Incidence and forecasting of animal bites and trends in post-exposure prophylaxis (PEP) consumption in East Azerbaijan province

Rabies is one of the most common human and animal diseases threatening public health, and annually, many people in different parts of the world are treated for rabies. In Iran, challenges arise in obtaining rabies post-exposure prophylaxis (PEP), as these treatments are often imported, and there are problems with the procurement of vaccines and immunoglobulin. Thus, it is necessary to study the incidence of animal bites to inform PEP supply planning. This study analyzed data from 68,682 cases of animal bites registered at rabies prophylaxis centers in Tabriz, Iran. The cumulative incidence of animal bites and the rates of PEP consumption over the study years were calculated. The number of animal bites was forecasted using the Box-Jenkins time series model. From 2015 to 2022, the average annual incidence of animal bites in the covered population was 232 per 100,000 people. During this same period, the average yearly usage of rabies vaccines was 24,853 doses, totaling 1,136,238 units of antirabies immunoglobulin. The mean age of those bitten by an animal was 31.8 years (standard deviation=17.24), with 85% being male. The majority of bites were from dogs (80%), and 58% of the victims resided in rural areas. The average forecasted annual incidence rates for 2023 and 2024 are projected to be 289 and 311 per 100,000 people, respectively. The increasing trend in animal bites necessitates the urgent need for public health interventions, including expanding vaccine supply and implementing targeted education programs to mitigate the risk and financial burden of rabies in East Azerbaijan Province. In addition, managing stray animals, especially dogs, and strengthening the healthcare system and immunization program are essential to reducing the incidence of rabies.