scholarly journals Predictors of Delay in Seeking Post-Exposure Prophylaxis in Older Adults with Animal Bite Injuries: A Population-Based Study

Author(s):  
Hassan Soleimanpour ◽  
Mehdi Abbasian ◽  
Ehsan Sarbazi ◽  
Seyed Pouya Paknezhad ◽  
Hadi Jalilvand ◽  
...  

Introduction: Animal bites are of the major health threats. Delayed post-exposure prophylaxis (PEP), especially in frail older people, may lead to mortal risks in this age group. The aim of this study was to investigate the pattern of delayed PEP in animal-bites injuries and to identify its contributing factors in older people of Tabriz city, Iran. Methods: In this cross-sectional study, the census method was used to obtain data from health records of older adults who were referred to Tabriz's Rabies Treatment Center between March 2013 and March 2018. The delay was defined as starting PEP longer than 24 hours after a suspected rabies virus exposure. The relations between delayed PEP and each of the predictors were investigated using the chi-square test in univariate analysis. The decision tree model was applied to predict the delay time of PEP. Results: A total of 322 older people with a mean age of 67.62 ± 7.18 were studied. In all, 31.7 % of the older persons victims who were bitten by an animal had a delayed PEP. Urban victims (34.1%) compared to rural (16.3 %), stray animal victims (42.0 %) compared to an owned animal-bite victim 24.6 %, all other animal bite-related victims (39.9 %) compared to dog-bite injuries (23.8%) experienced a higher frequency of delayed PEP. The decision tree revealed that animal ownership status, animal status, and animal species were the most important factors for predicting delayed PEP (p < 0.001). Conclusion: The possibility of delayed PEP in older adults bites victims, increased if the animal was ownerless and escaped. A reasonable approach to tackle this issue might be to conduct larger population studies in the future.

2019 ◽  
Vol 12 (7) ◽  
pp. 965-971
Author(s):  
Amir Hamta ◽  
Abedin Saghafipour ◽  
Seyed Abbas Hosseinalipour ◽  
Fatemeh Rezaei

Background and Aim: Data mining in medical sciences provides countless opportunities for demonstrating hidden patterns of a data set. These patterns can help general physicians and health workers in preventing diseases. This study aimed to forecast delay times in post-exposure prophylaxis (PEP) to human animal bite injuries in central Iran using a decision tree analysis. Materials and Methods: The data of 2072 human animal bite cases were collected from Centers for Disease Control and Prevention unit of Qom Provincial Health Center, Iran from January 2017 to December 2018. The information related to animal bite incidents, including the biting animal characteristics and data on the bitten humans, was obtained by investigating the epidemiological survey forms of human animal bites. The decision tree model was applied to forecast the delay time of receiving PEP. Results: A delay of more than 48 h in the initiation of PEP was estimated among 12.73% of animal bite victims. The most important variables to predict delay time of receiving PEP were the species of biting animal, time and cause of animal bite occurrences in 24 h a day, respectively. Hence, the model showed a delay in the initiation of PEP if the biting animal was a cattle or, a carnivore, and the time of being bitten was from 7 am to 1 pm, or if the animal was carnivore and the time of being bitten was between 1 and 7 pm, and the cause of animal bite was playing with the animal. Conclusion: Based on the findings of the study on different variables affecting the initiation of PEP, the concepts related to animal bite and rabies, including the timely injection of anti-rabies vaccine to prevent rabies, it is a must to educate and train, all the people, especially housewives and students.


Vaccine ◽  
2015 ◽  
Vol 33 (20) ◽  
pp. 2367-2378 ◽  
Author(s):  
Florence Ribadeau Dumas ◽  
Dieynaba S. N’Diaye ◽  
Juliette Paireau ◽  
Philippe Gautret ◽  
Hervé Bourhy ◽  
...  

2021 ◽  
pp. 4-6
Author(s):  
Chinmay Nandi ◽  
Saikat Bhattacharya ◽  
Soumitra Mondal ◽  
Shibasish Banerjee

Objectives -Rabies, an Endemic disease, is responsible for extensive morbidity and mortality in India. About 96% of the mortality and morbidity is associated with dog bites. The aim of the study was to estimate the prevalence and pattern of animal bites and rabies post exposure prophylaxis under National Rabies Control Programme Methodology – It was a Record cross sectional study where complete enumeration of all animal bite victims were done. Total 2940 such cases were found in that year. Data of 42 cases was excluded due to incomplete records. Data was analysed using MS Excel. Animal Bite Exposure register under National Rabies Control Programme, Patient Treatment cards, Consolidated reports were evaluated as study tools. Results - Majority of the wounds were found in limbs in 2695 (93%) cases. It is followed by wound in other areas like face 104(3.6%) and back 95 (3.3%). In a few cases site of wound was not mentioned in the case record. Children were most commonly affected (28.2%).Cat -bite is most common (49.3%). Around 84.9% were Category II bite and rest are category III. Conclusion - Dogs and cats are mostly responsible of animal bites in this part of the country. There is need to control stray dogs .Children are found to be most vulnerable for animal bites. There is gap between eligible candidates for vaccine and those who actually received it both in Category II and III animal bite victims.


