Dog Bite Epidemiology and Postexposure Practices Among Dog Owners in Some Communities in the Upper West Region of Ghana.

BACKGROUND: Rabies remains a neglected tropical disease in northern Ghana, where dog bites are common, and postexposure prophylaxis access is limited. Community-level data on bite epidemiology and health-seeking practices are scarce. METHODS: A cross-sectional survey was conducted among 370 dog-owning households (1824 individuals) in Lawra and Jirapa municipalities, Upper West Region, using a multistage sampling approach. Three submunicipalities were randomly selected from each municipality, after which households were selected using systematic sampling. We captured lifetime dog bite history, postexposure practices and rabies prevention behaviours. RESULTS: Overall rabies awareness was high (Jirapa 97.6% and Lawra 77.0%). Lifetime household-level dog bite prevalence was significantly higher in Jirapa (44.1%) than in Lawra (20.5%). Postbite care was suboptimal: 38.4% of victims in Jirapa first sought traditional remedies compared to 17.2% in Lawra. Death after a bite was reported in 33.3% of Jirapa victims and 16.4% of Lawra victims. Family members reported symptoms suggestive of rabies in some of these cases; however, none were clinically or laboratory confirmed. Higher education was positively associated with safer practices (β = 0.78, p = 0.008), while initial reliance on traditional healers was inversely associated (β = -1.12, p = 0.005). CONCLUSIONS: Dog bites and probable rabies deaths are underreported in these municipalities. The heavy reliance on traditional medicine and low formal health-seeking highlight critical barriers to rabies elimination. Strengthening community-based surveillance, integrated traditional healer referral, and targeted radio-based health education in local languages are urgently needed.