Profilaxia antirrábica humana: análise das condutas e desenvolvimento de tecnologia para a tomada de decisão

Abstract

Human rabies is an almost 100% fatal disease. The most effective strategy to prevent its occurrence is the appropriate indication of post-exposure prophylaxis following a potential exposure to the rabies virus. Therefore, this study aimed to analyze the prophylactic measures adopted in human rabies post-exposure care in the municipality of Camaçari, Bahia, Brazil, and to develop a decision-support technology for clinical decision-making. This was an epidemiological, exploratory, cross-sectional, quantitative study based on secondary data from the Brazilian Notifiable Diseases Information System (SINAN), covering human rabies post-exposure treatments reported between April 2022 and December 2024. Variables related to victims' characteristics, the offending animal, type of exposure, and prophylactic measures were analyzed. Inappropriate prophylactic management was identified in 20.9% of the analyzed records. Dogs were the main offending animals, followed by cats, while the most frequently affected anatomical sites were the hands/feet and limbs. There was a higher frequency of cases among males and a greater occurrence among individuals aged 1–19 years. Incompleteness was also identified in some fields of the human rabies post-exposure notification forms, indicating weaknesses in the recording process by healthcare professionals and limiting the robustness of epidemiological analyses. The analysis of the data supported the development of software designed to recommend appropriate post-exposure prophylaxis according to the clinical and epidemiological situation presented. It is concluded that errors in prophylactic indication and incomplete records may compromise the quality of care and health surveillance, highlighting the need for professional training strategies and decision-support technologies, such as the software developed, to promote safer and more standardized practices and the rational use of immunobiologicals.