{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T16:17:50Z","timestamp":1778084270887,"version":"3.51.4"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Rabies is a vaccine-preventable but fatal zoonotic disease. In India, where animal bite incidents are common, many reexposed patients do not have documentation of prior postexposure prophylaxis. This results in unnecessary administration of anti-rabies vaccines (ARVs) and rabies immunoglobulin (RIG), which leads to waste of resources and increased healthcare costs. This study aimed to quantify the burden and underlying causes of missing documentation in rabies reexposure cases. A prospective cross-sectional observational study was conducted at a tertiary Anti-Rabies Clinic in North India from August 2024 to November 2024, enrolling 200 patients with category 2 or 3 animal bites. Data were collected through validated questionnaires and analyzed using descriptive and inferential statistics. Of 61 patients with a prior bite exposure history, 78.7% lacked documentation, with the primary reasons being loss of documents (56.2%) and lack of awareness (31.2%). Undocumented patients incurred 2.18 times higher treatment costs, spending \u20b913,200 on ARVs and \u20b912,960 on RIG. Significant associations were found between documentation status and occupation (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.02) and time since the last bite (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002). The high rates of undocumented prior rabies exposure contribute to avoidable biological and financial burdens on healthcare systems. This study suggests integrating digital health tools such as short messaging service reminders, mobile applications, and centralized electronic health records to lower costs and improve case management, thereby enhancing the efficiency of rabies prevention programs in resource-limited settings.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0773","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T17:23:32Z","timestamp":1772731412000},"page":"961-965","source":"Crossref","is-referenced-by-count":0,"title":["Documentation Gaps in Animal Bite Reexposure Cases: Economic and Public Health Implications in a Tertiary Anti-Rabies Clinic in North India"],"prefix":"10.4269","volume":"114","author":[{"given":"Aman Dev","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Government Medical College, Patiala, Punjab, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simmi","family":"Oberoi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Government Medical College, Patiala, Punjab, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Kaler","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Government Medical College, Patiala, Punjab, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemkiran","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Japneet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Government Medical College, Patiala, Punjab, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0003709","article-title":"Estimating the global burden of endemic canine rabies","volume":"9","author":"Hampson","year":"2015"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e1847","article-title":"Deaths from symptomatically identifiable furious rabies in India: A nationally representative mortality survey","volume":"6","author":"Suraweera","year":"2012"},{"key":"b3","article-title":"Rabies Vaccines: WHO Position Paper\u2013April 2018.","year":"2018"},{"key":"b4","article-title":"Centers for Disease Control and Prevention. Recommendations for the Prevention and Control of Rabies in the United States. Morbidity and Mortality Weekly Report.","year":"2010"},{"key":"b5","series-title":"Int J Infect Dis","first-page":"29","article-title":"Assessing the burden of human rabies in India: Results of a national multi-center epidemiological survey","volume":"11","author":"Sudarshan","year":"2007"},{"key":"b6","series-title":"Indian J Public Health","first-page":"72","article-title":"Re-exposure animal bite management among incident animal bite cases in a secondary care hospital in Delhi, India","volume":"64","author":"Basu","year":"2020"},{"key":"b7","series-title":"Vaccine","first-page":"1859","article-title":"Redefining vaccination coverage and timeliness measures using electronic immunization registry data in low- and middle-income countries","volume":"37","author":"Dolan","year":"2019"},{"key":"b8","series-title":"Hum Vaccin Immunother","first-page":"2257054","article-title":"Challenges of vaccination information system implementation: A systematic literature review","volume":"19","author":"Rahmadhan","year":"2023"},{"key":"b9","series-title":"BMC Health Serv Res","first-page":"621","article-title":"Assessment of select electronic health information systems that support immunization data capture\u2013Kenya, 2017","volume":"18","author":"Namageyo-Funa","year":"2018"},{"key":"b10","series-title":"Public Health Rep","first-page":"332","article-title":"NVAC statement of support regarding efforts to better implement IIS-to-IIS data exchange across jurisdictions","volume":"130","year":"2015"},{"key":"b11","series-title":"J Family Med Prim Care","first-page":"1715","article-title":"Lack of documentation in animal bite cases and its impact on rabies biologicals utilization","volume":"13","author":"Batish","year":"2024"},{"key":"b12","series-title":"APCRI J","first-page":"65","article-title":"Documentation of anti-rabies vaccination could prevent vaccine wastage: A cross-sectional study","volume":"21","author":"Ashe","year":"2019"},{"key":"b13","series-title":"PLoS One","first-page":"e0222198","article-title":"Estimation of the incidence of animal rabies in Punjab, India","volume":"14","author":"Gill","year":"2019"},{"key":"b14","series-title":"J Family Med Prim Care","first-page":"728","article-title":"Epidemiological pattern and trend analysis of animal bite cases in the anti-rabies clinic of a tertiary care hospital in Delhi","volume":"11","author":"Jethani","year":"2022"},{"key":"b15","series-title":"Trop