{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:41:38Z","timestamp":1783406498482,"version":"3.54.6"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Rabies is endemic in Cambodia. For exposed humans, post-exposure prophylaxis (PEP) is very effective in preventing this otherwise fatal disease. The Institut Pasteur du Cambodge (IPC) in Phnom Penh was the primary distributor of PEP in Cambodia until 2018. Since then, and to increase distribution of PEP, two new centers have been opened by IPC in the provinces of Battambang and Kampong Cham. Data on bitten patients, who sometimes bring the head of the biting animal for rabies analyses, have been recorded by IPC since 2000. However, human cases are not routinely recorded in Cambodia, making it difficult to establish a human burden of disease and generate a risk map of dog bites to inform the selection of future PEP center locations in high-risk areas. Our aim was to assess the impact of accessibility to rabies centers on the yearly rate of PEP patients in the population and generate a risk map to identify the locations where new centers would be the most beneficial to the Cambodian population. To accomplish this, we used spatio-temporal Bayesian regression models with the number of PEP patients as the outcome. The primary exposure variable considered was travel time to the nearest IPC center. Secondary exposure variables consisted of travel time to a provincial capital and urban proportion of the population. Between 2000 and 2016, a total of 293,955 PEP patient records were identified. Our results showed a significant negative association between travel time to IPC and the rate of PEP patients: an increase in one hour travel time from the living location to IPC PEP centers leads to a reduction in PEP rate of 70% to 80%. Five provinces were identified as the most efficient locations for future centers to maximize PEP accessibility: Banteay Meanchey, Siem Reap, Takeo, Kampot and Svay Rieng. Adding a PEP center in every provincial capital would increase the proportion of Cambodians living within 60 minutes of a PEP center from 26.6% to 64.9%, and living within 120 minutes from 52.8% to 93.3%, which could save hundreds of lives annually.<\/jats:p>","DOI":"10.1371\/journal.pntd.0010494","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T17:24:49Z","timestamp":1656609889000},"page":"e0010494","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Accessibility to rabies centers and human rabies post-exposure prophylaxis rates in Cambodia: A Bayesian spatio-temporal analysis to identify optimal locations for future centers"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9036-1218","authenticated-orcid":true,"given":"Jerome N.","family":"Baron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Chevalier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sowath","family":"Ly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0353-1678","authenticated-orcid":true,"given":"Veasna","family":"Duong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1931-3037","authenticated-orcid":true,"given":"Philippe","family":"Dussart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-3885","authenticated-orcid":true,"given":"Didier","family":"Fontenille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yik Sing","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Mart\u00ednez-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"pntd.0010494.ref001","first-page":"1","volume-title":"Infectious diseases transmissible between Animals and Humans","author":"Viral zoonoses. 4th ed","year":"2015","edition":"4"},{"key":"pntd.0010494.ref002","unstructured":"ICTV Master Species List. 2008."