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Review Article 
RMJ. 2025; 50(2): 526-531


Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis

Ifrah Hameed, Bilal Fattani, Soobia Pathan, Abdul Rehman Khalil Shaikh, Seemi Tanvir, Madeeha Minhas.


Abstract
Objective: T0 assess both the strength and boundaries of rabies post-exposure prophylaxis (PEP) treatments for exposed risk groups.
Methodology: The search followed PRISMA 2020 guidelines from 2010 to 2025 within PubMed and Scopus and Web of Science databases. Studies that fit the criteria included clinical trials, retrospective and prospective studies, cost-effectiveness analyses and case reports. Two reviewers independently extracted data. The risk of bias was assessed through the Evidence Project Risk of Bias Tool. A meta-analysis utilized random effects model to measure the effectiveness of pool of PEP against rabies prevention.
Results: The analysis evaluated 70 identified records, 10 studies fulfilling the inclusion criteria. The implementation of PEP procedures resulted in almost 100% success rates. Patients living in LMICs showed poor adherence to their treatment course because of financial constraints and logistic reasons. Immunocompromised patients exhibited weakened immune reactions to vaccinations thus requiring specific changes in dosage. The absence of rabies immune globulin (RIG) availability in rural areas revealed significant limitations for PEP effectiveness. Intradermal vaccination proved to be an economical option which helped patients follow recommended treatment properly.
Conclusion: Although rabies PEP demonstrates high efficacy, challenges such as non-adherence, RIG scarcity, and immune response variability among vulnerable populations limit its optimal impact. Policy interventions should prioritize the free of cost PEP programs, improved vaccine access and customized immunization strategies to enhance rabies prevention.

Key words: Rabies, post-exposure prophylaxis, immunization, treatment outcome.


 
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How to Cite this Article
Pubmed Style

Hameed I, Fattani B, Pathan S, Shaikh ARK, Tanvir S, Minhas M. Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. RMJ. 2025; 50(2): 526-531.

Web Style

Hameed I, Fattani B, Pathan S, Shaikh ARK, Tanvir S, Minhas M. Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. https://www.rmj.org.pk/?mno=250325 [Access: May 12, 2025].

AMA (American Medical Association) Style

Hameed I, Fattani B, Pathan S, Shaikh ARK, Tanvir S, Minhas M. Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. RMJ. 2025; 50(2): 526-531.


Vancouver/ICMJE Style

Hameed I, Fattani B, Pathan S, Shaikh ARK, Tanvir S, Minhas M. Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. RMJ. (2025), [cited May 12, 2025]; 50(2): 526-531.


Harvard Style

Hameed, I., Fattani, . B., Pathan, . S., Shaikh, . A. R. K., Tanvir, . S. & Minhas, . M. (2025) Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. RMJ, 50 (2), 526-531.


Turabian Style

Hameed, Ifrah, Bilal Fattani, Soobia Pathan, Abdul Rehman Khalil Shaikh, Seemi Tanvir, and Madeeha Minhas. 2025. Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. Rawal Medical Journal, 50 (2), 526-531.


Chicago Style

Hameed, Ifrah, Bilal Fattani, Soobia Pathan, Abdul Rehman Khalil Shaikh, Seemi Tanvir, and Madeeha Minhas. "Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis." Rawal Medical Journal 50 (2025), 526-531.


MLA (The Modern Language Association) Style

Hameed, Ifrah, Bilal Fattani, Soobia Pathan, Abdul Rehman Khalil Shaikh, Seemi Tanvir, and Madeeha Minhas. "Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis." Rawal Medical Journal 50.2 (2025), 526-531. Print.


APA (American Psychological Association) Style

Hameed, I., Fattani, . B., Pathan, . S., Shaikh, . A. R. K., Tanvir, . S. & Minhas, . M. (2025) Assessing medicinal efficacy and limitations of rabies post-exposure prophylaxis in vulnerable populations: Pathological insights to a systematic review and meta-analysis. Rawal Medical Journal, 50 (2), 526-531.


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