scholarly journals A dog bite study in a dog rabies-affected area in South Africa

2020 ◽  
Vol 35 (1) ◽  
Author(s):  
Jacqueline Weyer ◽  
Chantel A. Le Roux ◽  
Charles Kajese ◽  
Lucy Fernandes
Keyword(s):  
Developing Countries ◽  
Temporal Distribution ◽  
Healthcare Facility ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Healthcare Facilities ◽  
Post Exposure ◽  
Direct Training ◽  
Using Data ◽  
Exposure Prophylaxis

Background: Rabies is an untreatable and highly fatal viral zoonosis. Despite the ability to control and prevent the disease, it is estimated that one person dies of rabies every 10 minutes in developing countries. However, the true burden of the disease remains undefined in most developing countries because of a lack of systematic surveillance. Dog bite data obtained from healthcare facilities where dog bite victims seek medical care may provide an additional source of information that can be used to inform the burden of disease and identify points for interventions for improved delivery of post-exposure prophylaxis (PEP) to prevent the disease.Methods: A descriptive epidemiological study was conducted using data obtained from dog bite registers and patient case files at a healthcare facility for a two year period (2015-2017).Results: The study reported frequency, demographics, source, geographic and temporal distribution of bite cases reported to a hospital serving a rabies-affected community. In addition, the post-exposure management of dog bite cases at this facility is described.Conclusion: Dog bites was not an infrequently reported at the healthcare facility, with up to 29 cases reported in a month during the study period. The affected population was defined and it is motivated that this information is useful for targeted health interventions. Findings related to the delivery of PEP may also be used to direct training and re-training of healthcare workers for improved delivery of PEP.

Pattern and Outcome of Dog Bite Injuries among Children-a Study in 200 Cases

2021 ◽  
pp. 1-5
Author(s):  
Md Waliur Rahman ◽  
◽  
Md Habibullah Sarkar ◽  
Samir Kumar Talukder ◽  
Md Joynal Abedin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
Hospital Treatment ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Post Exposure ◽  
Dog Bites ◽  
Exposure Prophylaxis ◽  
Bite Injuries

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

scholarly journals A Retrospective Study on Dog Bite Associated Rabies in Human and the Use of Post-exposure Prophylaxis in Nepal during 2008 to 2017

2021 ◽  
Vol 11 (2) ◽  
pp. 181-186
Author(s):  
Pushkar Pal ◽  
Hiroshi Shimoda ◽  
Rajendra Bashyal ◽  
Adisorn Yawongsa ◽  
Theera Rukkwamsuk
Keyword(s):  
Population Management ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Stray Dogs ◽  
Post Exposure ◽  
Dog Bites ◽  
Stray Dog ◽  
The Government ◽  
Exposure Prophylaxis

A 10-year (2008-2017) retrospective canine-mediated human rabies epidemiology was studied to assess the burden of rabies in Nepal. To this end, the number of dog bites, the use of post-exposure prophylaxis (PEP), and human death records from 2008 to 2017 were retrieved from Sukraraj Tropical Hospital, Kathmandu, Nepal. The findings revealed that the number of human rabies occurrences was consistent with minor fluctuations throughout the study period. There were 252,297 dog bite cases in humans recorded between 2008 and 2017. Every month, 2,102 people were bitten by mostly stray dogs. There was a gradual increase in PEP use throughout 10 years. On average, 36,995 PEP dosages were used per year for stray dog bites. The PEP consumption and the number of human deaths were negatively correlated. A total of 482 human rabies deaths were recorded in Nepal during the study period. On average, 49 people died of canine-mediated rabies each year. Although there was an increase in the use of PEP, the number of human deaths and street dog bites recorded were still high. The high mortality due to rabies could then be attributed to the flawed surveillance system and stray dog population management, and not merely the lack of PEP services. Hence, it is recommended that the government agencies and other concerned stakeholders should organize mass vaccination and population management program for stray dogs in order to reduce the country’s rabies burden.

