Territorial and Programmatic Determinants of Human Rabies Exposure and Postexposure Prophylaxis in Brazil: A Population-Based Municipal Study.

IntroductionHuman rabies exposure occurs at the interface between urban areas, peri-urban environments, and health surveillance systems. This study analyzed territorial and programmatic dimensions of human rabies exposure and postexposure management in a Brazilian municipality.MethodsA population-based ecological study used secondary surveillance data from the Brazilian Notifiable Diseases Information System from 2007 to 2025. All notified human rabies exposure events were included. Variables included age, animal species involved, type of exposure, and postexposure prophylaxis management. Incidence rates per 100,000 inhabitants were calculated.ResultsA total of 14,343 notifications were identified. Dogs accounted for most of the exposures, although cat-related incidents increased over time. Children <15 y of age represented a substantial proportion of notifications. Incidence increased over time, particularly after 2010. Most exposures were classified as preventable events requiring postexposure prophylaxis.ConclusionsHuman rabies exposure in this setting reflects persistent vulnerabilities at the urban-wildlife interface and challenges in postexposure management. Strengthening surveillance, responsible animal ownership, and One Health strategies are essential to reduce preventable exposures.