A systematic review of prophylaxis practices after rabies exposure in Türkiye: a 14-year retrospective evaluation (2010–2024)

Abstract Background Rabies is a fatal viral zoonotic disease. Despite Türkiye’s integrated human, domestic animal, and wildlife vaccination programs alongside post-exposure prophylaxis (PEP) services, human rabies cases continue to occur annually. Aim This review systematically examines the current state of Post-Exposure Prophylaxis (PEP) following suspected rabies exposure in Türkiye, evaluating rabies control practices and prophylaxis data from the literature. Method Following PRISMA 2020 guidelines, a descriptive evidence synthesis was conducted using data from 43 observational studies on rabies prophylaxis in Türkiye published between 2010 and 2024, retrieved from databases including PubMed, Web of Science, TR Dizin, and local repositories. Results All included studies were retrospective and reported 111,677 presentations; among the 110,094 individuals with available prophylaxis data, 92.5% received PEP. Contact with stray animals accounted for 67.8%, while contact with owned but unvaccinated animals was 18.3%. The 4-dose vaccine regimen was the most common, and rabies immunoglobulin (RIG) was administered in 36.2% of cases. Notably, 81.5% of individuals sought PEP within 24 h. Side effects, including fever, local swelling, and erythema, were reported in 3.84% of cases. Conclusion Although rabies control measures in Türkiye have achieved substantial progress, regional disparities in PEP administration remain evident. Observed variations in prophylaxis completion, delayed presentation (> 24 h), and inconsistent RIG administration highlight ongoing public health challenges. As the included studies did not directly assess the causes of these patterns, factors such as guideline adherence, public awareness, and regional service organization warrant further investigation. Continuous professional training, public health outreach, and stray animal population management may help optimize rabies prophylaxis strategies.