Integrated bite case management within a One Health framework for rabies elimination at the primary care level in Kerala, India: an implementation research protocol using a stepped-wedge cluster randomised design.

ABSTRACT:

Introduction

Rabies remains a persistent public health threat in India, while gaps in surveillance and coordination of control measures undermine progress towards ending human rabies deaths. The WHO advocates a One Health approach, combining mass dog vaccination, postexposure prophylaxis (PEP) and Integrated Bite Case Management (IBCM). IBCM is not yet incorporated into India's national rabies action plan for rabies elimination. This study seeks to generate robust evidence on the effectiveness, cost-effectiveness, feasibility, facilitators and barriers of IBCM implemented within Kerala's Rabies Control Programme.

Methods and analysis

This implementation research adopts a stepped-wedge cluster randomised controlled trial (RCT) design. IBCM will be implemented across six admin

SUBMITTER: Nujum ZT 

PROVIDER: S-EPMC13629920 | biostudies-literature | 2026 Sep

REPOSITORIES: biostudies-literature