scholarly journals Equine Rabies Immunoglobulin: A Review

2019 ◽  
Vol 9 (4-s) ◽  
pp. 730-735 ◽  
Author(s):  
P.V. Shelke ◽  
Punit R. Rachh
Keyword(s):  
Developing Countries ◽  
Immune Globulin ◽  
Caprylic Acid ◽  
Specific Activity ◽  
High Specific Activity ◽  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Rabies is a major cause of human death in many developing countries. There is a worldwide shortage of human and equine rabies immune globulin. The WHO recommends combined administration of rabies vaccine and rabies immune globulin to patients after exposure. The implementation of post exposure prophylaxis by vaccination and specific immunoglobulin therapy are largely hampered by its high cost. The equine rabies immunoglobulin is less expensive than human rabies immunoglobulin, and is used for rabies post-exposure prophylaxis in developing countries. Equine rabies immunoglobulin is a F(ab)2 with high specific activity, purity, and safety. Healthy horses are immunized with a rabies vaccine. Crude plasma is collected and immunoglobulin is converted into F(ab)2 fragments by pepsin digestion. The F(ab)2 fragments are purified using caprylic acid precipitation followed by ultrafiltration. Keywords: Rabies, Equine rabies immunoglobulin (ERIG), Human rabies immunoglobulin (HRIG), IgG, Caprylic acid, Pepsin.

scholarly journals Economical way to decrease financial burden: anti rabies vaccines by intra dermal administration in developing countries

2020 ◽  
Vol 7 (4) ◽  
pp. 1419
Author(s):  
Prachi Kori ◽  
Manju Toppo ◽  
Seema Patel
Keyword(s):  
Developing Countries ◽  
Financial Burden ◽  
Care Facility ◽  
Health Care Facility ◽  
Cost Benefit ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Dermal Administration ◽  
Exposure Prophylaxis ◽  
Rabies Vaccination

Background: To prevent deaths due to rabies only remedy available is post exposure prophylaxis. The major constraint is affordability to anti-rabies vaccine for intramuscular administration or intra dermal administration as PEP. So, intra dermal anti rabies vaccination (IDRV) as recommended by WHO in developing countries like India, reduces the quantity and cost of vaccination, although in most of the health facilities still intra muscular anti rabies vaccination is preferred. Objective of our study is to assess the cost benefit of intra dermal anti rabies vaccination and to find out the demographic profile of patients attending ARV clinic.Methods: It is a hospital record-based study done after ethical committee approval, carried out in a tertiary health care facility, Hamidia hospital, Bhopal (M.P.), India.Results: Our study includes 4818 entries of dog bite cases in whom vaccination cost is found to be approximately Rs. 3,90,420 with Intra dermal administration and it reduces vaccine cost by 60-70% compared with mostly preferred intramuscular vaccination. Among them 31.47% were below 14 years of age and majority 75% were male. Category III bite cases are most common 83.6% and commonest site of dog bite was over the lower limb 68.73%.Conclusions: Intra dermal regimen is more cost beneficial compared to intra muscular regimen, which is thus more helpful to reduce financial burden in developing countries like India.

scholarly journals Delays in initiating rabies post-exposure prophylaxis among dog bite victims in Wakiso and Kampala districts, Uganda

2021 ◽  
Vol 4 ◽  
pp. 49
Author(s):  
Stevens Kisaka ◽  
Fredrick Makumbi ◽  
Samuel Majalija ◽  
Gloria Bahizi ◽  
SM Thumbi
Keyword(s):  
Formal Education ◽  
Post Exposure Prophylaxis ◽  
Delayed Presentation ◽  
Dog Bite ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Post Exposure ◽  
Bite Wounds ◽  
Exposure Prophylaxis ◽  
To Receive

Background   Although rabies in dog bite patients is preventable through timely initiation of post-exposure prophylaxis (PEP), a number of barriers to achieving PEP exist. This study investigated the delays to initiation of PEP among dog bite patients in the emergency departments of two PEP centers in Uganda. Methods A cross-sectional study was conducted among dog-bite patients that presented to two selected rabies PEP centers. A semi-structured questionnaire was used to collect data. Delay to receive PEP was defined as reporting for PEP beyond 24 hours after the bite event. Generalized linear models were used to calculate prevalence ratios and the 95% confidence intervals as a measure of association between delay and patient factors. Results Out of 376 participants, just over half (53.5%) were males. The majority of participants (54.0%) were 15 years or older and 28.5% had no formal education. Just over three-quarters (77.9%) had category II dog bite wounds. Nearly 40% delayed to receive PEP, and median (inter quartile range) lag time between bite event and seeking medical care of 18 (41) hours. Compared to education level of secondary or above, patients with no formal education (adj. PR=4.06, 95% CI: 2.69 -  6.10) or primary education (adj.PR=2.15, 95% CI: 1.37 -  3.35), belonging to the lowest socio-economic tertile as compared to the highest (adj.PR=1.58, 95% CI: 1.10 - 2.28), knowing the owner of the biting dog (adj.PR=1.30, 95% CI: 1.02 - 1.65) and having category II wounds (adj.PR=2.31, 95% CI: 1.43 - 3.71) were all associated with delayed presentation for PEP. Conclusions and recommendations Delays to receive PEP are common and are associated with poor level of education or low socio-economic status, knowledge of who the dog owner is and less severity of bite wounds. Seeking care irrespective of wound severity or knowledge of dog owner should be promoted.

