Burden of dog bites and associated healthcare seeking behavior for rabies post-exposure prophylaxis in North and South Shahdara municipal zones of Delhi, India.

BACKGROUND: Rabies is a zoonotic disease of global public health importance which accounts for 59,000 human deaths annually. In India, about 60 million stray or free ranging dogs are found in the country posing a significant risk of increase in incidences of dog bite and transmission of rabies. The aim of this study was to assess the burden of dog bites and associated healthcare seeking behavior for rabies post-exposure prophylaxis in North and South Shahdara municipal zones of Delhi, India. METHODS: A cross-sectional study was conducted between the period of May 2023 to November 2024 in North and South Shahdara municipal zones of Delhi. Data was collected using a semi-structured, pretested and prevalidated interviewer administered schedule from family members of selected five types of residential settlements. RESULTS: Total of 800 families were interviewed. The overall annual incidence of dog bites was 25.5 per 1000 population and it ranged from 15.9 in Planned Colony to 32.1 in Jhuggi Jhopri Cluster. Around three fourth (75.5%) of the total dog bite cases reported in the last one year were by stray dogs. Category III dog bites were more common across all settlements, comprising 67/102 (65.7%) of the total cases. Category II dog bites had a higher odds of receiving rabies Post-Exposure Prophylaxis (PEP) as per national guidelines compared to those with Category III dog bites (OR: 5.54, 95% CI: 2.25, 13.66). CONCLUSIONS: Dog bite incidence in Delhi was high and varied across type of settlements. More emphasis should be placed on mass dog vaccination and animal birth control measures in areas with high incidence of dog bites. Despite good anti-rabies vaccine uptake, the shortfall in rabies immunoglobulin (RIG) administration for high risk Category III bites highlights the need for periodic training of health workers.