{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:07:53Z","timestamp":1793113673480,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Rabies is a life-threatening zoonotic disease in India, leading to numerous fatalities annually. Despite the availability of effective post-exposure prophylaxis (PEP), compliance with completing the vaccination regimen remains low, impeding efforts to control and eliminate the disease. This study aimed to assess PEP compliance rates among individuals exposed to rabies in India and identify key factors contributing to non-compliance. A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases including PubMed, Scopus, Embase, and Web of Science were searched for studies on PEP compliance in India. Eligible studies were community-based or hospital-based and published in English. The Joanna Briggs Institute (JBI) tool assessed study quality. A random effects model calculated pooled compliance rates, with heterogeneity assessed using the I\u00b2 statistic and a Chi-square-based Q test. Subgroup and sensitivity analyses, as well as Egger\u2019s test, were performed to explore variations and check for publication bias. The analysis included 30 studies, with a pooled compliance rate of 57% and high heterogeneity (I\u00b2 =99.69%). Compliance was higher with the intradermal (ID) regimen than the intramuscular (IM) regimen, though adherence decreased over time. Economic constraints, logistical challenges, lack of awareness, cultural beliefs, and fear of side effects were major barriers to completion. Compliance was higher among those with severe bites. PEP compliance in India is low, hindered by various barriers. The ID regimen showed better adherence but also faced declining compliance over time. Improving PEP adherence requires targeted interventions such as education, logistical support, and promoting shorter ID regimens.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_1957_24","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:02:00Z","timestamp":1758639720000},"page":"3121-3131","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Compliance of post-exposure prophylaxis (PEP) following animal bite in Indian population: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"14","author":[{"given":"Aninda","family":"Debnath","sequence":"first","affiliation":[{"name":"Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu George","family":"Toppo","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Panwar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trideep Jyoti","family":"Deori","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, PA Sangma International Medical College and Hospital, Meghalaya, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aereosonova","family":"Khongsit","sequence":"additional","affiliation":[{"name":"Doctoral Researcher, Faculty of Social Sciences (SOC), Tampere University, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jugal","family":"Kishore","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"issue":"(Suppl)","key":"R1-20250924","first-page":"S20","article-title":"Health-seeking behavior and compliance to post exposure prophylaxis among animal bite victims in India","volume":"63","author":"Haradanhalli","year":"2019","journal-title":"Indian J Public Health"},{"key":"R4-20250924","doi-asserted-by":"crossref","first-page":"3258","DOI":"10.4103\/jfmpc.jfmpc_592_19","article-title":"Noncompliance of the postexposure prophylactic vaccination following animal bites reporting to a rural primary health center","volume":"8","author":"Gadapani","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"R5-20250924","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.18203\/2394-6040.ijcmph20190610","article-title":"Clinical safety profile of Premi-Rab a new indigenous equine rabies immunoglobulin for cat III animal bite victims at anti rabies clinic of a tertiary care hospital, Karnataka","volume":"6","author":"Rajagopal","year":"2019","journal-title":"Int J Community Med Public Health"},{"key":"R6-20250924","doi-asserted-by":"crossref","first-page":"2890","DOI":"10.18203\/2394-6040.ijcmph20232384","article-title":"Compliance to post-exposure prophylaxis among patients attending anti-rabies vaccination clinic in a tertiary health care centre in central India:A cross sectional study","volume":"10","author":"Sastry","year":"2023","journal-title":"Int J Community Med Public Health"},{"key":"R7-20250924","first-page":"e14229","article-title":"Anti-rabies vaccine compliance and knowledge of community health worker regarding animal bite management in rural area of Eastern India","volume":"13","author":"Sahu","year":"2021","journal-title":"Cureus"},{"key":"R8-20250924","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3126\/ajms.v14i1.47839","article-title":"Dropout rate of anti-rabies vaccination among rural and urban communities in Tamil Nadu:A comparative cross-sectional study","volume":"14","author":"Sellan","year":"2023","journal-title":"Asian J Med Sci"},{"key":"R9-20250924","doi-asserted-by":"crossref","first-page":"9","DOI":"10.24321\/2454.325X.201829","article-title":"Adherence to Recommended Anti-Rabies Vaccine Schedule:A Rabies Clinic Based Study","volume":"4","author":"Titoria","year":"2018","journal-title":"Int J Preven Curat Comm Med"},{"key":"R10-20250924","doi-asserted-by":"crossref","first-page":"444","DOI":"10.55489\/njcm.150620243792","article-title":"Post-exposure rabies vaccine compliance and reasons for non-adherence-A mixed method study in Puducherry","volume":"15","author":"Sowbarnika","year":"2024","journal-title":"Nat J Community Med"},{"key":"R12-20250924","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.18203\/2394-6040.ijcmph20182194","article-title":"Awareness about rabies among general population and treatment seeking behaviour following dog-bite in rural Puducherry:A community based cross-sectional study","volume":"5","author":"Krishnamoorthy","year":"2018","journal-title":"Int J Community Med Public Health"},{"key":"R13-20250924","first-page":"643","article-title":"Non-compliance of post exposure prophylaxis amongst dog bite cases attending antirabies clinic of a tertiary care hospital \u2013A record based study","volume":"9","author":"Wadde","year":"2018","journal-title":"Nat J Community Med"},{"key":"R14-20250924","first-page":"68","article-title":"Evaluation of intradermal vaccination at the anti rabies vaccination OPD","volume":"16","author":"Mankeshwar","year":"2014","journal-title":"Nepal Med Coll J"},{"key":"R15-20250924","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4103\/0974-777X.150888","article-title":"Epidemiological characteristics of patients attending for rabies post-exposure prophylaxis at the infectious diseases hospital of lucknow, India","volume":"7","author":"Sahu","year":"2015","journal-title":"J Glob Infect Dis"},{"key":"R16-20250924","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/0019-557X.152867","article-title":"Compliance to anti-rabies vaccination in post-exposure prophylaxis","volume":"59","author":"Shankaraiah","year":"2015","journal-title":"Indian J Public Health"},{"key":"R17-20250924","first-page":"1","article-title":"Compliance of Animal Bite Patients Managed by Intramuscular Route of Anti-rabies Vaccination","volume":"4","author":"Bariya","year":"2014","journal-title":"Research &Reviews:A Journal of Immunology"},{"key":"R18-20250924","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5455\/2394-6040.ijcmph20150205","article-title":"A retrospective epidemiological study of delay for updated Thai red cross intradermal anti-rabies vaccination schedule amongst animal bite cases attending ARV clinic at a tertiary care centre","volume":"2","author":"Patil","year":"2015","journal-title":"Int J Community Med Public 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G Medical College, Odisha, India","volume":"4","author":"Jena","year":"2017","journal-title":"Int J Community Med Public Health"},{"issue":"Suppl 1","key":"R35-20250924","doi-asserted-by":"crossref","first-page":"A99","DOI":"10.1016\/j.vaccine.2018.11.072","article-title":"An overview of the immunogenicity and effectiveness of current human rabies vaccines administered by intradermal route","volume":"37","author":"Denis","year":"2019","journal-title":"Vaccine"},{"issue":"(Suppl 1)","key":"R38-20250924","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, 2003-2014","volume":"37","author":"Tarantola","year":"2019","journal-title":"Vaccine"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1957_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:48:15Z","timestamp":1787068095000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1957_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1957_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-12-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}