# A Nationwide Cross-Sectional Survey of Knowledge, Attitudes, and Practices on Rabies in Saudi Arabia

## TL;DR

This study surveyed 2116 Saudi residents to assess their knowledge, attitudes, and practices regarding rabies, finding significant gaps in knowledge and unsafe behaviors despite positive attitudes.

## Contribution

The study provides a nationwide assessment of rabies-related KAP in Saudi Arabia, identifying sociodemographic predictors and highlighting the need for targeted interventions.

## Key findings

- Over half of participants had poor knowledge of rabies etiology and wound care.
- Positive attitudes toward prevention were common, but unsafe practices like interacting with strays persisted.
- Higher income and pet ownership were linked to better knowledge, while younger age and Northern residency predicted poorer practices.

## Abstract

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.