{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:41:18Z","timestamp":1787604078488,"version":"build-2736575974"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah bint Abdulrahman University","doi-asserted-by":"crossref","award":["PNURSP2026R778"],"award-info":[{"award-number":["PNURSP2026R778"]}],"id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Trop. Med. Infect. Dis.","TropicalMed"],"abstract":"<jats:p>Rabies remains a fatal yet preventable zoonotic disease, and understanding population-level knowledge, attitudes, and practices (KAP) is essential to guide national elimination strategies. This nationwide cross-sectional study assessed rabies-related KAP among 2116 residents across all major regions of Saudi Arabia. An online validated questionnaire measured sociodemographic characteristics and KAP indicators. Descriptive and inferential statistics, including logistic regression, were used to identify predictors of good KAP outcomes. Overall, more than half of participants demonstrated poor knowledge (54.9%), particularly regarding rabies etiology, transmission, and essential post-exposure wound care, while attitudes toward prevention were overwhelmingly positive (92%). Despite this, several unsafe practices persisted, including interaction with stray animals and use of traditional remedies. Good knowledge was significantly associated with higher income, pet ownership, and residency in the Central region, whereas younger age and Northern residency predicted poorer practices. Mediation analysis suggested that knowledge may partly explain (mediate) the association between sociodemographic characteristics and reported preventive practices; however, causal inference is limited by the cross-sectional design. These findings demonstrate substantial knowledge and behavioral gaps despite favorable attitudes and highlight the need for culturally tailored educational interventions, improved access to post-exposure prophylaxis, and strengthened One Health strategies to support rabies elimination in Saudi Arabia.<\/jats:p>","DOI":"10.3390\/tropicalmed11020055","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:22:46Z","timestamp":1771320166000},"page":"55","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Nationwide Cross-Sectional Survey of Knowledge, Attitudes, and Practices on Rabies in Saudi Arabia"],"prefix":"10.3390","volume":"11","author":[{"given":"Ebtisam","family":"Bakhsh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Doumi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najd","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad","family":"Althubiti","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Hagr","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5592-5662","authenticated-orcid":false,"given":"Abeer","family":"Alnujide","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8976-5168","authenticated-orcid":false,"given":"Shouq","family":"Alobaid","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Allaboon","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1318-2738","authenticated-orcid":false,"given":"Shatha","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duaa","family":"Aljuhaymi","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Assiri","sequence":"additional","affiliation":[{"name":"Ministry of Health, Riyadh 11176, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Shaban, M., Osman, Y.M., Mohamed, N.A., and Shaban, M.M. (2025). Empowering Breast Cancer Clients through AI Chatbots: Transforming Knowledge and Attitudes for Enhanced Nursing Care. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-03585-w"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"a0000385","DOI":"10.36877\/pmmb.a0000385","article-title":"Comprehensive Update on Rabies: A Neglected Zoonotic Disease of Public Health Concern","volume":"6","author":"Manjunatha","year":"2023","journal-title":"Prog. Microbes Mol. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J.D., Briggs, D.J., and Cleaveland, S. (2015). Estimating the Global Burden of Endemic Canine Rabies. PLoS Neglected Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003786"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"\u015eahin, \u015e., and \u00d6zhanl\u0131, Y. (2025). Emotional Experiences, Difficulties, and Facilitators in Patient Care of Nurses Working in Surgical Units: A Qualitative Study. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-04010-y"},{"key":"ref_5","first-page":"e50424","article-title":"Alarming Rise in Global Rabies Cases Calls for Urgent Attention: Current Vaccination Status and Suggested Key Countermeasures","volume":"15","author":"Pattnaik","year":"2023","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100105","DOI":"10.1016\/j.vetvac.2025.100105","article-title":"Rabies Vaccines: Journey from Classical to Modern Era","volume":"4","author":"Khan","year":"2025","journal-title":"Vet. Vaccine"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Swedberg, C., Bote, K., Gamble, L., F\u00e9nelon, N., King, A., and Wallace, R.M. (2024). Eliminating Invisible Deaths: The Woeful State of Global Rabies Data and Its Impact on Progress towards 2030 Sustainable Development Goals for Neglected Tropical Diseases. Front. Trop. Dis., 5.","DOI":"10.3389\/fitd.2024.1303359"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Sambo, M., Ferguson, E.A., Abela-Ridder, B., Changalucha, J., Cleaveland, S., Lushasi, K., Mchau, G.J., Nanai, A., Nonga, H., and Steenson, R. (2022). Scaling-up the Delivery of Dog Vaccination Campaigns against Rabies in Tanzania. PLoS Neglected Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010124"},{"key":"ref_9","first-page":"100047","article-title":"Rabies in Africa: Vaccination Coverage and Strategies for Elimination by 2030","volume":"3","author":"Aborode","year":"2025","journal-title":"Decod. Infect. Transm."