},{"key":"pntd.0010494.ref003","volume-title":"Third report","author":"WHO Expert Consultation on Rabies","year":"2018"},{"key":"pntd.0010494.ref004","first-page":"1","article-title":"Estimating the Global Burden of Endemic Canine Rabies","volume":"9","author":"K Hampson","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010494.ref005","first-page":"360","article-title":"Re-evaluating the burden of rabies in Africa and Asia","volume":"83","author":"DL Knobel","year":"2005","journal-title":"Bull World Health Organ"},{"key":"pntd.0010494.ref006","article-title":"Rabies situation in Cambodia","volume":"3","author":"S Ly","year":"2009","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010494.ref007","article-title":"Oxford Textbook of Zoonoses: Biology, Clinical Practice, and Public Health Control","author":"SJ Peacock","year":"2011","journal-title":"Occupational Medicine"},{"key":"pntd.0010494.ref008","first-page":"498","article-title":"Control of Communicable Diseases Manual. 19th ed","author":"T Hemachudha","year":"2008","journal-title":"American Public Health Association"},{"key":"pntd.0010494.ref009","unstructured":"Institut Pasteur du Cambodge\u2014Rabies. Available: http:\/\/www.pasteur-kh.org\/rabies\/"},{"key":"pntd.0010494.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0254192","article-title":"Large scale dog population demography, dog management and bite risk factors analysis: a crucial step towards Rabies control in Cambodia","volume":"16","author":"V Chevalier","year":"2021","journal-title":"PLoS One"},{"key":"pntd.0010494.ref011","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/S1473-3099(19)30311-1","article-title":"A 1-week intradermal dose-sparing regimen for rabies post-exposure prophylaxis (RESIST-2): an observational cohort study","volume":"19","author":"T Cantaert","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"pntd.0010494.ref012","first-page":"201","article-title":"Weekly epidemiological record. Rabies vaccines: WHO position paper\u2014April 2018","volume":"931","author":"WHO","year":"2018","journal-title":"World Heal Organ\u2014Tech Rep Ser"},{"key":"pntd.0010494.ref013","doi-asserted-by":"crossref","first-page":"A118","DOI":"10.1016\/j.vaccine.2018.10.054","article-title":"Intradermal rabies post-exposure prophylaxis can be abridged with no measurable impact on clinical outcome in Cambodia, 2003\u20132014","volume":"37","author":"A Tarantola","year":"2019","journal-title":"Vaccine"},{"key":"pntd.0010494.ref014","unstructured":"Rabies Postexposure Prophylaxis (PEP) | Medical Care | Rabies | CDC. [cited 4 Feb 2021]. Available: https:\/\/www.cdc.gov\/rabies\/medical_care\/index.html"},{"key":"pntd.0010494.ref015","unstructured":"CDC\u2014Travelers: Preexposure Vaccinations\u2014Rabies. [cited 4 Feb 2021]. Available: https:\/\/www.cdc.gov\/rabies\/specific_groups\/travelers\/pre-exposure_vaccinations.html"},{"key":"pntd.0010494.ref016","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2147\/VMRR.S51147","article-title":"Global epidemiology of canine rabies: past, present, and future prospects","volume":"6","author":"L Taylor","year":"2015","journal-title":"Vet Med Res Reports"},{"key":"pntd.0010494.ref017","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1017\/S0950268897008601","article-title":"Rabies in Thailand","volume":"120","author":"C Mitmoonpitak","year":"1998","journal-title":"Epidemiol Infect"},{"key":"pntd.0010494.ref018","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.prevetmed.2004.05.009","article-title":"Vaccination coverage and epidemiological parameters of the owned-dog population in Thungsong District, Thailand","volume":"65","author":"W Kongkaew","year":"2004","journal-title":"Prev Vet Med"},{"key":"pntd.0010494.ref019","first-page":"1","article-title":"Geographical and temporal patterns of rabies post exposure prophylaxis (PEP) incidence in humans in the mekong river delta and southeast central coast regions in Vietnam from 2005 to 2015","volume":"13","author":"HS Lee","year":"2018","journal-title":"PLoS One"},{"key":"pntd.0010494.ref020","doi-asserted-by":"crossref","first-page":"199","DOI":"10.20506\/rst.38.1.2953","article-title":"Progress towards rabies control and elimination in Vietnam","volume":"38","author":"HTT Nguyen","year":"2019","journal-title":"Rev Sci Tech"},{"key":"pntd.0010494.ref021","author":"WHO","year":"2018","journal-title":"Rabies vaccines and immunoglobulins: WHO position"},{"key":"pntd.0010494.ref022","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.meegid.2015.12.011","article-title":"Evidence of two distinct phylogenetic