2021 ◽  
pp. 1-5
Author(s):  
Md Waliur Rahman ◽  
◽  
Md Habibullah Sarkar ◽  
Samir Kumar Talukder ◽  
Md Joynal Abedin ◽  
...  

Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost


2013 ◽  
Vol 142 (7) ◽  
pp. 1486-1494 ◽  
Author(s):  
A. BIZRI ◽  
A. ALAWIEH ◽  
N. GHOSN ◽  
A. BERRY ◽  
U. MUSHARRAFIEH

SUMMARYRabies is one of the most important zoonotic infections worldwide. The burden of the disease continues to be significant in countries in the Middle East where the most important vector is stray dogs. Control efforts are hindered by lack of awareness and incomplete post-exposure prophylaxis. The aim of this article is to re-assess the situation of rabies in Lebanon and compare it to other Middle Eastern countries. Eight cases of rabies and 5280 incidents of animal bites to humans were reported to the Lebanese Ministry of Public Health between 2001 and 2012. Dogs were the only vector of infection and were responsible for most reported animal bites to humans. An average of 3·2 doses of vaccine per bite was administered as post-exposure prophylaxis. The status of human and canine rabies control, the risks associated with children's behaviour and the hazards of secondary wild reservoirs are discussed. Our data illustrates the importance of prevention through vector control, public awareness and education, and timely administration of active and passive immunization, as well as the significance of regional cooperation and monitoring the circulation of viral variants in wild animals.


2020 ◽  
Author(s):  
Tongtong Liu ◽  
Xi Wang ◽  
Aixin Li ◽  
Jiangzhu Ye ◽  
Duo Shan ◽  
...  

Abstract Background: College students are the key group we should pay more attention for acquired immune deficiency syndrome (AIDS) prevention and control in recent years in China, and few studies of HIV non-occupational post-exposure prophylaxis(nPEP) knowledge awareness and service acceptance have been conducted among them in China. This study conducted a cross-sectional survey to understand the service acceptance of nPEP and its influencing factors among college students in the three cities of China. Methods: A questionnaire survey was conducted to collect information on socio-demographic, behavioral characteristic, HIV/AIDS knowledge, nPEP knowledge, acceptance of nPEP services among the college students in Beijing, Shenzhen, and Kunming of China from March to April of 2019. Each participant completed a computer-assisted or mobile phone-assisted self-interview with informed consent and completed an anonymous questionnaire on line. Multivariable logistic regression analyses identified predictors for service acceptance of nPEP. Results A total of 4698 students were surveyed with the average age of 20 years old. 98.0% (4605/4698) of them were undergraduates, 21.8%(1022/4698) had sexual intercourse; 48.6% (2282/4698)had heard of nPEP, among which4.95%(113/2282) received nPEP services. The rate of AIDS knowledge awareness was 85.6% (5495/4698) with the differences statistically significant between the three cities. The nPEP knowledge awareness rate was 16.5% (774/4698). There were differences in receiving nPEP services among students of different ages, genders, sexual behaviors, and knowledge of AIDS by univariate analysis. Multivariable analyses indicated that age group of 18 and under (OR=2.551, 95% CI=1.153-5.646), male (OR=3.131, 95% CI=1.866-5.253), homosexual behavior (OR=4.661,95%CI=2.658-8.172), heterosexual behavior (OR=1.676, 95% CI=1.040-2.947), no awareness of AIDS (OR=3.882, 95% CI=2.371-6.356) and nPEP (OR=4.788, 95% CI=2.50-9.169) knowledge, were associated factors with the service acceptance of nPEP among the college students. Conclusion The low acceptance of nPEP services was mainly affected by nPEP knowledge awareness among the college students and further publicity and education of nPEP knowledge are necessary, as well as dissemination of knowledge of HIV/AIDS prevention and treatment. More attention should be paid to the factors associated with acceptance of nPEP services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cyrine Bennasrallah ◽  
Manel Ben Fredj ◽  
Moncef Mhamdi ◽  
Meriem Kacem ◽  
Wafa Dhouib ◽  
...  

Abstract Background Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011). Methods We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included. Results A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = − 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared. Conclusion Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease.


Sign in / Sign up

Export Citation Format

Share Document