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

Epidemiological Features of Dog Bites among Children Attending Emergency Room in Al-showmely General Hospital

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Hasan Alwan Baiee ◽  
Weli Hatif
Keyword(s):  
Emergency Room ◽  
General Hospital ◽  
Health Problem ◽  
Lower Limbs ◽  
Care Providers ◽  
Dog Bite ◽  
Female Ratio ◽  
Post Exposure ◽  
Dog Bites ◽  
Bite Injuries

Dog bites are common and can affect victims of different ages.Dog bite injuries in children are a preventable health problem.Dog bites are a serious health problem that cause both physical and emotional damage to victims and considerable cost to communities. Studies on dog bites among Iraqi children were very scarce.This study focuses on theincidence,mechanisms,and epidemiologicalcircumstances ofdog biteinjuriesin a series of pediatric patients who sustained dog bites in emergency Room. MethodologyA cross sectional study was designed to studyall cases of dog bites attending the emergency room in AL-Showmely General Hospital located in the southern district – Babylon province-Iraq, during the period ; from the January, first,2017 through theend of March, 2018.Special constructed were prepared to collect data through interview of victims or their companions who attended the emergency section during this period,ethical clearances were obtained.*A total of 320 children presented to the hospital with dog bite injuries.The incidence rate of dog bites was 275 per 100000 population, the male to female ratio was 3:1.the most common dog bite injuries took place in September44 (13.75%). Injury rates were highest in those aged 0-4,declining thereafter with age. In the 6-10, year age group141 (44.1%), most of cases living in rural district (villages). The most affected location were lower limbs, only 3.4% of the injured children had completed the post exposure anti rabies vaccine. Dog bites are common health problem among children,Children who are younger than 10 years represent the high-risk group for dog attacks. very few of them had complete the prophylactic post exposure vaccine Therefore, prevention strategies should focus on public education,training health care providers and controlling stray dogs.

scholarly journals “As long as the patient tells you it was a dog that bit him, why do you need to know more?” A qualitative study of how healthcare workers apply clinical guidelines to treat dog bite injuries in selected hospitals in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254650
Author(s):  
Stevens Kisaka ◽  
Fredrick E. Makumbi ◽  
Samuel Majalija ◽  
Alexander Kagaha ◽  
S. M. Thumbi
Keyword(s):  
Clinical Guidelines ◽  
Clinical Management ◽  
Health Workers ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Dog Bites ◽  
Rabies Control ◽  
Exposure Prophylaxis ◽  
Control And Management ◽  
Bite Injuries

Dog-mediated rabies is on the increase in Uganda despite the availability of post-exposure prophylaxis (PEP). PEP procedures are expounded in the Uganda Clinical Guidelines (UCG) of 2016. We assessed adherence by health workers to UCG while managing dog bites in two PEP centers and obtained insights into motivations of their practices. Using qualitative methods, we observed the health worker-patient encounters, reviewed medical records, and interviewed 14 health workers that were involved in managing dog bite injuries. We used deductive thematic analysis to identify codes in themes developed from UCG. We found that much of the history of the bites was taken, but it was neither verified nor written down on the patient’s file. Classification of wounds was inaccurate and ancillary laboratory assessments like culture and sensitivity tests were not conducted in all cases. Although antibiotics were given for both treatment and prophylactic purposes, the prescription was based on availability and affordability, not UCG recommendations. Rabies immunoglobulin (RIG) was not administered to deserving patients due to unavailability and high costs to the patient. Anti-rabies vaccine (ARV) was prescribed indiscriminately and some health workers attributed this to pressure from patients. Health education regarding prevention of dog bites was not given to patients due to time constraints on the side of the providers as a result of high caseloads at the emergency departments. Challenges to adherence to guidelines were identified as frequent ARV stock outs; inadequate cooperation among health facilities; and insufficient knowledge and skills on how injuries and rabies should be managed. We conclude that clinical management of dog bites is not fully in line with UCG. We argue that adoption of an integrated bite case management and cost-saving strategies as well as continuing medical education programs on rabies control and management could improve the clinical management of dog bites.

