Dwaah, P. K.; Squire, S. A.; Djang-Fordjour, H. N.; Bagulo, I.; Osei-Tutu, A.; Opokuware, S.; Opoku, E. Y.; Gyarko, R. T.; Kando, D.; Num, A.; Amissah, P.; Ntow, C. A. N.; Awua-Boateng, N. Y.

Abstract Background: Dog-mediated rabies remains a major neglected tropical disease and an important cause of preventable human mortality in sub-Saharan Africa. Despite ongoing control efforts, limited laboratory-confirmed surveillance data hinder accurate assessment of the disease burden and the development of evidence-based interventions in Ghana. This study investigated the epidemiological characteristics of laboratory-confirmed rabies cases among suspected animal submissions and evaluated the contribution of routine diagnostic surveillance to rabies control. Methodology/Principal Findings: A retrospective analysis was conducted using laboratory surveillance records of suspected rabies cases submitted to a regional veterinary laboratory in Ghana between 2020 and 2025. Brain tissue samples were examined using Sellers staining, the direct fluorescent antibody test (FAT), and polymerase chain reaction (PCR). Epidemiological information, including animal species, vaccination history, ownership status, bite history, and diagnostic outcomes, was extracted and analysed descriptively. Of the 51 suspected cases examined, 46 (90.2%) were laboratory confirmed as rabies. Domestic dogs accounted for 96.1% of submissions, while cats represented 3.9%. Most suspected animals were either unvaccinated (64.7%) or had unknown vaccination status (33.3%), and 90.2% had reportedly bitten humans before submission. Confirmed cases were detected throughout the study period, indicating sustained viral circulation and continued zoonotic risk within the study area. Conclusions/Significance: The consistently high proportion of laboratory-confirmed rabies cases demonstrates persistent transmission of rabies virus among domestic animals and highlights substantial risks to human health. The integration of conventional and advanced laboratory diagnostic methods strengthened surveillance and improved case confirmation. These findings underscore the urgent need to expand dog vaccination coverage, strengthen laboratory-based surveillance, improve bite reporting systems, and enhance collaboration between veterinary and public health sectors. Reinforcing integrated One Health strategies will be essential to accelerate progress towards the global goal of eliminating dog-mediated human rabies by 2030.