Evaluation of prophylaxis protocols and spatial distribution of humans wounded by bats: a descriptive study, Palmas, 2013-2023.

Abstract

OBJECTIVE: To evaluate prophylaxis prescriptions in cases of bat-related accidents involving humans and the spatial distribution of accidents and bats captured by the zoonosis surveillance unit of Palmas, Tocantins, from 2013 to 2023. METHODS: This was a retrospective descriptive study of prophylaxis prescriptions during initial care of bat-related accidents involving humans, held on electronic medical records (e-SUS) and on the case reporting form (via the Notifiable Health Conditions Information System) for rabies treatment. The following variables were analyzed: patient sex and age, type of exposure, site and characterization of the wound, history of rabies treatment, treatment prescribed according to the current protocol, indication of rabies antiserum and interruption of treatment. The location of patients treated and bats captured for laboratory diagnosis was georeferenced to produce distribution maps. RESULTS: Of 136 reported cases, 68.4% (93/136) of initial care adequately followed the current prophylaxis protocol. The Southeast region of the municipality presented the highest concentration of reported residents (37/123). Between 2015 and 2023, 133 bats were captured from residences and analyzed for the presence of the rabies virus, of which 2.3% (3/133) were reactive, found in the Northwest, Southwest and Southern regions of the municipality. CONCLUSION: The study highlighted the relevance of epidemiological surveillance in monitoring prophylaxis protocols and care for accidents involving bats, given the inconsistencies in initial care. The importance of continuous training for health professionals stood out. Detection of the virus in urban bats evidenced its circulation and reinforced the need for integrated interinstitutional actions.