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 An increasing public health problem: Suspected rabies exposures

2021 ◽  
Vol 15 (11) ◽  
pp. 1694-1700
Author(s):  
Ahmet Onder Porsuk ◽  
Cigdem Cerit
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Health Problem ◽  
Hospital Admissions ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Post Exposure Prophylaxis ◽  
Cross Sectional ◽  
Exposure Prophylaxis ◽  
Special Studies

Introduction: The increasing trend of rabies suspected exposures is a serious public health problem that is challenging the health systems of developing countries both in terms of labor and economics. The purpose of our study is to determine the current state of rabies suspected exposure cases. Methodology: This descriptive and cross-sectional study was conducted by retrospectively examining the applications made due to suspected exposures to a state hospital’s emergency service in Turkey. Descriptive and analytical statistics were used in data analysis and p ≤ 0.05 was considered as statistically significant. Results: Between 2015 and 2019, 3,378 hospital admissions due to suspected exposures were detected (n = 3,378). The number of admissions, which was 558 in 2015, increased every year and reached 829 in 2019 (p < 0.001). Also admissions after contact with cats have increased over the years and have passed contact with dogs in 2019 (p < 0.001). Post-exposure prophylaxis was applied to all cases, but 0.8% (n = 26) of them were found to be inappropriate according to guidelines. It was observed that 38.3% of overall cases examined were individuals aged 19 and under. It was also observed that 69.1% (n = 2,326) of the suspected exposures were caused by owned animals (p < 0.001). Conclusions: The case rates seen in children indicate the need for special studies for children. Applications for suspected exposures due to contact with cats were found to be a growing problem. Therefore, it was concluded that the patterns of rabies suspected exposure cases in Turkey and similar developing countries should be monitored regularly and measures should be taken according to local needs. Besides, stray animals in cities must be minimized and all animals living in cities owned or stray, must be monitored in terms of vaccination.

scholarly journals Study on Fate of Rabies Patients following Canine Animal Bite or Scratch

2015 ◽  
Vol 3 (1-2) ◽  
pp. 32-38
Author(s):  
Mohammad Anwarul Bari ◽  
TH Zohra Moon Moon ◽  
Zinat Begum ◽  
Md Asadul Kabir ◽  
Mohammad Murad Hossain
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Lower Limbs ◽  
Rural Resident ◽  
Post Exposure Prophylaxis ◽  
Major Public Health Problem ◽  
Post Exposure ◽  
The Status ◽  
Clinical Records ◽  
Exposure Prophylaxis

Background & Objective: Rabies is major public health problem in Bangladesh, although little epidemiological information is available about the disease. The present study is, therefore, intended to assess the extent of animal bite and rabies, and the status of post-exposure prophylaxis in Bangladesh. Materials & Methods: Data were retrospectively collected from clinical records and registers of patients with animal bites and rabies cases attended at IDH between January 2010 to December 2012. All the rabies cases were diagnosed clinically and were analysed using descriptive statistics. Result: Of the 276 patients of rabies patients admitted in the Infectious Disease Hospital, Mohakhali, Dhaka during the period 2009 to 2013, about 39% were 10 or <10 years old and 26.4% more than 40 years old with mean age of the patients being 26 years (range: 2-90 years). Over three-quarters (76.1%) were male (3:1). Majority (80.1%) was rural resident. The injuries were primarily inflicted by bite (92%) and rarely by scratch (8%). About 96% had injury with bleeding. Dogs were the prime biting animal (88%) followed by cat (7.2%), jackal (2.9%), mongoose (1.4%) and others (0.4%). About three-quarters (74.6%) of the animals were stray animal, followed by rabid (mad) animal (18.1%), pet (4.3%) and others (2.9%). In most cases (82.6%) the biting animal could not be traced. Most of the patients received bite in lower limbs (76.4%), were multiple (70%) and were of category III (96%). Of the total cases, only 34(12.3%) received vaccine before admission at our hospital. Of them only 9(26.5%) completed the course schedule. Half of the patients received vaccine from the pharmacy and 38.3% from Institute of Public Health (IPH). However, over 60% of the patients were uncertain about their preservation status. More than 60% of patients took more than 40 days to develop rabies following bite, 27.5% 20 - 40 days and 10.9% < 20 days. The mean interval was 72.8 days (range 10 days to 3 years). Conclusion: Rabies is usually a disease of children, male and rural resident primarily caused by bite of stray dogs. The post-exposure prophylaxis is at its worst with majority does not receive vaccine. Protection by rabies immunoglobulin is even rare. None of the patients survived of the disease. Ibrahim Cardiac Med J 2013; 3(1&2): 32-38