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"i54","DOI":"10.1093\/heapol\/czae046","article-title":"The Pathway to Health in All Policies through Intersectoral Collaboration on the Health Workforce: A Scoping Review","volume":"39","author":"Tancred","year":"2024","journal-title":"Health Policy Plan."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Swedberg, C., Mazeri, S., Mellanby, R.J., Hampson, K., and Chng, N.R. (2022). Implementing a One Health Approach to Rabies Surveillance: Lessons From Integrated Bite Case Management. Front. Trop. Dis., 3.","DOI":"10.3389\/fitd.2022.829132"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"26","DOI":"10.14202\/IJOH.2024.26-36","article-title":"One Health in Practice: Benefits and Challenges of Multisectoral Coordination and Collaboration in Managing Public Health Risks: A Meta-Analysis","volume":"10","author":"Sanga","year":"2024","journal-title":"Int. J. One Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.jiph.2018.10.005","article-title":"Rabies among Animals in Saudi Arabia","volume":"12","author":"Kasem","year":"2019","journal-title":"J. Infect. Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zha, R., Lu, J., Chen, J., Guo, C., and Lu, J. (2025). Exploring One Health-Based Strategies for Rabies Elimination: Overview and Future Prospects. PLoS Neglected Trop. Dis., 19.","DOI":"10.1371\/journal.pntd.0013159"},{"key":"ref_15","first-page":"97","article-title":"Main Challenges in the Control of Zoonoses and Related Foodborne Diseases in the South Mediterranean and Middle East Region","volume":"54","author":"Seimenis","year":"2018","journal-title":"Vet. Ital."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hariri, N.H., Alrougi, K.S., Almogbil, A.A., Kassar, M.H., Alharbi, R.G., Krenshi, A.O., Altayyar, J.M., Alibrahim, A.S., Alandiyjany, M.N., and Bashal, F.B. (2025). Public Awareness of Rabies and Post-Bite Practices in Makkah Region of Saudi Arabia: Cross-Sectional Study. Trop. Med. Infect. Dis., 10.","DOI":"10.3390\/tropicalmed10120337"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"279","DOI":"10.21474\/IJAR01\/19253","article-title":"Rabies epidemiology and health authorities efforts in control and prevention of the disease in the kingdom of saudi arabia: A narrative review","volume":"12","author":"Alqatifi","year":"2024","journal-title":"Int. J. Adv. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.5455\/OVJ.2023.v13.i11.1","article-title":"Tracking Lethal Threat: In-Depth Review of Rabies","volume":"13","author":"Khairullah","year":"2023","journal-title":"Open Vet. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e066587","DOI":"10.1136\/bmjopen-2022-066587","article-title":"Rabies in Southeast Asia: A Systematic Review of Its Incidence, Risk Factors and Mortality","volume":"13","author":"Halim","year":"2023","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5361","DOI":"10.4103\/jfmpc.jfmpc_211_22","article-title":"Knowledge, Attitude and Practices of Rabies during an Outbreak in Samtse Municipality, Bhutan: A Cross-Sectional Study","volume":"11","author":"Lhendup","year":"2022","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100751","DOI":"10.1016\/j.onehlt.2024.100751","article-title":"Factors Influencing Canine Rabies Vaccination among Dog-Owning Households in Nigeria","volume":"18","author":"Mshelbwala","year":"2024","journal-title":"One Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"850","DOI":"10.4103\/jfmpc.jfmpc_1674_20","article-title":"Knowledge, Attitude, and Practice Study on Animal Bite, Rabies, and Its Prevention in an Urban Community","volume":"10","author":"Sivagurunathan","year":"2021","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Hetta, H.F., Albalawi, K.S., Almalki, A.M., Albalawi, N.D., Albalawi, A.S., Al-Atwi, S.M., Alatawi, S.E., Alharbi, M.J., Albalawi, M.F., and Alharbi, A.A. (2025). Rabies Vaccination and Public Health Insights in the Extended Arabian Gulf and Saudi Arabia: A Systematic Scoping Review. Diseases, 13.","DOI":"10.3390\/diseases13040124"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100126","DOI":"10.1016\/j.onehlt.2020.100126","article-title":"Knowledge and Attitudes about Rabies in Dog-Bite Victims in Bangladesh","volume":"9","author":"Alam","year":"2020","journal-title":"One Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1057\/s41267-020-00389-9","article-title":"Unraveling the Effects of Cultural Diversity in Teams: A Retrospective of Research on Multicultural Work Groups and an Agenda for Future Research","volume":"52","author":"Stahl","year":"2021","journal-title":"J. Int. Bus. Stud."