New Delhi, July 7 Nearly four-fifths of the public health facilities in India have anti-rabies vaccine — crucial to achieve the goal of rabies elimination by 2030 –, revealed a new study led by the Indian Council of Medical Research (ICMR).
Ensuring accessible and affordable post-exposure prophylaxis is a crucial strategy to eliminate rabies.
The new study, published in the journal The Lancet Regional Health – Southeast Asia, is based on a nationwide survey of health facilities to understand the availability of anti-rabies vaccine and rabies immunoglobulin.
“We found that nearly four-fifths of the public health facilities had anti-rabies vaccine,” said corresponding author Dr. Manoj Murhekar, Director of the ICMR-National Institute of Epidemiology (ICMR-NIE).
According to data from the ICMR, India has recorded a 75 per cent reduction in rabies-related deaths.
Yet, India is one of the leading countries in the world for rabies fatalities as the infection claims about 5,700 lives every year. Around 9 million animal bite cases are also reported annually.
The cross-sectional study across 60 districts in 15 Indian states also found considerable geographic and facility-level variations in the availability of the medications.
Of the 534 health facilities surveyed, 467 (87.5 per cent) were public sector health facilities.
Anti-rabies vaccine was available in 372 public sector health facilities, ranging from 60.0 per cent to 93.2 per cent in different geographic regions.
The availability of anti-rabies vaccine was lowest in urban primary healthcare centres (UPHCs), while rabies immunoglobulin was available in 95 public sector health facilities, with the highest availability in southern states.
The availability of rabies immunoglobulin ranged from 1.8 per cent in UPHCs to 69.2 per cent in medical college hospitals.
“The availability (of anti-rabies vaccine) was lowest in the north-east region and highest in the southern states. Two-third of the public facilities providing anti-rabies vaccine followed had adopted the dose saving intradermal regimen as recommended by the National Rabies Control Programme, while the remaining were still following the older intra-muscular regimen,” Murhekar said.
“Rabies immunoglobulin was available only in one-fifth of public health facilities. Nearly two-third of the medical college hospitals had rabies immunoglobulin available, but the availability was notably low in the public primary care facilities,” he added.
The researchers noted that the non-availability of anti-rabies vaccine in the health facility on the day of the visit could lead to bite victims returning home without receiving the jab, which can undermine the efforts toward the goal of rabies elimination.
The findings called for bridging the gap in the availability of anti-rabies vaccine and rabies immunoglobulin to achieve the goal of zero-dog-mediated human rabies deaths by 2030, Murhekar said.
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