scholarly journals Epidemiological Aspect of Dog Bite and Response of The Dog Bite Victims Attending Vaccination Centre of Sadar Hospital, Sirajganj

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 148-152
Author(s):  
Ahmed Nawsher Alam ◽  
Mahmuda Siddiqua ◽  
Asma Siddiqua ◽  
Nasreen Akther ◽  
Moushumi Sarker ◽  
...  
Keyword(s):  
Rural Areas ◽  
Public Health Problem ◽  
Education Level ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Primary Level ◽  
Epidemiological Aspect ◽  
Low Education ◽  
Knowledge And Attitude ◽  
Exposure Prophylaxis

Background: Rabies is a public health problem in Bangladesh, with poorer people and children being mainly affected. Objectives: The aim of this study was to investigate the behaviours of dog bite victims following a bite and to assess the knowledge and attitude about rabies among dog bite victims. Materials and Methods: A crosssectional type of descriptive study was designed where individual people who came to the vaccination centre from the month of April 2015 to July 2015 for post-exposure prophylaxis were considered. They were interviewed and followed during subsequent visits until they had received their final dose of vaccination. Result: Among the victims, males 60.9% were more common than females 39.1% and most of them were children aged below 20 years 51 %, mostly from rural areas 69.3%, had very little primary 46.1% or no education 24.7%. Victims were bitten mostly at their legs 89.3%. In response to question regarding what happens following dog bite, 49% couldn't say anything, and 46% mentioned hydrophobia. Most of them (87%) know that rabies can be transmitted from dogs to humans; 68.4% had no idea that rabies can be prevented in dogs. Though 82.3% bite victims didn't know that rabies in humans can be prevented before a dog bite, 77.7% knew that rabies can be prevented after a dog bite. Use of soap and water was found lowest 13.1% among those who had education upto primary level and highest 53.9% in graduates. Conclusion: This study showed that most victims didn't take any washing measures before visiting to hospital which is one of the most important measures recommended by WHO and it was found mostly who had low education level. It also observed that knowledge gap about rabies among the dog bite victims decreased with increased education level. KYAMC Journal Vol. 9, No.-4, January 2019, Page 148-152

Rabies risk and use of post‐exposure prophylaxis associated with dog bites in Tennessee

2018 ◽  
Vol 65 (4) ◽  
pp. 425-430
Author(s):  
H. Henderson ◽  
L. R. Carpenter ◽  
J. R. Dunn
Keyword(s):  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Dog Bites ◽  
Exposure Prophylaxis

scholarly journals Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cyrine Bennasrallah ◽  
Manel Ben Fredj ◽  
Moncef Mhamdi ◽  
Meriem Kacem ◽  
Wafa Dhouib ◽  
...  
Keyword(s):  
Health Care ◽  
Public Health Problem ◽  
Surveillance Data ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Major Public Health Problem ◽  
Post Exposure ◽  
Yearly Average ◽  
Animal Bites ◽  
Exposure Prophylaxis

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.

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