ISLAMABAD: The updated abridged regimen for rabies is effective and carries shorter treatment protocols which is best for countries like Pakistan with scarce resources, chronic shortage of vaccines and innumerable rabid dog-bite cases.
This was stated by Dr Naseem Sallahuddin, head of Department of Infectious Diseases in a leading private hospital.
Instead of 28-day treatment, the new abridged regimen is a two-dose anti-rabies treatment and prolongs for only a week (7 days).
A research study, carried out by the Indus Hospital Infectious Diseases Department, says that 89% of tested patients with the new regimen were confirmed as being well and there were no reports of rabies suspected deaths among the remaining 11%.
This study was also overseen by the National Institute of Health (NIH), as told by its Executive Director Dr Aamir Ikram to this correspondent. The updated low-dose regimen for rabies was also recommended by the World Health Organisation (WHO) to countries facing huge number of rabies cases.
When Secretary Health Amir Khuwaja was asked about the awareness and dissemination of the new regimen low-dose anti-rabies vaccine among the local clinical staff and doctors, the official said, "Health Services Academy is holding a roundtable discussion on this with experts from all provinces to discuss pros & cons and suggest a way forward".
Explaining the new low-dose intradermal vaccine, Miss Naseem, who is also a member of the WHO rabies team and founder of Free Rabies Pakistan campaign, said that in their study, they found that treatment with the abridged, three-dose, one-week version of the previously updated Thai Red Cross regimen, also recommended by WHO in 2018, was effective and associated with lower costs and good treatment adherence. Emphasising its awareness and more usage across the country, she said that in 2019, researchers demonstrated through mathematical calculations that the abridged regimen could be used to treat more patients in less cost.
"In our study, we found evidence that this new regimen is effective. Moreover, compared with the previous 1-month regimen with immunoglobulin injections into wound and muscle, use of the abridged, two-site, 1-week regimen with dose-sparing immunoglobulin injections was associated with an annual cost saving despite an increase in patient volume," added Miss Naseem.
Moreover, the findings of the study also concur with the results of the RESIST-2 cohort study, which showed that the administration of rabies vaccine beyond day 7 offered no additional benefit.
In addition, a clinical trial in Thailand established that a two-site, abridged regimen was noninferior in effectiveness and safety to a four-site, 1-week regimen.
The research further revealed that patients did not have to travel to the rabies prevention centre to receive a vaccine dose on day 28, which not only saved their time and expense but also conserved time for hospital personnel.
"Since 2018, we have organised over 20 workshops in Karachi and other areas across Pakistan, including Badin in Sindh province, Quetta in Balochistan and Abbottabad and Mansehra in Khyber-Pakhtunkhwa province. In total, we have trained over 150 healthcare providers in the abridged regimen and we intend to continue with refresher training.
“We are now training providers in the use of the new regimen across Sindh province," notes the study.
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