lineages of dog rabies virus circulating in Cambodia","volume":"38","author":"C Mey","year":"2016","journal-title":"Infect Genet Evol"},{"key":"pntd.0010494.ref023","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/jtm.12228","article-title":"Rabies Vaccine and Rabies Immunoglobulin in Cambodia: Use and Obstacles to Use","volume":"22","author":"A Tarantola","year":"2015","journal-title":"J Travel Med"},{"key":"pntd.0010494.ref024","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.inhe.2011.12.001","article-title":"Knowledge, attitudes and practices of rabies prevention and dog bite injuries in urban and peri-urban provinces in Cambodia, 2009","volume":"4","author":"M Lunney","year":"2012","journal-title":"Int Health"},{"key":"pntd.0010494.ref025","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.actatropica.2016.04.015","article-title":"A prospective study on the incidence of dog bites and management in a rural Cambodian, rabies-endemic setting","volume":"160","author":"A Ponsich","year":"2016","journal-title":"Acta Trop"},{"key":"pntd.0010494.ref026","doi-asserted-by":"crossref","first-page":"A14","DOI":"10.1016\/j.vaccine.2018.10.011","article-title":"Descriptive assessment of rabies post-exposure prophylaxis procurement, distribution, monitoring, and reporting in four Asian countries: Bangladesh, Bhutan, Cambodia, and Sri Lanka, 2017\u20132018","volume":"37","author":"AJ Li","year":"2019","journal-title":"Vaccine"},{"key":"pntd.0010494.ref027","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0167-5877(02)00125-3","article-title":"A Bayesian model for spatial wildlife disease prevalence data","volume":"56","author":"C Staubach","year":"2002","journal-title":"Prev Vet Med"},{"key":"pntd.0010494.ref028","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4081\/gh.2014.38","article-title":"Evaluation of the spatial patterns and risk factors, including backyard pigs, for classical swine fever occurrence in Bulgaria using a Bayesian model","volume":"8","author":"B Mart\u00ednez-L\u00f3pez","year":"2014","journal-title":"Geospat Health"},{"key":"pntd.0010494.ref029","first-page":"1","article-title":"A Bayesian spatio-temporal model for forecasting the prevalence of antibodies to Ehrlichia species in domestic dogs within the contiguous United States","volume":"10","author":"Y Liu","year":"2017","journal-title":"Parasit Vectors"},{"key":"pntd.0010494.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1476-072X-6-14","article-title":"Spatial and temporal patterns of enzootic raccoon rabies adjusted for multiple covariates","volume":"6","author":"S Recuenco","year":"2007","journal-title":"Int J Health Geogr"},{"key":"pntd.0010494.ref031","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.proenv.2015.05.019","article-title":"Spatiotemporal Disease Mapping Applied to Infectious Diseases","volume":"26","author":"S Coly","year":"2015","journal-title":"Procedia Environ Sci"},{"key":"pntd.0010494.ref032","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.sste.2011.03.001","article-title":"A comparison of conditional autoregressive models used in Bayesian disease mapping","volume":"2","author":"D. Lee","year":"2011","journal-title":"Spat Spatiotemporal Epidemiol"},{"key":"pntd.0010494.ref033","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1002\/env.1065","article-title":"Spatio-temporal disease mapping using INLA \u2020","volume":"22","author":"B Schrodle","year":"2011","journal-title":"Environmetrics"},{"key":"pntd.0010494.ref034","author":"C Lagazio","year":"2001","journal-title":"A hierarchical Bayesian Model for Space-Time Variation of Disease Risk A hierarchical Bayesian model for space\u2013time variation of disease risk"},{"key":"pntd.0010494.ref035","first-page":"1","article-title":"Bayesian Random Effect Modeling for analyzing spatial clustering of differential time trends of diarrhea incidences","author":"FB Osei","year":"2019","journal-title":"Sci Rep"},{"key":"pntd.0010494.ref036","first-page":"1","author":"N Asmarian","year":"2019","journal-title":"Bayesian Spatial Joint Model for Disease Mapping of Zero-Inflated Data with R-INLA: A