Awareness about Rabies Post Exposure Prophylaxis in Pakistan Among Patients and Health Care Workers: Results from an Asian Rabies Expert Bureau Study.
Summary of "Awareness about Rabies Post Exposure Prophylaxis in Pakistan Among Patients and Health Care Workers: Results from an Asian Rabies Expert Bureau Study."
Objective: To identify the gaps in information on rabies and post exposure prophylaxis (PEP) in relation to categorization of wound severity, wound washing and appropriate use of vaccine and rabies immunoglobulin after exposure, and define actions that should be taken at dog bite management centres for prevention of rabies occurring after animal bites. Study Design: Cross-sectional survey. Place and Duration of Study: A multicentre study across Pakistan conducted from 1st July 2007 to 31st January 2008. Methodology: A pre-tested questionnaire was distributed to the respective medical officers in 6 dog bite management centres across Pakistan from 1st July 2007 to 31st January 2008. Information was obtained about demographics of dog bite victims, the timing and type of PEP administered and their responses to the injury. Results: Out of 519 completed questionnaires the mean age of dog bite victims was 24 years. Over one-third were less than 18 years of age; male/female ratio was 4.9:1; 43% lived in rural Pakistan; 67.8% were classified as lower socioeconomic class; 98% animal bites were from dogs, of which 92.5% were first time bites. 45.5% wounds were classified as Category I (no risk), 42.7%, Category II (moderate risk) and 11.9% Category III (severe risk). Tissue culture vaccine (TCV) was used 54% by intramuscular route and 45% by intradermal route. Only 118 (22.9%) patients received rabies immunoglobulin (RIG). Critical analysis of the results reveals serious gaps in understanding of wound severity classification and correct application of PEP with vaccine and RIG. Conclusion: There is a dire need for improved awareness and understanding of dog bite management among health care givers in order to prevent rabies deaths.
Affiliation
Division of Infectious Diseases, The Indus Hospital, Karachi.
Journal Details
This article was published in the following journal.
Name: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
ISSN: 1681-7168
Pages: 491-4
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21798137
- DOI: http://dx.doi.org/08.2011/JCPSP.491494
Medical and Biotech [MESH] Definitions
Rabies Vaccines
Vaccines or candidate vaccines used to prevent and treat RABIES. The inactivated virus vaccine is used for preexposure immunization to persons at high risk of exposure, and in conjunction with rabies immunoglobulin, for postexposure prophylaxis.
Post-exposure Prophylaxis
The prevention of infection or disease following exposure to a pathogen. This is most frequently addressed by administering a vaccine or anti-viral medication following exposure to a virus.
Lyssavirus
A genus of the family RHABDOVIRIDAE that includes RABIES VIRUS and other rabies-like viruses.
Rabies Virus
The type species of LYSSAVIRUS causing rabies in humans and other animals. Transmission is mostly by animal bites through saliva. The virus is neurotropic multiplying in neurons and myotubes of vertebrates.
Empathy
An individual's objective and insightful awareness of the feelings and behavior of another person. It should be distinguished from sympathy, which is usually nonobjective and noncritical. It includes caring, which is the demonstration of an awareness of and a concern for the good of others. (From Bioethics Thesaurus, 1992)
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