Modelling factors associated with the probability of seeking traditional care after dog bites in Sierra Leone

Abstract

Evidence suggests a rising incidence of dog bites in Sierra Leone despite ongoing efforts to prevent rabies. However, little is known about the factors influencing the decision to seek medical care following a dog bite. To address this gap, we developed a probabilistic model to examine factors associated with the likelihood of seeking traditional care in Sierra Leone. Among the 2558 respondents who completed the survey, 31 % (782/2558) indicated that they would seek traditional care after a dog bite. The posterior distributions of our model estimates indicated that the probability of seeking traditional care was higher among respondents with lower levels of education, those residing in rural areas, individuals lacking knowledge about rabies virus transmission and its hosts, and those who owned vaccinated dogs. Conversely, respondents living in locations with a livestock officer or veterinary establishment had lower odds of seeking traditional remedies compared with those uncertain about access. We observed a negative relationship between the percentage of health facilities and the probability of seeking traditional care, with higher percentages associated with a decreased likelihood of seeking traditional remedies. We also found regional variation in the probability of seeking traditional care. Respondents in the Eastern and Western Area were less likely to seek traditional remedies than those in the Northern and Southern Provinces. These findings highlight the need for targeted educational campaigns to raise awareness about rabies and the importance of timely medical care after exposure. Improving healthcare access in rural areas and fostering collaboration with traditional healers are also essential for reducing reliance on traditional care and strengthening rabies prevention and control efforts.