jimma zone, southwestern Ethiopia","volume":"18","author":"S Kebede","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"pntd.0014729.ref047","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2022.e11366","article-title":"Knowledge, attitude and practice related to rabies among residents of Amhara region, Ethiopia","volume":"8","author":"A Bahiru","year":"2022","journal-title":"Heliyon"},{"key":"pntd.0014729.ref048","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3390\/diseases8010005","article-title":"Rabies: Knowledge, Attitude and Practices in and Around South Gondar, North West Ethiopia","volume":"8","author":"A Bihon","year":"2020","journal-title":"Diseases"},{"issue":"1","key":"pntd.0014729.ref049","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/2049-9957-4-3","article-title":"Incidence of human rabies exposure and associated factors at the Gondar Health Center, Ethiopia: a three-year retrospective study","volume":"4","author":"M Yibrah","year":"2015","journal-title":"Infect Dis Poverty"},{"key":"pntd.0014729.ref050","first-page":"128","article-title":"Current situation of rabies prevention and control in developing countries: Ethiopia perspective","volume":"4","author":"AM Aga","year":"2016","journal-title":"J Infect Dis Preve Med"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014729","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:23:53Z","timestamp":1791912233000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014729"}},"subtitle":[],"editor":[{"given":"Andrea","family":"Marzi","sequence":"first","affiliation":[{"name":"NIAID DIR: National Institute of Allergy and Infectious Diseases Division of Intramural Research","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014729","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]}}}