Publication:

Determinants of delay in initiating rabies post-exposure prophylaxis among animal bite victims: a hospital-based cross-sectional study from central India

Background Rabies is an almost invariably fatal yet preventable disease. Timely post-exposure prophylaxis (PEP) is essential, but delays remain common. This study assessed factors associated with delayed PEP initiation among animal bite victims attending an anti-rabies clinic in central India.

Methods A hospital-based cross-sectional study was conducted from May to mid-June 2025 at a tertiary care hospital in central India. A total of 323 animal bite victims were recruited by consecutive sampling. Data were collected using a pre-tested semi-structured questionnaire. Delay was defined as receiving the first anti-rabies vaccine dose after 24 hours. Data were analysed using Jamovi with descriptive statistics and Chi-square test.

Results Dogs caused 96% of bites. Most participants were male (67%), rural residents (61.5%), and 30.5% were illiterate. PEP initiation was delayed in 41% of cases. Delay was significantly associated with distance >10 km from the vaccination centre (p<0.001), monthly income <₹5000 (p=0.004), and increasing age (p=0.041). Major reasons for delay were work-related barriers (48.7%), lack of awareness (27.7%), and clinic closure on holidays (23.6%).

Conclusions Delay in PEP initiation was common and mainly linked to access, socioeconomic, and awareness-related barriers. Strengthening community education, improving rural access, and ensuring uninterrupted anti-rabies services may reduce delays.