Simulation Study and an Application to Male Breast Cancer in Iran"},{"key":"pntd.0010494.ref037","doi-asserted-by":"crossref","DOI":"10.1177\/0886260516639583","article-title":"The Geography of Child Maltreatment: A Spatiotemporal Analysis Using Bayesian Hierarchical Analysis With Integrated Nested Laplace Approximation","author":"GE Barboza","year":"2019"},{"key":"pntd.0010494.ref038","article-title":"Spatiotemporal mapping and detection of mortality cluster due to cardiovascular disease with Bayesian hierarchical framework using integrated nested Laplace approximation: A discussion of suitable statistic applications in Kersa, Oromia","volume":"13","author":"M Dedefo","year":"2018","journal-title":"Ethiopia on m er us e on on m er al"},{"key":"pntd.0010494.ref039","first-page":"147","article-title":"a Bayesian Spatial and Temporal Modeling Approach To Mapping Geographic Variation in Mortality Rates for Subnational Areas With R-Inla","volume":"16","author":"D Khana","year":"2018","journal-title":"J Data Sci"},{"key":"pntd.0010494.ref040","first-page":"1","article-title":"Spatial Modelling of Some Conditional Autoregressive Priors in A Disease Mapping Model: the Bayesian Approach","volume":"14","author":"D. Obaromi","year":"2019","journal-title":"Biomed J Sci Tech Res"},{"key":"pntd.0010494.ref041","first-page":"403","article-title":"Stomach cancer incidence in Southern Portugal 1998\u20132006: A spatio-temporal analysis","volume":"56","author":"AL Papoila","year":"2014"},{"key":"pntd.0010494.ref042","unstructured":"General Population Census of Cambodia 1998. Phnom Penh; 2002."},{"key":"pntd.0010494.ref043","unstructured":"General Population Census of Cambodia 2008. Phnom Penh; 2009."},{"key":"pntd.0010494.ref044","unstructured":"General Population Census of the Kingdom of Cambodia 2019. Phnom Penh; 2020."},{"key":"pntd.0010494.ref045","unstructured":"Humanitarian Data Exchange\u2014Cambodia\u2014Subnational Administrative Boudaries. 2018. Available: https:\/\/data.humdata.org\/dataset\/cambodia-admin-level-0-international-boundaries"},{"key":"pntd.0010494.ref046","unstructured":"GADM data (version 4.0)\u2014Cambodia. 2022. Available: https:\/\/gadm.org\/download_country.html"},{"key":"pntd.0010494.ref047","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1038\/nature25181","article-title":"A global map of travel time to cities to assess inequalities in accessibility in 2015","volume":"553","author":"DJ Weiss","year":"2018","journal-title":"Nature"},{"key":"pntd.0010494.ref048","author":"RJ Hijmans","year":"2020","journal-title":"raster: Geographic Data Analysis and Modeling"},{"key":"pntd.0010494.ref049","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v076.i13","article-title":"R Package gdistance: Distances and Routes on Geographical Grids","volume":"76","author":"J. van Etten","year":"2017","journal-title":"J Stat Softw"},{"key":"pntd.0010494.ref050","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.sste.2012.12.001","article-title":"Spatial and spatio-temporal models with R-INLA","volume":"4","author":"M Blangiardo","year":"2013","journal-title":"Spat Spatiotemporal Epidemiol"},{"key":"pntd.0010494.ref051","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v063.i20","article-title":"Spatial data analysis with R-INLA with some extensions","volume":"63","author":"RS Bivand","year":"2015","journal-title":"J Stat Softw"},{"key":"pntd.0010494.ref052","first-page":"1","volume":"63","author":"F Lindgren","year":"2015","journal-title":"Bayesian Spatial Modelling with R\u2014INLA"},{"key":"pntd.0010494.ref053","doi-asserted-by":"crossref","DOI":"10.1002\/wics.1443","article-title":"Spatial modeling with R-INLA: A review","volume":"10","author":"H Bakka","year":"2018","journal-title":"Wiley Interdiscip Rev Comput Stat"},{"key":"pntd.0010494.ref054","doi-asserted-by":"crossref","DOI":"10.1201\/9781315370279","volume-title":"Generalized Additive Models: An Introduction with R","author":"SN Wood","year":"2017","edition":"2"},{"key":"pntd.0010494.ref055","first-page":"14","article-title":"Comparing INLA and OpenBUGS for hierarchical Poisson modeling in disease mapping","author":"R Carroll","year":"2015","journal-title":"Spat Spatiotemporal Epidemiol"},{"key":"pntd.0010494.ref056","author":"M Gamer","year":"2019","journal-title":"irr: Various Coefficients of Interrater Reliability and Agreement"},{"key":"pntd.0010494.