Delayed rabies post-exposure prophylaxis treatment among Dutch travelers during their stay abroad: a comprehensive analysis

2021 ◽  
Author(s):  
Loes Verdoes ◽  
Floriana S Luppino ◽  
Jacco Wallinga ◽  
Leo G Visser
Keyword(s):  
Post Exposure Prophylaxis ◽  
Travel Destination ◽  
Factors Associated ◽  
Post Exposure ◽  
Associated Injury ◽  
Immune Globulins ◽  
Study Population ◽  
Sample Characteristics ◽  
Exposure Prophylaxis ◽  
Main Factor

Abstract Background After an animal-associated injury (AAI) in rabies-endemic regions, post-exposure prophylaxis (PEP) is needed to prevent infection.1,3 PEP consist of rabies vaccinations (RV) and in some cases also additional rabies immune globulins (RIG). Not always PEP medication, and RIG in particular, is accessible. Along with an increased number of exposure notifications among Dutch travelers, this might lead to treatment delay, and thus to increased health risks. Until now, research mainly focused on factors associated with exposition, but none on which factors are associated with PEP delay. This study aimed to identify which general sample characteristics are associated with PEP delay while being abroad. Methods A quantitative retrospective observational study was conducted. The study population consisted of insured Dutch international travelers who actively contacted their medical assistance company (2015-2019) because of an animal-associated injury (AAI) (N = 691). The association between general sample characteristics and delay of different PEP treatments was studied using survival analysis. Results Travelers without PrEP had an increased hazard, and therefore a shorter delay, for receiving their first RV as compared to travelers with PrEP (HR:1.11, 95%CI:1.01-1.22). The travelers needing both RV and RIG had a decreased hazard, and therefore a longer delay, as compared to travelers only needing RV (HR:0.81, 95%CI:0.67-0.96). General sample characteristic associated with RIG administration delay was travel destination. Travelers to Central and South America, East Mediterranean and Europe had a decreased hazard, and therefore a longer delay, for receiving RIG treatments relative to travelers to South East Asia (HR:0.31, 95%CI:0.13-0.70; HR:0.34, 95%CI:0.19-0.61; HR:0.46, 95%CI:0.24-0.89; HR:0.48, 95%CI:0.12-0.81 respectively). Conclusions Our results suggest that the advice for PrEP should be given based travel destination, as these was found to be the main factor for PEP delay, among travelers going to rabies endemic countries.

scholarly journals Factors associated with intention to take non-occupational HIV post-exposure prophylaxis among Thai men who have sex with men

2017 ◽  
Vol 3 (3) ◽  
pp. 128-139 ◽  
Author(s):  
Nitiya Chomchey ◽  
Thira Woratanarat ◽  
Narin Hiransuthikul ◽  
Somrat Lertmaharit ◽  
Vitool Lohsoonthorn ◽  
...  
Keyword(s):  
Post Exposure Prophylaxis ◽  
Factors Associated ◽  
Post Exposure ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals BNT162b2 post-exposure-prophylaxis against COVID-19

2022 ◽  
Author(s):  
Zohar Shemuelian ◽  
Yehuda Warszawer ◽  
Omri Or ◽  
Sagit Arbel-Alon ◽  
Hilla Giladi ◽  
...  
Keyword(s):  
Vaccination Campaign ◽  
Control Group ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Unvaccinated Control ◽  
Study Population ◽  
Exposure Prophylaxis ◽  
Therapeutic Prevention ◽  
First Time ◽  
Prevention Approach

Background: During the COVID-19 pandemic, post-exposure-prophylaxis is not a practice. Following exposure, only patient isolation is imposed. Moreover, no therapeutic prevention approach is applied. We asked whether evidence exists for reduced mortality rate following post-exposure-prophylaxis. Methods: To estimate the effectiveness of post-exposure-prophylaxis, we obtained data from the Israeli Ministry of Health (MoH) registry. The study population consisted of Israeli residents aged 12 years and older, identified for the first time as PCR-positive for SARS-CoV-2, between December 20th, 2020 (the beginning of the vaccination campaign) and October 7th, 2021. We compared 'recently injected' patients - that proved PCR-positive on the same day or on one of the five consecutive days after first vaccination (representing an unintended post-exposure-prophylaxis), to unvaccinated control group. Results: Among Israeli residents identified PCR-positive for SARS-CoV-2, 11,690 were found positive on the day they received their first vaccine injection (BNT162b2) or on one of the 5 days thereafter. In patients over 65 years, 143 deaths occurred among 1413 recently injected (10.12%) compared to 280 deaths among the 1413 unvaccinated (19.82%), odd ratio (OR) 0.46 (95% confidence interval (CI), 0.36 to 0.57; P<0.001). The most significant reduction in the death toll was observed among the 55 to 64 age group, with 8 deaths occurring among the 1322 recently injected (0.61%) compared to 43 deaths among the 1322 unvaccinated control (3.25%), OR 0.18 (95% CI, 0.07 to 0.39; P<0.001). Conclusion: Post-exposure-prophylaxis is effective against death in COVID-19 infection. Israeli MoH Registry Number: HMO-0372-20

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections

2020 ◽  
Vol 19 (3) ◽  
pp. 242-248
Author(s):  
Anthony Idowu Ajayi ◽  
Mohammed Sanusi Yusuf ◽  
Elmon Mudefi ◽  
Oladele Vincent Adeniyi ◽  
Ntombana Rala ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Study of sharp injuries and blood splash exposures among healthcare workers in a tertiary hospital in Bangalore

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Shalini Sivananjiah Pradeep ◽  
Suman Gadicherla Raghu ◽  
Prathab A G ◽  
Banashankari G Rudresh ◽  
Radhika Kunnavil
Keyword(s):  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Post Exposure ◽  
Increased Risk ◽  
Management Procedures ◽  
Exposure Prophylaxis ◽  
Sharps Injury ◽  
Sharps Injuries

The working environment of healthcare workers (HCW) exposes them to sharp injuries. This communication attempts to examine the injury registers, incidence of sharps injuries and blood splash exposures, and the post-exposure prophylaxis status of employees in a tertiary care hospital. Analysis included records form 54 locations of two units of a tertiary hospital attached to a Medical College. Maintenance of the injury register overall was highly satisfactory in both units. Two hundred and nine injuries were recorded from both units of the hospital. The majority of injuries (60.5%) occurred in the age group of 20-30 years with 70% among females. Waste handlers were at increased risk during waste management procedures. Thirty two percent of sharps injury injuries occurred in wards. Of the ward nursing staff, 25.3% received sharps injuries. Post-exposure prophylaxis for Hepatitis B (primary dose) was given to 25 HCWs; 11 received booster doses. The basic regimen for HIV post-exposure prophylaxis was given to 4 HCWs. Awareness about records maintenance, regular documentation, awareness and training, and implementation of appropriate preventive measures can reduce the incidence of injuries. Key words: Sharps, injury register, Health care workers (HCW),Post exposure prophylaxis (PEP)

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P&lt; 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P&lt; 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P&lt; 0.001), pregnancy (39.0% vs 79.6%; P&lt; 0.001), syphilis (3.4% vs 89.8%; P&lt; 0.001), hepatitis B (15.3% vs 95.5%; P&lt; 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

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