Analyzing the distribution of rabies clinics and achievements of standardized rabies clinics implementation in mainland China

BACKGROUND: For rabies prevention and treatment, the Chinese government has been establishing standardized rabies clinics since 2016. This study aimed to investigate the distribution of rabies clinics and the achievements of newly-implemented standardized rabies clinics in mainland China, for the purpose of providing further rabies control strategies. METHODS: The number of rabies clinics, including per million inhabitants in each region, was determined. We sampled 1200 clinics from 8 provinces by multi-stage stratified sampling, and a questionnaire survey was carried out to record each clinic’s achievements. Data collected from 1185 questionnaires were analyzed. RESULTS: We found that rabies clinics were mostly located in the southwest, central, and eastern regions of China; these accounted for 67.1% of all clinics. The eastern and south regions showed the lowest number of rabies clinics per million inhabitants (0.15 and 0.12, respectively). The total standard-reaching rate of rabies clinics in mainland China was only 11.0%, with significant differences in the rate among regions (X(2) = 33.004, p < 0.001). Specifically, the qualified rates of supporting facilities and functional areas were 13.9% (X(2) = 34.003, p < 0.001) and 56.1% (X(2) = 9.943, p = 0.019), respectively. Vaccines with 2 different substrates and professional flushing equipment were provided by 40.5% (X(2) = 27.935, p = 0.001) and 37.7% (X(2) = 54.922, p = 0.001) of clinics, respectively. CONCLUSION: Regional differences do exist in the distribution of rabies clinics in mainland China, with relative low number per million population in south and eastern China. There are few standardized rabies clinics in mainland China. Efforts are needed to establish supporting facilities, especially for wound treatment and vaccination. Future research should focus on the improvement of rabies clinics standardization.