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Spatiotemporal Trends in Rabies Burden Across Indian States and Union Territories (1990-2021): Insights from the GBD 2021 Study
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  • Pawan Kumar,
  • Arunima Sen,
  • Jezina Jayan,
  • Shilpa Gaidhane,
  • Suhas Ballal,
  • Sanjay Kumar,
  • Mahakshit Bhat,
  • Shilpa Sharma,
  • Ravi Kumar M,
  • Sarvesh Rustagi,
  • Quazi Syed Zahiruddin,
  • Yashaswi Singh,
  • Sanjit Sah,
  • Prakasini Satapathy
Pawan Kumar
Post Graduate Institute of Medical Education and Research School of Public Health Department of Community Medicine
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Arunima Sen
Post Graduate Institute of Medical Education and Research School of Public Health Department of Community Medicine
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Jezina Jayan
Global Center for Evidence Synthesis
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Shilpa Gaidhane
Datta Meghe Institute of Medical Sciences Deemed to be University
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Suhas Ballal
JAIN (Deemed-to-be-university) Centre for Nano and Material Sciences
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Sanjay Kumar
Vivekananda Global University
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Mahakshit Bhat
NIMS University
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Shilpa Sharma
Chandigarh Group of Colleges Jhanjeri
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Ravi Kumar M
Raghu Engineering College
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Sarvesh Rustagi
Uttaranchal University School of Applied and Life Sciences
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Quazi Syed Zahiruddin
Datta Meghe Institute of Medical Sciences Deemed to be University
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Yashaswi Singh
Graphic Era Deemed to be University
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Sanjit Sah
D Y Patil Medical College
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Prakasini Satapathy
SIMATS Deemed University

Corresponding Author:[email protected]

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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.