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2334-5-52","article-title":"Transmission dynamics of rabies virus in Thailand: Implications for disease control","volume":"5","author":"J Denduangboripant","year":"2005","journal-title":"BMC Infect Dis"},{"key":"pntd.0010494.ref058","first-page":"1","article-title":"Knowledge of rabies and dog-related behaviors among people in Siem Reap Province, Cambodia","volume":"46","author":"S Sor","year":"2018","journal-title":"Trop Med Health"},{"key":"pntd.0010494.ref059","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/aje\/kwx234","article-title":"Rabies Postexposure Prophylaxis Noncompletion after Dog Bites: Estimating the Unseen to Meet the Needs of the Underserved","volume":"187","author":"A Tarantola","year":"2018","journal-title":"Am J Epidemiol"},{"key":"pntd.0010494.ref060","article-title":"Svay Rieng girl dies after contracting rabies","author":"L. Kimmarita","year":"2019","journal-title":"The Phnom Penh Post"},{"key":"pntd.0010494.ref061","article-title":"Ministry attempts to calm stampede for rabies vaccinations","author":"L. Kimmarita","year":"2019","journal-title":"The Phnom Penh Post"},{"key":"pntd.0010494.ref062","volume":"9655","author":"L Grilli","year":"2017","journal-title":"Fitting logistic multilevel models with crossed random effects via Bayesian Integrated Nested Laplace Approximations: a simulation study Fitting logistic multilevel models with crossed random effects via Bayesian Integrated Nested Laplace Approximations"},{"key":"pntd.0010494.ref063","unstructured":"UNECLAC-CELADE::Redatam Webserver | Statistical Process and Dissemination Tool. [cited 2 Nov 2021]. Available: https:\/\/redatam.org\/binkhm\/RpWebEngine.exe\/Portal?BASE=KHM2008"},{"key":"pntd.0010494.ref064","unstructured":"Rabies Prevention Centers\u2013Institut Pasteur du Cambodge. [cited 28 Oct 2021]. Available: https:\/\/www.pasteur-kh.org\/rabies-prevention-centers\/"},{"key":"pntd.0010494.ref065","first-page":"281","article-title":"Economics of human and canine rabies elimination: Guidelines for programme orientation","volume":"68","author":"K Bogel","year":"1990","journal-title":"Bull World Health Organ"},{"key":"pntd.0010494.ref066","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002372","article-title":"Designing Programs for Eliminating Canine Rabies from Islands: Bali, Indonesia as a Case Study","volume":"7","author":"SE Townsend","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010494.ref067","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/0264-410X(91)90246-3","article-title":"Rabies control in the Republic of the Philippines: benefits and costs of elimination","volume":"9","author":"DB Fishbein","year":"1991","journal-title":"Vaccine"},{"key":"pntd.0010494.ref068","article-title":"Implementation of an Intersectoral Program to Eliminate Human and Canine Rabies: The Bohol Rabies Prevention and Elimination Project","volume":"6","author":"SMD Lapiz","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010494.ref069","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.prevetmed.2010.07.009","article-title":"Stray dog population demographics in Jodhpur, India following a population control\/rabies vaccination program","volume":"97","author":"SC Totton","year":"2010","journal-title":"Prev Vet Med"},{"key":"pntd.0010494.ref070","unstructured":"Rabies in Cambodia\u2014News from the Institut Pasteur. [cited 28 Oct 2021]. Available: https:\/\/www.pasteur.fr\/en\/research-journal\/news\/rabies-cambodia"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T17:25:50Z","timestamp":1656609950000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010494"}},"subtitle":[],"editor":[{"given":"Mauro","family":"Sanchez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":70,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010494","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}