Epidemiology and Determinants of Antirabies Vaccine Full-Dose Completion Among Patients Attending the Nyagatare District Hospital, Rwanda: A Facility-Based Cross-Sectional Study

Antirabies vaccine postexposure prophylaxis (PEP) is effective in preventing rabies when administered promptly and in full. This study assessed factors associated with antirabies PEP full-dose completion among patients attending Nyagatare District Hospital.

A facility-based cross-sectional study was conducted using data from patients who sought antirabies PEP at the hospital's emergency department in 2022. Patient files and registers were reviewed, and data were analyzed in STATA. Logistic regression was performed to identify factors associated with vaccine completion.

Of the 472 participants, 50.0% were under 16 years, 58.9% were male, and 63.6% lived in rural areas. Most (90.9%) had health insurance, 51.7% received PEP during the dry season, 11.0% received the antitetanus vaccine, and 82.2% had WHO wound Category II. Only 26.5% completed the full vaccination schedule, 16.1% missed appointments, and 57.4% dropped out before completion. Health insurance significantly increased the odds of completing PEP (AOR = 2.19, p = 0.032). Age, sex, and wound characteristics were not significantly associated with ARV full-dose completion.

Compliance with the full antirabies vaccine course was low, with only a quarter of patients completing all five doses. Improving completion requires targeted interventions such as reminder systems, community education, provider counseling, and financial support.