How does Nursing Students Knowledge and Attitude correlate in relation to Rabies? An institutional based Cross-Sectional study in Assam

Introduction: Rabies is a vaccine-preventable viral disease. Every year, Rabies causes 18 000-20 000 deaths in India and dogs are responsible for 99 % of all human deaths.Objectives: 1) To assess the knowledge and attitude about rabies among the nursing students.2) To assess whether there is any difference of knowledge and attitude about Rabies among different academic year of the nursing students.3) To assess whether there is any relation between scores of knowledge and attitude.Material & Methods: A cross sectional study was conducted among 142 students of B.Sc. Nursing College, Dibrugarh, Assam in January 2022 using Google form containing pre designed structured closed ended questionnaire by convenience sampling. Knowledge and attitude was assessed by a scoring system. Results were expressed in proportion, percentage, mean, standard deviation. ANOVA and Spearman”s correlation was applied. Results: Mean knowledge & attitude score was 15.7±3.6 and 23.6±2.6.Majority (82.4%) of the students had good knowledge about rabies.Almost all (97.9 %) students had positive attitude towards rabies. There was no significant difference between knowledge score and attitude score among different academic year of the students. Knowledge was positively correlated with attitude of the students.Conclusion: The study revealed good knowledge and positive attitude regarding rabies among the students

Lesions caused by human and domestic and wild animal bites

ABSTRACT Animal bites are a common problem in the emergency room. There are many reports of isolated cases (mainly of domestic mammals); however, texts with more comprehensive and general guidance on these kinds of bite injuries are necessary, including those caused by wild mammals, reptiles, and even fish. This review aims to update knowledge on this problem, which includes human and domestic and wild animal bites. Health teams in emergency care centers should be aware of the initial and late measures required to control this problem.

Myths and unhealthy wound practices regarding animal bite among subjects attending anti rabies clinic in a South Delhi municipal corporation polyclinic in Mehrauli, Delhi

Background: Rabies is one of the highly fatal diseases, with nearly fifty nine thousand deaths annually globally and almost one third of these are in India. Higher rates of dog bites are common in our country, due to large stray dog population. Despite a preventable disease, unhealthy wound practices are still prevailing in the community due to lot of myths related to the disease. The objectives of the study were to assess the magnitude of unhealthy wound practices and to assess the knowledge regarding health seeking behaviour following animal bite.Methods: The present study was a cross sectional study conducted at SDMC Polyclinic, Mehrauli, Delhi from January to December 2015. A total of 160 cases of animal bite that attended OPD and consented were analysed for knowledge, practices and health seeking behaviour towards animal bite.Results: Out of total 160 respondents almost all were bitten by dogs of which 2/3rd was stray dogs and most common site of bite was lower limb. 55% of the subjects did not wash or clean the wounds after bite. 27% of subjects applied chilli powder or its paste with oil and 2.5% used oil and turmeric paste and 1.9% oil on the wound. Only 41.9% of the subjects believed that vaccination is the treatment of the choice following animal bite.Conclusions: Intensive health education through mass media and mid media can be used to create awareness about the disease transmission and preventive measures like wound management and post-exposure prophylaxis. Also, pet vaccination should be made mandatory for all those who keep pets.

Awareness about rabies and health seeking behavior among animal bite victims attending a tertiary care hospital of Jharkhand

Background: Rabies is an acute fatal disease of central nervous system, caused by Lyssavirus Type 1. Rabies in dogs is the source of 99% of human infection. Awareness about rabies and health seeking behavior are crucial determinants of rabies control. Present study was done to assess awareness regarding animal bite and health seeking behavior among affected population.Methods: A hospital based cross sectional study was conducted in central emergency department of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand for a period of four months. A semi-structured questionnaire was used for data collection. Sample size was 114 using consecutive sampling method. The participants were interviewed after taking informed consent. Data collected were entered in MS Excel and analyzed using SPSS version 20.Results: A total of 114 subjects participated in the study of which 83 (72.8%) were male and 31 (27.2%) female. Most commonly affected age group found was 21-30 years (35.1%). Majority 101 (88.6%) of them resided in urban areas, and only 79 (69.3%) acquired secondary education and above. Most of the animal bite was caused by dogs 102 (89.5%), unprovoked 79 (69.3%) in nature and most common site involved lower limb 70 (61.4%). Majority 68 (59.6%) of the dog bite wound were of category II. Only 55 (48.2%) of animal bite victims washed their wound with soap and water. Majority 58 (50.9%) of the study participants had no knowledge about consequences of dog bite. Median reporting time to tertiary institute was found to be four hours.Conclusions: There was average level of awareness about rabies among animal bite victims attending RIMS, Ranchi

Profile of dog bite cases reporting to ARV OPD of a tertiary care hospital

Background: Animal bites pose a major public health problem in children and adults worldwide. Rabies is a viral zoonosis caused by bite of a rabid dog that occurs in >100 countries and territories. India accounts for 60% of all the world burden of rabies related deaths. The objective of the present study is to analyse the profile of dog bite victims reporting to ARV OPD of a tertiary care hospital.Methods: This was a cross-sectional study conducted in the ARV OPD of a tertiary care hospital. A total of 228 victims of dog bite were interviewed. They were selected using systematic random sampling technique. Analysis of data obtained was done using SPSS.Results: Majority of the participants belonged to the age group 20-30 years. The proportion of male was higher than female. Most of the victims had suffered category II type of dog bite (66.2%). A statistically significant association was seen between age group and nature of dog bite, sex of victim and type of dog, type of dog and category of dog bite and the category of bite and history of dog biting other individuals.Conclusions: The burden of dog bite seems to be borne by the economically productive age group. All individuals need to be educated on how to behave around animals so that they can avoid animal bite.