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/tbed.12637","article-title":"Towards Canine Rabies Elimination: Economic Comparisons of Three Project Sites","volume":"65","author":"Elser","year":"2018","journal-title":"Transbound. Emerg. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Shaban, M., Shaban, M.M., Mohammed, H.H., Alanazi, M.A., and Elkest, H.R.A. (2025). Analyzing the Correlation between Psychological Capital in Community Nurses and Their Stress Management and Job Satisfaction. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-03071-3"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mohanty, P., Durr, S., Heydtmann, S., Sarkar, A., and Tiwari, H.K. (2025). Improving Awareness of Rabies and Free-Roaming Dogs in Schools of Guwahati, Assam, India: Exploring the Educators\u2019 Perspective. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21892-4"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"509","DOI":"10.26719\/2025.31.8.509","article-title":"Policy Recommendations for Managing Stray Dogs in Morocco","volume":"31","author":"Mahdi","year":"2025","journal-title":"East. Mediterr. Health J."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sujarwoto, S., Holipah, H., and Maharani, A. (2022). A Cross-Sectional Study of Knowledge, Attitudes, and Practices Concerning COVID-19 Outbreaks in the General Population in Malang District, Indonesia. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19074287"},{"key":"ref_31","unstructured":"WHO (2008). A Guide to Developing Knowledge, Attitude and Practice Surveys."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e048551","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":"Nyasulu","year":"2021","journal-title":"BMJ Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1080\/17437199.2010.547985","article-title":"Personality Is of Central Concern to Understand Health: Towards a Theoretical Model for Health Psychology","volume":"7","author":"Ferguson","year":"2013","journal-title":"Health Psychol. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s41649-021-00199-7","article-title":"Exploring the Ethical Dilemmas in End-of-Life Care and the Concept of a Good Death in Bhutan","volume":"14","author":"Dorji","year":"2022","journal-title":"Asian Bioeth. Rev."},{"key":"ref_35","first-page":"e75845","article-title":"Influences of Cultural Factors on Vaccination Practices Among Parents Prior to School Age: A Systematic Review and Meta-Analysis","volume":"16","author":"Rezq","year":"2024","journal-title":"Cureus"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10871209.2018.1522679","article-title":"Key Beliefs Underlying Public Feeding of Free-Roaming Cats in Malaysia and Management Suggestions","volume":"24","author":"Davey","year":"2019","journal-title":"Hum. Dimens. Wildl."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1057\/s41599-023-01724-9","article-title":"Mechanism of Attitude, Subjective Norms, and Perceived Behavioral Control Influence the Green Development Behavior of Construction Enterprises","volume":"10","author":"Li","year":"2023","journal-title":"Humanit. Soc. Sci. Commun."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e079783","DOI":"10.1136\/bmjopen-2023-079783","article-title":"Utilisation of the Health Belief Model to Study the Behavioural Intentions Relating to Obesity Management among University Students: A Cross-Sectional Study","volume":"14","author":"Albasheer","year":"2024","journal-title":"BMJ Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.cpr.2016.10.008","article-title":"Early Risk and Protective Factors for Problem Gambling: A Systematic Review and Meta-Analysis of Longitudinal Studies","volume":"51","author":"Dowling","year":"2017","journal-title":"Clin. Psychol. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"979","DOI":"10.3390\/idr14060097","article-title":"Ecological and Socioeconomic Factors in the Occurrence of Rabies: A Forgotten Scenario","volume":"14","author":"Subedi","year":"2022","journal-title":"Infect. Dis. Rep."},{"key":"ref_41","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":"Wani","year":"2020","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/1367493509337443","article-title":"Risk-Taking Behaviour in Adolescence: A Literature Review","volume":"13","author":"Leather","year":"2009","journal-title":"J. Child Health Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"100959","DOI":"10.1016\/j.onehlt.2024.100959","article-title":"One Health Interventions and Challenges under Rural African Smallholder Farmer Settings: A Scoping Review","volume":"20","author":"Omuse","year":"2025","journal-title":"One Health"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/11\/2\/55\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:37:53Z","timestamp":1787243873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/11\/2\/55"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["tropicalmed11020055"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed11020055","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]}}}