Assessment of the awareness of rabies, rabies prophylaxis guidelines and rabies practice among physicians in Sudan: a national cross-sectional study, 2024

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BACKGROUND: Rabies is a preventable viral zoonotic disease with a near 100% case fatality rate once clinical symptoms appear. In Sudan, rabies remains a significant public health concern, exacerbated by limited resources and the ongoing armed conflict. Physicians play a critical role in rabies prevention and management, yet their knowledge and adherence to updated clinical guidelines remain poorly understood. This study assesses physicians' knowledge, and awareness of rabies disease, adherence to updated rabies prophylaxis guidelines, and clinical practices in Sudan. METHODS: A cross-sectional study was conducted in June 2024, targeting licensed physicians actively practicing in Sudan. Data were collected using a self-administered, structured questionnaire distributed via social media platforms. The questionnaire evaluated demographic characteristics, general rabies knowledge, familiarity with updated guidelines, and clinical practices. Descriptive and inferential statistical analyses were performed using SPSS version 28, with significance set at p < 0.05. RESULTS: A total of 468 physicians participated, with (52%) demonstrating adequate general rabies knowledge and only (7.1%) showing good knowledge of updated guidelines. Awareness of critical aspects, such as the intradermal route of vaccine administration (20.1%) and the appropriate use of post-exposure prophylaxis (PEP) (25.5%), was limited. Clinical practice scores indicated moderate knowledge, with 56.2% demonstrating good practice in rabies management. Correlation analysis revealed a positive association between knowledge of updated guidelines and clinical practice (r = 0.230, p < 0.001). No significant associations were found between knowledge levels and demographic or professional characteristics. CONCLUSIONS: The study reveals significant gaps in rabies knowledge, updated rabies prophylaxis guidelines awareness, and clinical practices among Sudanese physicians, highlighting the need for targeted training and resource allocation. Strengthening healthcare systems, particularly in conflict-affected regions, and promoting adherence to WHO rabies guidelines are critical to improving rabies prevention and management in Sudan.

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