One Health Surveillance for Rabies: A Case Study of Integrated Bite Case Management in Albay Province, Philippines

• Published in: Frontiers in tropical diseases 2022-03, Vol.3
• Main Authors: Rysava, Kristyna, Espineda, Jason, Silo, Eva Angela V., Carino, Sarah, Aringo, Ariane Mae, Bernales, Rona P., Adonay, Florencio F., Tildesley, Michael J., Hampson, Katie
• Format: Article
• Language: English
• ISSN: 2673-7515; 2673-7515
• DOI: 10.3389/fitd.2022.787524

Canine rabies is a significant public health concern and economic burden in the Philippines. Animal Bite Treatment Centers (ABTCs) that provide post-exposure prophylaxis (PEP) to bite patients have been established across the country, but the incidence of bite patient presentations has grown unsustainably, whilst rabies transmission in domestic dogs has not been controlled. Moreover, weak surveillance leads to low case detection and late outbreak responses. Here we investigated the potential for Integrated Bite Case Management (IBCM) to improve rabies detection in Albay province. Using information obtained from animal bite histories combined with phone follow-ups and field investigations, we demonstrated that IBCM resulted in a fourfold increase in case detection over 13 months of study compared to the prior period. Bite patient incidence across Albay was very high (>600/100,000 persons/year) with PEP administered mostly indiscriminately. Clinic attendance reflected availability of PEP and proximity to ABTCs rather than rabies incidence (