Factors associated with the spatiotemporal distribution of dog rabies in Tunisia

by Sana Kalthoum, Samia Mzoughi, Raja Gharbi, Monia Lachtar, Bassem Bel Haj Mohamed, Haikel Hajlaoui, Wiem Khalfaoui, Anissa Dhaouadi, Imed Ben Sliman, Chafik Ben Salah, Haykel Kessa, Hend Benkirane, Ahmed Jawher Fekih, Kahoula Barrak, Hajer Sayari, Chokri Bahloul, Thibaud Porphyre

Despite continuous efforts of veterinary services to control rabies in dogs since 1982, rabies remains a cause of death in Tunisia, with more than five reported human cases in 2022. As little is known on the determinants of transmission of rabies in dogs, better understand which factors contribute to its spatial heterogeneity in Tunisia is critical for developing bespoke mitigation activities. In this context, we developed Bayesian Poisson mixed-effect spatio-temporal model upon all cases of rabid dogs reported in each delegation during the period from 2019 to 2021. The best fitting model highlighted the association between the risk of rabies and the mean average monthly temperature, the density of markets and the density of dogs in delegations. Interestingly, no relationship was found between intensity of vaccination in dogs and the risk of rabies. Our results provided insights into the spatio-temporal dynamics of dog rabies transmission and highlighted specific geographic locations where the risk of infection was high despite correction for associated explanatory variables. Such an improved understanding represent key information to design bespoke, cost-efficient, rabies prevention and control strategies to support veterinary services activities and policymaking.