A systematic review of rabies epidemiology, transmission dynamics and control from a One Health perspective in Nigeria

Rabies is a fatal viral zoonosis responsible for an estimated 20,000 human deaths annually in sub-Saharan Africa. Nigeria, Africa’s most populous nation, bears a substantial rabies burden, yet no comprehensive systematic review has synthesised evidence across human, animal, and One Health domains. We systematically searched Scopus, Web of Science, CABI, PubMed, and Google Scholar from inception to March 2026. Studies reporting rabies epidemiology, transmission, vaccination coverage, post-exposure prophylaxis (PEP) utilisation, or One Health interventions in Nigeria were included. Quality assessment was performed using the OHAT Risk of Bias Tool. Narrative synthesis followed SWiM guidelines. Fifty-one studies (1981–2026) were included. Nationwide dog vaccination coverage ranged from 4.1% to 12.3% across different studies using varying methodologies and time periods, far below the WHO-recommended programme target of 70% vaccination coverage for achieving population-level protection through mass dog vaccination. Rabies positivity in submitted dog samples ranged from 1.6% to 69.1%, with significant geographic bias (72% from Plateau State). Human rabies cases were uniformly fatal (100% case fatality rate among clinically diagnosed or laboratory-confirmed rabies cases), with children aged < 15 years accounting for 46–81% of dog bite victims in studies that reported age distribution. PEP completion rates ranged from 23.4% to 95.8% across studies, with most settings reporting rates below 50%, with cost as the primary barrier. Traditional treatment use ranged from 9.6% to 91.1% across studies. Only six studies (11.8%) documented explicit One Health cross-sector collaboration, and 58% of Local Government Areas had no rabies surveillance data. Rabies remains endemic in Nigeria with persistent transmission, critically low vaccination coverage, and fragmented surveillance. Achieving the Zero by 2030 target will require urgent investment in decentralised laboratory capacity, subsidised PEP, community engagement to address traditional practices, and institutionalised One Health coordination between the human and animal health sectors.