Background: In spite of availability of vaccine, many rabies cases continue to occur. Is this due to the improper functioning of vaccination centres? Objective of the study was to evaluate the performance of dog anti rabies vaccination centres, for vaccination of pet dogs (DARVCs) and post exposure prophylaxis against rabies (PtEPAR) centres for humans for suspected rabies exposure in an urban area.Methods: The study was carried out during 1989-90, by way of observations, interviews and analysis of records maintained at various institutes. For observations procedures like dog licensing, dog vaccination, dog catching in fields, keeping them in kennels and their destruction, human post exposure prophylaxis against rabies viz. history taking by a physician, his advice to patients, procedure of vaccination and local wound care.Results: All (9) MCGB (Municipal Corporation of greater Bombay) run DARVCs and one (25%) DAHD (district animal husbandry department, Bombay suburbs) run DARVC had unsatisfactory services. Three (75%) DAHD run DARVCs and all three voluntary organizations run DARVCs (100%) had satisfactory services. The practices at PtEPAR centres and the knowledge of the doctors appointed there were dismally poor for post exposure prophylaxis against rabies. Only 2 (5.88%) PtEPAR centres were fit to provide PtEPAR services.Conclusions: Significant findings included poor dog anti-rabies vaccination services involving negligible number of dogs every year, dismally poor performances by the human post exposure prophylaxis against rabies centres, lack of pre-exposure prophylaxis to high risk individuals, ignorance on the part of physicians and pathologists regarding availability of rabies diagnostic services in this urban area, poor surveillance by public health department and lack of co-ordination among various institutes.
Effectiveness of hepatitis A vaccination as post-exposure prophylaxis
