Review of Literature on Traditional Rabies Extraction

An in-depth exploration of traditional methods and scientific evaluations since 2014

traditional healer and rural medical setting

Key Highlights

Limited Efficacy: Multiple studies show that traditional rabies extraction methods have not been proven effective in preventing or treating rabies.
Integration with Modern Medicine: Literature emphasizes the need to integrate traditional practices with modern post-exposure prophylaxis to ensure timely and accurate care.
Scientific Rigor: Researchers have highlighted that modern diagnostic tools and biological interventions (vaccines and immunoglobulins) are superior and essential for rabies management.

Introduction

Rabies remains a critical public health concern worldwide, especially in regions where traditional medicine coexists with modern medical practices. Since 2014, several scholarly articles and literature reviews have evaluated the efficacy of traditional rabies extraction methods. These reviews typically investigate methods such as wound manipulation techniques – including "Tandok" and "Tawak" – practiced by traditional healers in an attempt to extract pathogens from bite wounds, as well as herbal and animal-based remedies used in various cultural settings.

The overall consensus in the literature is that traditional extraction methods lack scientific evidence of effectiveness in the prevention or treatment of rabies. In contrast, modern interventions—most notably the post-exposure prophylaxis (PEP) with rabies vaccines and immunoglobulins—have been consistently validated through controlled clinical trials, making them the gold standard for rabies management. This review synthesizes findings from multiple studies, citing relevant work from 2014 onwards with detailed citations, authors, publication years, and sources.

Traditional Rabies Extraction Methods

Description and Cultural Context

Traditional rabies extraction practices originate from cultural beliefs and historical treatment strategies. Common techniques such as "Tandok" involve using animal horns to remove toxins or presumed infected substances from wounds. Similarly, "Tawak" refers to the direct suction of wound exudates by a traditional practitioner, which is believed to extract harmful material. While these methods have deep cultural roots and are often passed down through generations, most literature indicates that their perceived efficacy is overshadowed by the risk of delay in accessing scientifically proven medical treatments.

For example, early ethnographic studies and community-based surveys in rabies-endemic regions have documented a reliance on such practices, particularly in settings where access to modern healthcare is limited. Researchers such as those cited in reviews from the mid-2010s have noted that while traditional methods may hold symbolic and cultural significance, their potential to alter the progression of rabies infection is unproven.

Scientific Evaluations and Limitations

Literature Review Findings

A comprehensive literature review published in 2018 underscored that no traditional remedy, including various extraction techniques, has been scientifically validated for rabies prevention or treatment. The review detailed that the outcomes of traditional methods are difficult to measure due to variable application techniques and the absence of controlled trial data. The study stressed that the modest perceived success rates might be a result of a naturally low transmission risk rather than the efficacy of the extraction procedure itself.

For instance, research by Hossain et al. (2020) from Nigeria studied the determinants of traditional medicine use following dog bites. Their findings revealed that many victims who relied on traditional practices experienced delays in receiving definitive post-exposure prophylaxis, ultimately undermining the potential benefits of any such traditional intervention. Similarly, several studies published between 2014 and 2022 reiterated that modern rabies vaccines and immunoglobulins offer clear, evidence-based benefits in preventing the disease.

Herbal and Animal-Based Remedies

Some studies have investigated the potential antiviral properties of specific plant extracts and animal-based products. For example, a study conducted by Admasu et al. (2014) explored the antiviral properties of Phytolacca dodecandra L’Hérit. leaves, which contain a ribosomal inhibiting protein dubbed dodecandrin. While the in vitro findings indicated some antiviral activity, there has been no successful translation of this laboratory research into clinical practice for rabies treatment.

Another study published in 2018 examined the effects of Datura metel Linn. extract, which appeared to increase survival time in experimental animal models compared to control groups. Despite these intriguing preliminary results, neither extract nor any other traditional preparation has demonstrated consistent efficacy in human trials. The scientific community broadly regards these isolated findings as interesting leads that require further exploration, but they do not justify replacing or delaying established PEP protocols.

