Assessing rabies post-exposure prophylaxis usage and dog bite cases at Mubende Regional Referral Hospital,Uganda.

Abstract

Background: Rabies post-exposure prophylaxis (PEP) is crucial in preventing rabies-related deaths in humans, yet it remains underutilized in many developing countries. In Uganda, limited data exists regarding adherence to rabies PEP among dog bite victims attending health facilities. Objective: This study assessed the usage of rabies PEP and dog bite cases at Mubende regional referral hospital (MRRH), Uganda. Methods: A hospital-based retrospective cross-sectional study was conducted using medical records of dog bite victims who sought rabies PEP at the hospital from January 2014 to January 2025. Frequencies and percentages were calculated, and logistic regression models were used to identify factors associated with rabies PEP non-completion among the dog bite victims. Results: Of 711 dog bite victims registered at the hospital during the 11-year period, 69.3% (493/711) did not complete the rabies PEP regimen. Males had a higher non-completion rate (62.1%) than females (37.9%), with a significant difference (cOR = 0.71, P = 0.036). Dog bite victims presenting in September (aOR = 3.15, P = 0.016) and October (aOR = 4.82, P = 0.001) were more likely to complete the PEP regimen compared to those who sought rabies PEP from the hospital in January. Most dog bite cases occurred in children aged 5–9 years, with peak incidence in April and October. Non-completion rate was highest during periods of increased dog bite cases, suggesting possible vaccine stock outs. Conclusion: Rabies PEP adherence among dog bite victims remains poor, threatening progress toward eliminating human rabies deaths by 2030. Strategic interventions such as targeted education of children and adults, seasonal vaccine supply planning with sufficient supplies required in April and October, and follow up systems like short message services are recommended to improve rabies PEP completion rates among dog bite victims.