Rabies post-exposure prophylaxis initiation and adherence among patients in Vietnam, 2014–2016

An Evaluation of the Rabies Surveillance in Southern Vietnam

“…Improvements in the implementation of rabies surveillance over the evaluation period may explain the increase in notifications. Despite this, our finding, together with the low completion rates of PEP among animal-bite individuals and patients found in a previous study ( 10 ), indicates a significant challenge for this region to control canine rabies by 2021 and keep track of the progress toward elimination of dog-transmitted human rabies. Addressing this issue will require greater political will and involvement of different levels of the government and public sectors, larger resources, better strategic planning, and continued surveillance, response, and prevention programs of both human health and animal health sectors.…”

“…The low annual incidence of human rabies reported in our surveillance review may indicate the low-level transmission of rabies from animals to humans in Southern Vietnam. This is as low as in Thailand and much lower than those seen in other Asian countries ( 9 ) and lower than the incidence found in the Northern Vietnam ( 10 ). Large-scale implementation of rabies vaccination programs for domestic dogs over an extended period of time and standard, simplified, and widely accessible PEP regimens ( 11 ), in conjunction with greater public awareness about rabies associated with health promotion programs and economic growth, may have contributed to this low incidence of human rabies.…”

Clofazimine derivatives as potent broad-spectrum antiviral agents with dual-target mechanism

“…To date, pre- or post-exposure prophylaxis, along with rabies immunoglobulin (RIG) is the only available way to protect the infected crowd [ 3 ]. However, multiple administrations of rabies vaccine and the public's lack of awareness hampere their in-time protection against the rabies virus [ [4] , [5] , [6] ], and an average of 60,000 people die from rabies each year globally t [ 2 ]. The most favored Milwaukee protocol (M therapy) and its modified regimens obtained disappointing clinical outcomes [ 7 , 8 ].…”

Evaluation of Vietnam’s post-exposure prophylaxis delivery system, 2017

“…Furthermore, to address eRIG shortages, Vietnam should consider stricter enforcement of eRIG, offering it to patients with category 3 or higher risk exposure. A recent study found that 51% of patients with a category 1 and 2 wound were given eRIG unnecessarily, thus contributing to a potential shortage [19]. Lastly, our evaluation found that independent DPMCs reported more delays and challenges in paying for biologics than PPMCs.…”

“…Expansion of ID administration is feasible given the demand for biologics exists and there is a trained workforce already familiar with ID administration. It is of interest to note that a separate study conducted in Vietnam on vaccine adherence found that 82% of ID patients completed the regimen compared to 41% of IM patients [19]. Furthermore, to address eRIG shortages, Vietnam should consider stricter enforcement of eRIG, offering it to patients with category 3 or higher risk exposure.…”