Modern Medical Approaches vs. Traditional Methods

Modern Post-Exposure Prophylaxis (PEP)

The advent and wide-scale application of modern rabies PEP have dramatically reduced the number of rabies-related deaths worldwide. Modern treatments involve a combination of wound cleansing, rabies vaccines, and, when indicated, the administration of rabies immunoglobulins. These interventions have been rigorously tested and proven to be nearly 100% effective in preventing the onset of rabies when administered promptly after exposure.

Furthermore, recent advancements include the use of monoclonal antibodies (mAbs) that provide standardized, safe, and effective alternatives to traditional immunoglobulins. A prospective study on pediatric patients in 2025 demonstrated the potential of mAbs in validating and streamlining the use of these biologicals in cases of severe animal exposures.

Diagnostic Accuracy and Timeliness

Accurate and timely diagnosis is another cornerstone of effective rabies management. Modern diagnostic techniques, such as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase-polymerase chain reaction (RT-PCR), offer high sensitivity and specificity compared to traditional diagnostic practices. As noted in a systematic review conducted in 2025, these modern diagnostic methods are instrumental in confirming suspected rabies cases promptly, thereby facilitating immediate and appropriate treatment.

The Role of Traditional Medicine in Complementary Settings

While the effectiveness of traditional extraction methods remains scientifically unverified, there is some discussion in the literature regarding their potential role in culturally sensitive health care strategies. Researchers have suggested that a collaborative approach that respects traditional practices while educating communities on the importance of early and modern medical interventions could lead to better health outcomes overall. Such collaborations could help bridge gaps in health-seeking behaviors by integrating local beliefs with evidence-based practices.

Comprehensive Table of Selected Studies

Study/Review	Authors	Year	Summary	Source
Roles of Traditional Medicine and Traditional Healers for Rabies	Various	2018	Comprehensive review evaluating the application of traditional techniques like Tandok and Tawak, emphasizing cultural context and lack of efficacy in scientific trials.	NCBI - PMC Article
Determining Traditional Medicine Use Post-Dog Bites	Hossain et al.	2020	Analyzes how reliance on traditional care leads to dangerous delays in effective treatment, highlighting factors influencing patient choices.	PLOS Neglected Tropical Diseases
Investigation of Phytolacca dodecandra's Antiviral Properties	Admasu et al.	2014	Explores the presence of dodecandrin in P. dodecandra leaves; potential antiviral effects were observed, yet clinical translation remains unverified.	ResearchGate
Datura Metel Linn. Extract Study	Roy et al.	2018	Reports increased survival times in experimental animal models treated with the extract, suggesting potential antiviral properties that require further study.	Philippine Journal of Science
Modern Diagnostic Techniques for Rabies	Various	2025	A systematic review comparing modern ELISA and RT-PCR to traditional diagnostic methods, emphasizing timely and accurate diagnosis.	ScienceDirect

Synthesis and Critical Analysis

Interpreting the Findings

From the literature reviewed, it is evident that while traditional healing methods for rabies extraction are deeply entrenched in cultural practices, their effectiveness remains unsubstantiated. Most studies converge on the point that any advantages seen in traditional practices are not due to the physiological efficacy of the extraction techniques but rather to other extraneous factors such as low exposure rates.

In particular, modern approaches not only provide a robust scientifically validated method of intervention, but they also offer a framework for immediate diagnosis and treatment. The multiple studies conducted between 2014 and 2025 have collectively reaffirmed that once clinical symptoms of rabies appear, the disease is nearly always fatal—emphasizing that prompt PEP is indispensable. Therefore, even though there is ongoing investigation into bioactive compounds within traditional remedies, none have supplanted the comprehensive benefits of modern medical treatment.

Implications for Public Health

For public health policy and clinical practice, the emphasis must remain on ensuring access to modern rabies vaccines and immunoglobulins immediately after exposure. However, acknowledging traditional practices can be beneficial when designing culturally sensitive health education programs. Engaging traditional healers in public health strategies can bridge gaps between community beliefs and the need for clinically proven interventions, thereby reducing delays that can result in fatal outcomes.