scholarly journals Delays in initiating rabies post-exposure prophylaxis among dog bite victims in Wakiso and Kampala districts, Uganda

2021 ◽  
Vol 4 ◽  
pp. 49
Author(s):  
Stevens Kisaka ◽  
Fredrick Makumbi ◽  
Samuel Majalija ◽  
Gloria Bahizi ◽  
SM Thumbi
Keyword(s):  
Formal Education ◽  
Post Exposure Prophylaxis ◽  
Delayed Presentation ◽  
Dog Bite ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Post Exposure ◽  
Bite Wounds ◽  
Exposure Prophylaxis ◽  
To Receive

Background   Although rabies in dog bite patients is preventable through timely initiation of post-exposure prophylaxis (PEP), a number of barriers to achieving PEP exist. This study investigated the delays to initiation of PEP among dog bite patients in the emergency departments of two PEP centers in Uganda. Methods A cross-sectional study was conducted among dog-bite patients that presented to two selected rabies PEP centers. A semi-structured questionnaire was used to collect data. Delay to receive PEP was defined as reporting for PEP beyond 24 hours after the bite event. Generalized linear models were used to calculate prevalence ratios and the 95% confidence intervals as a measure of association between delay and patient factors. Results Out of 376 participants, just over half (53.5%) were males. The majority of participants (54.0%) were 15 years or older and 28.5% had no formal education. Just over three-quarters (77.9%) had category II dog bite wounds. Nearly 40% delayed to receive PEP, and median (IQR) lag time between bite event and seeking medical care of 18 (41) hours. Compared to education level of secondary or above, patients with no formal education (adj. PR=4.06, 95% CI: 2.69 -  6.10) or primary education (adj.PR=2.15, 95% CI: 1.37 -  3.35), belonging to the lowest socio-economic tertile as compared to the highest (adj.PR=1.58, 95% CI: 1.10 - 2.28), knowing the owner of the biting dog (adj.PR=1.30, 95% CI: 1.02 - 1.65) and having category II wounds (adj.PR=2.31, 95% CI: 1.43 - 3.71) were all associated with delayed presentation for PEP. Conclusions and recommendations Delays to receive PEP are common and are associated with poor level of education or low socio-economic status, knowledge of who the dog owner is and less severity of bite wounds. Seeking care irrespective of wound severity or knowledge of dog owner should be promoted.

scholarly journals Number of people requiring post-exposure prophylaxis to end leprosy: A modeling study

2021 ◽  
Vol 15 (2) ◽  
pp. e0009146
Author(s):  
Anneke T. Taal ◽  
David J. Blok ◽  
Wim H. van Brakel ◽  
Sake J. de Vlas ◽  
Jan Hendrik Richardus
Keyword(s):  
Contact Tracing ◽  
Post Exposure Prophylaxis ◽  
First Year ◽  
Post Exposure ◽  
Leprosy Patients ◽  
Using Data ◽  
The Individual ◽  
Exposure Prophylaxis ◽  
The Impact

Background Worldwide, around 210,000 new cases of leprosy are detected annually. To end leprosy, i.e. zero new leprosy cases, preventive interventions such as contact tracing and post-exposure prophylaxis (PEP) are required. This study aims to estimate the number of people requiring PEP to reduce leprosy new case detection (NCD) at national and global level by 50% and 90%. Methodology/Principal findings The individual-based model SIMCOLEP was fitted to seven leprosy settings defined by NCD and MB proportion. Using data of all 110 countries with known leprosy patients in 2016, we assigned each country to one of these settings. We predicted the impact of administering PEP to about 25 contacts of leprosy patients on the annual NCD for 25 years and estimated the number of contacts requiring PEP per country for each year. The NCD trends show an increase in NCD in the first year (i.e. backlog cases) followed by a significant decrease thereafter. A reduction of 50% and 90% of new cases would be achieved in most countries in 5 and 22 years if 20.6 and 40.2 million people are treated with PEP over that period, respectively. For India, Brazil, and Indonesia together, a total of 32.9 million people requiring PEP to achieve a 90% reduction in 22 years. Conclusion/Significance The leprosy problem is far greater than the 210,000 new cases reported annually. Our model estimates of the number of people requiring PEP to achieve significant reduction of new leprosy cases can be used by policymakers and program managers to develop long-term strategies to end leprosy.

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)

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