Epidemiology of animal bites and post-exposure vaccination coverage in Davao City, Philippines: A five-year retrospective cohort study, 2019-2023.
Hinay Alfredo A AA, Parilla-Sarabia April Joy AJ, Reyes Jennifer Ashley H JAH, Lopez Mariel Phoebe M MPM et al.
Rabies remains a major public health threat in the Philippines, particularly in urban areas such as Davao City, where frequent animal bites from domestic reservoirs increase the transmission risk at the human-animal-environment interface. Detailed epidemiological data on animal bites and post-exposure prophylaxis (PEP) coverage are limited. This One Health-framed retrospective cohort study describes trends in bite incidents, assesses PEP coverage, and identifies gaps in rabies prevention efforts from 2019 to 2023. Surveillance data from the Davao City Animal Bite Treatment Centers captured 98,442 cases. Dogs caused 63.5% of bites, with a significant upward trend (p = 0.027; τ = 1.0, 95% CI 0.200-1.800); cat bites (36.4%) rose sharply, indicating an emerging reservoir challenge. Children ≤15 years of age showed a significant increase (p = 0.027). The 3rd congressional district had the most pronounced rise across demographics and exposure categories. Tissue culture vaccine coverage remained at 100%, equine rabies immunoglobulin rose from 18.5% to 85.9%, whereas human rabies immunoglobulin remained low post-COVID. Despite universal TCV access, immunoglobulin gaps limit its control. Rising cat bites and severe exposures demand integrated One Health strategies, enhanced surveillance, animal vaccination, and supply chain strengthening, to achieve zero human rabies deaths by 2030.