Spatiotemporal Trends in Rabies Burden Across Indian States and Union
Territories (1990-2021): Insights from the GBD 2021 Study
Abstract
Objective The study investigates spatiotemporal trends in
rabies incidence, mortality, and DALYs across Indian states and union
territories from 1990-2021. It aims to assess current control measures
and identify areas needing intervention, informing strategies to achieve
zero rabies deaths by 2030. Results India showed significant
declining trend over this period for age-standardized incidence rate
(AAPC: -5.22; 95%, CI: -5.32 to -5.11; p < 0.05) with the
highest decline observed during the period 2007-2010 (APC: -10.12;
95%CI: -10.91 to -8.21; p < 0.05). The highest reductions
were observed in Andhra Pradesh (AAPC: -8.08, 95% CI: -8.21 to -7.94),
and Bihar (AAPC: -7.10, 95% CI: -7.38 to -6.82). Mortality trends
mirrored incidence declines. Total DALYs decreased significantly from
760,115 in 1990 to 12,803 in 2021, primarily due to a reduction in Years
of Life Lost (YLL). The age-standardized DALYs per 100,000 persons
decreased by -50.22% over the study period. Despite these improvements,
rabies remains a critical concern, with 4,023 deaths recorded in 2021.
Conclusion Significant declines in rabies incidence, mortality,
and DALYs were observed across the time. State-specific multifaceted
approach integrating public health, accessible PEP, one health approach
and humane management of stray dogs is essential.