Documentation Gaps in Animal Bite Reexposure Cases: Economic and Public Health Implications in a Tertiary Anti-Rabies Clinic in North India

Rabies is a vaccine-preventable but fatal zoonotic disease. In India, where animal bite incidents are common, many reexposed patients do not have documentation of prior postexposure prophylaxis. This results in unnecessary administration of anti-rabies vaccines (ARVs) and rabies immunoglobulin (RIG), which leads to waste of resources and increased healthcare costs. This study aimed to quantify the burden and underlying causes of missing documentation in rabies reexposure cases. A prospective cross-sectional observational study was conducted at a tertiary Anti-Rabies Clinic in North India from August 2024 to November 2024, enrolling 200 patients with category 2 or 3 animal bites. Data were collected through validated questionnaires and analyzed using descriptive and inferential statistics. Of 61 patients with a prior bite exposure history, 78.7% lacked documentation, with the primary reasons being loss of documents (56.2%) and lack of awareness (31.2%). Undocumented patients incurred 2.18 times higher treatment costs, spending ₹13,200 on ARVs and ₹12,960 on RIG. Significant associations were found between documentation status and occupation (P = 0.02) and time since the last bite (P = 0.002). The high rates of undocumented prior rabies exposure contribute to avoidable biological and financial burdens on healthcare systems. This study suggests integrating digital health tools such as short messaging service reminders, mobile applications, and centralized electronic health records to lower costs and improve case management, thereby enhancing the efficiency of rabies prevention programs in resource-limited settings.