Rabies causes 59,000 deaths globally each year, with 391 and 368 cases reported in the Philippines in 2022 and 2023, respectively. In Davao City, 4 human rabies deaths were recorded in 2023. Though fatal, rabies is preventable through vaccination. The COVID-19 pandemic disrupted rabies eradication and immunization efforts. This study investigated its effect on the compliance with post-exposure rabies prophylaxis (PEP) and the reasons for non-compliance.

To compare the compliance with PEP and reasons for non-compliance among pediatric patients with animal bites before and during the COVID-19 pandemic.

This single-center retrospective cross-sectional study in a private tertiary hospital in Davao City reviewed 1,277 animal bite cases between March 16, 2017 and March 16, 2023. Data was gathered through chart reviews with follow-up through phone interviews. Compliance rates and reasons for non-compliance to PEP were determined.

There were 1,224 cases of animal bites included in the study, 599 cases before the pandemic, and 625 during the pandemic. Thirty six percent of cases were aged 3-6 years old, with equal sex distribution. The highest cases were from the downtown area of the city (69% pre-pandemic and 53% during the pandemic); dogs were the primary biting animals. Bites in the upper extremities were common before the pandemic, while bites in the head and neck region increased during the pandemic. Most exposures were bites from vaccinated pets (65% pre-pandemic and 84% during the pandemic) and classified as Category III (52% pre-pandemic and 55% during the pandemic). Despite the pandemic, compliance with PEP among the animal bite cases remained to be high, 93.8% pre-pandemic and 93.1% during the pandemic. Non-compliance with PEP was influenced by psychological factors (fear of hospitals and vaccination and acquiring infection during hospital visit and socioeconomic factors (cost, distance and loss of wages).

The most significant factors for non-compliance with PEP during the pandemic were fear of hospitals and acquiring illnesses while in the hospital, while compliance was linked to parent’s higher socio-economic status and awareness.