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Peer reviewedOpen accessRabiesRabies post-exposure prophylaxis

An epidemiological study of suspected rabies exposures and adherence to rabies post-exposure prophylaxis in Eastern Thailand, 2015

PLOS Neglected Tropical Diseases·

Onphirul Yurachai, Soawapak Hinjoy, Ryan M. Wallace

DOI
10.1371/journal.pntd.0007248
PMID
32106251
PMCID
PMC7077841
OpenAlex
Study type
Journal article
Publisher
Public Library of Science (PLoS)
Article type
journal-article
Integrity
current

Why this research matters now

The findings reveal substantial gaps in rabies post-exposure prophylaxis adherence in Eastern Thailand, with potential under-detection of exposures at non-participating facilities. These gaps are relevant to Thailand's 2020 rabies elimination goal and highlight the need for improved surveillance and treatment adherence strategies.

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Structured evidence summary

Research question

The study examined suspected rabies exposures and adherence to post-exposure prophylaxis in Eastern Thailand during 2015, analyzing data from a hospital-based electronic surveillance system.

Study design

This was a retrospective analysis of data from a voluntary electronic hospital-based surveillance system covering eight provinces in Eastern Thailand from January through December 2015. The system collected information on suspected rabies exposures from participating healthcare facilities.

Population and setting

The study included persons presenting to participating healthcare facilities in eight Eastern Thailand provinces with suspected rabies exposures. A total of 6,204 suspected exposures were reported during the study period.

Main findings

The crude reported exposure rate was 106 per 100,000 population, with an estimated adjusted rate of 204 per 100,000 when accounting for under-detection. Dogs were the main source of exposure (77.8%), and children under 15 and adults over 60 had the highest reported rates. Adherence to post-exposure prophylaxis was low, with 15.8% completing the five-dose intramuscular regimen and 46.5% completing the four-dose intradermal regimen. Only 15% of persons for whom rabies immunoglobulin was indicated actually received it.

Public-health relevance

The findings reveal substantial gaps in rabies post-exposure prophylaxis adherence in Eastern Thailand, with potential under-detection of exposures at non-participating facilities. These gaps are relevant to Thailand's 2020 rabies elimination goal and highlight the need for improved surveillance and treatment adherence strategies.

Important limitations

The surveillance system was voluntary and did not capture exposures treated at non-participating healthcare facilities, leading to likely under-detection of the true exposure burden. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of methods, analysis details, and complete limitations.

GIDS interpretation

This article was indexed with disease classifiers for rabies and rabies post-exposure prophylaxis, a country classifier for Thailand, and topic classifiers for surveillance, treatment, and vaccination. These links support discoverability for users monitoring rabies-related public health literature in Southeast Asia.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 13 auditable classifier relationships to diseases, places, topics, and study design.

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