Med Int Health","first-page":"397","article-title":"Quantity vs. quality: An assessment of the current pipeline for rabies","volume":"25","author":"Neevel","year":"2020"},{"key":"b16","series-title":"Trop Med Infect Dis","first-page":"16","article-title":"The deadly details: How clear and complete are publicly available sources of human rabies information?","volume":"10","author":"Patane","year":"2025"},{"key":"b17","series-title":"Indian J Public Health","first-page":"65","article-title":"Market mapping and landscape analysis of human rabies biologicals in India","volume":"63","author":"Sudarshan","year":"2019"},{"key":"b18","series-title":"Vaccine","first-page":"A28","article-title":"Rabies vaccine and immunoglobulin supply and logistics: Challenges and opportunities for rabies elimination in Kenya","volume":"37","author":"Wambura","year":"2019"},{"key":"b19","series-title":"IJID Reg","first-page":"100386","article-title":"Effect of telephone reminders on adherence to anti-rabies vaccine amongst animal bite patients in North India: A randomised, single-blind, parallel-group, single-centre, interventional superiority trial","volume":"12","author":"Singh","year":"2024"},{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0003709","article-title":"Estimating the global burden of endemic canine rabies","volume":"9","author":"Hampson","year":"2015"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e1847","article-title":"Deaths from symptomatically identifiable furious rabies in India: A nationally representative mortality survey","volume":"6","author":"Suraweera","year":"2012"},{"key":"b3","article-title":"Rabies Vaccines: WHO Position Paper\u2013April 2018.","year":"2018"},{"key":"b4","article-title":"Centers for Disease Control and Prevention. Recommendations for the Prevention and Control of Rabies in the United States. Morbidity and Mortality Weekly Report.","year":"2010"},{"key":"b5","series-title":"Int J Infect Dis","first-page":"29","article-title":"Assessing the burden of human rabies in India: Results of a national multi-center epidemiological survey","volume":"11","author":"Sudarshan","year":"2007"},{"key":"b6","series-title":"Indian J Public Health","first-page":"72","article-title":"Re-exposure animal bite management among incident animal bite cases in a secondary care hospital in Delhi, India","volume":"64","author":"Basu","year":"2020"},{"key":"b7","series-title":"Vaccine","first-page":"1859","article-title":"Redefining vaccination coverage and timeliness measures using electronic immunization registry data in low- and middle-income countries","volume":"37","author":"Dolan","year":"2019"},{"key":"b8","series-title":"Hum Vaccin Immunother","first-page":"2257054","article-title":"Challenges of vaccination information system implementation: A systematic literature review","volume":"19","author":"Rahmadhan","year":"2023"},{"key":"b9","series-title":"BMC Health Serv Res","first-page":"621","article-title":"Assessment of select electronic health information systems that support immunization data capture\u2013Kenya, 2017","volume":"18","author":"Namageyo-Funa","year":"2018"},{"key":"b10","series-title":"Public Health Rep","first-page":"332","article-title":"NVAC statement of support regarding efforts to better implement IIS-to-IIS data exchange across jurisdictions","volume":"130","year":"2015"},{"key":"b11","series-title":"J Family Med Prim Care","first-page":"1715","article-title":"Lack of documentation in animal bite cases and its impact on rabies biologicals utilization","volume":"13","author":"Batish","year":"2024"},{"key":"b12","series-title":"APCRI J","first-page":"65","article-title":"Documentation of anti-rabies vaccination could prevent vaccine wastage: A cross-sectional study","volume":"21","author":"Ashe","year":"2019"},{"key":"b13","series-title":"PLoS One","first-page":"e0222198","article-title":"Estimation of the incidence of animal rabies in Punjab, India","volume":"14","author":"Gill","year":"2019"},{"key":"b14","series-title":"J Family Med Prim Care","first-page":"728","article-title":"Epidemiological pattern and trend analysis of animal bite cases in the anti-rabies clinic of a tertiary care hospital in Delhi","volume":"11","author":"Jethani","year":"2022"},{"key":"b15","series-title":"Trop Med Int Health","first-page":"397","article-title":"Quantity vs. quality: An assessment of the current pipeline for rabies","volume":"25","author":"Neevel","year":"2020"},{"key":"b16","series-title":"Trop Med Infect Dis","first-page":"16","article-title":"The deadly details: How clear and complete are publicly available sources of human rabies information?","volume":"10","author":"Patane","year":"2025"},{"key":"b17","series-title":"Indian J Public Health","first-page":"65","article-title":"Market mapping and landscape analysis of human rabies biologicals in India","volume":"63","author":"Sudarshan","year":"2019"},{"key":"b18","series-title":"Vaccine","first-page":"A28","article-title":"Rabies vaccine and immunoglobulin supply and logistics: Challenges and opportunities for rabies elimination in Kenya","volume":"37","author":"Wambura","year":"2019"},{"key":"b19","series-title":"IJID Reg","first-page":"100386","article-title":"Effect of telephone reminders on adherence to anti-rabies vaccine amongst animal bite patients in North India: A randomised, single-blind, parallel-group, single-centre, interventional superiority trial","volume":"12","author":"Singh","year":"2024"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/5\/article-p961.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/5\/article-p961.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/5\/article-p961.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T15:37:43Z","timestamp":1778081863000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/5\/article-p961.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":38,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0773","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]}}}