Perfil Epidemiológico e Manejo do Atendimento Antirrábico Humano em Campo Grande/MS (2011-2023): desafios e perspectivas sob a abordagem One Health

Abstract

Introduction: Rabies is a lethal viral disease primarily transmitted through the saliva of infected animals via bites. Despite being vaccine-preventable, rabies remains a global public health concern, requiring integrated strategies based on the One Health methodology. This approach acknowledges the interdependence of human, animal, and environmental health, fostering intersectoral cooperation for rabies prevention and control. Objective: To characterize human rabies prophylaxis care in Campo Grande/MS between 2011 and 2023 by analyzing the epidemiological profile of patients, the adequacy of clinical management, and factors associated with prophylaxis abandonment. Methodology: This is an observational, descriptive, and retrospective study based on secondary data from the Notifiable Diseases Information System. A total of 40,880 notifications were analyzed. The variables included sociodemographic and epidemiological characteristics, the prophylactic management adopted, and the treatment abandonment rate. Data were processed and statistically analyzed using frequency distribution, temporal trend analysis, and risk assessment. The One Health methodology was used as a reference framework for interpreting the results. Thus, aspects such as the presence of urban and wild reservoirs, socioeconomic conditions, and healthcare infrastructure were analyzed to understand the effectiveness of prevention strategies. Results and Discussion: Most cases involved female patients (50.8%), individuals aged 1 to 19 years (38.3%), those with incomplete elementary education (8.9%), and residents of urban areas (98.1%). The majority of cases were treated in emergency units (99.2%). Inadequate management was observed in 29.7% of cases, particularly in situations involving unobservable dogs/cats and wild animals. Additionally, in 2022, only 41.1% of clinical decisions were classified as appropriate. The treatment abandonment rate varied over the years, peaking at 31.8% in 2021, coinciding with the COVID-19 pandemic. Conclusion: The study highlighted persistent challenges in human rabies prophylaxis care in Campo Grande/MS, particularly regarding the adequacy of prophylactic management and treatment abandonment rates. The adoption of the One Health approach underscores the need for multidisciplinary interventions to enhance care and contribute to the elimination of human rabies in Brazil. Implementing actions focused on professional training, strengthening surveillance systems, and optimizing clinical protocols is essential for the effectiveness of public policies in disease prevention and control.