A study on knowledge, attitude and practice about rabies among pharmacy students in a tertiary care hospital

Background: Rabies, a disease of antiquity, continues to be a major public health problem in India and itis 100% fatal. Objective: To assess the knowledge, attitude and practice about rabies among pharmacy students of Assam Medical College and Hospital, to assess whether there is any difference of knowledge, attitude and practice among male and female students and study the socio-demographic profile of the students. Materials &Methods: A cross sectional study was conducted among 156 pharmacy students by purposive sampling using pre designed structured close ended questionnaire. Knowledge and attitude was assessed by a scoring system. Statistical analysis was done by percentage and chi square test. Results: The mean age of the students was 20.64 ± 1.42 years. Most (63.5%) of the students were males and most (46.7%) of them belong to the Hindu religion. Almost all (97.4%) the students had heard the word rabies. Conclusion: Most (61.2%) of the students had average knowledge, 38.8 % had good knowledge, 48.7 % had negative attitude and 51.3 % had positive attitude about rabies.

Out of Pocket Expenditure among Animal Bite Patients Attending a Tertiary Care Hospital for Treatment in Rajasthan

Introduction: Rabies is an infectious viral disease that isalmost always fatal. It is present on all continents, exceptAntarctica, with over 95% of human deaths occurring in theAsia and Africa regions. Treating a rabies exposure, wherethe average cost of rabies post-exposure prophylaxis (PEP) isUS$ 40 in Africa, and US$ 49 in Asia, can be a catastrophicfinancial burden on affected families whose average dailyincome is around US$ 1–2 per person. Study was conductedwith the objectives to analyse the direct and indirect out ofpocket expenditure of the post exposure prophylaxis ofanimal bites in spite of free supply of anti-rabies vaccine andimmunoglobulin.Material and methods: A cross sectional observational studywas carried out at Anti Rabies Clinic, SMS Hospital Jaipur,Rajasthan from October 2018 to March 2019 to know out ofpocket expenditure of animal bite patients and its determinants.Prior approval from institutional ethics committee andinformed consent were taken and a pre-designed, pre-testedproforma was filled from the persons attending anti rabiesclinic on last visit of post-exposure prophylaxis (PEP). Apartfrom socio-demographic details, information about director indirect out of pocket expenditure due to animal bite wasrecorded and analysis was done using chi square test, ANOVAtest, ‘t’-test and univariate and multivariate regression.Results: Total out of pocket expenditure by 81 studied patientswas Rs. 53201.00, out of which 91.69% i.e. Rs. 48780.00 wereindirect expenses and 5.04% i.e. Rs. 2681.00 was expenditureon medical and surgical management including registrationand consumables. Only 3.27% i.e. Rs. 1740.00 was on postexposure anti-rabies prophylaxis of 81 patients. Mean out ofpocket expenditure was Rs. 656.80±1387.76 ranging from Rs.0.00 to Rs. 8550.00 per patient with median of Rs. 290.00.Conclusion: Despite free supply of anti-rabies vaccine andanti-rabies serum under Mukhyamantri Nishulk Dava Yojna(MNDY) the indirect out of pocket expenditure in animal bitetreatment is still high, which should draw attention for policymakers.

Differences in health seeking behavior of animal bite patients between urban and rural areas of Aurangabad city

Background: The present study explores the variation in epidemiology and treatment seeking behavior of animal bite patients in rural and urban areas. The rural urban differences would be imperative in effective policy making, planning and implementation of preventive and control measures. Methods: This cross-sectional study was carried out in 50 urban patients were from anti-rabies vaccination clinic of government medical college Aurangabad and 50 rural patients from areas of Paithan from January 2016 to May 2016. All patients were subjected to socio-demographic profile and detailed history of animal bites, wound toileting and treatment including both active and passive immunization. Results: Overall, 66% were males and 34% were females. Most of the people in rural area were bitten by stray dog (42%) followed by wild animals like pig, monkey (16%) as compared with 38% of stray dog bite cases in urban areas. The commonest site of animal bites was found to be lower limb followed by upper limb, trunk and head in both areas. Maximum cases belonged to category III (84%) in rural areas followed by category I (10%). Also, most of the rural patients (46%) preferred home remedies of treatment i.e. application of oil, salt, red chilies, and turmeric paste applications as compared with 10% urban patients. Conclusions: Our study revealed that majority of the patients from rural areas were inflicted upon by stray dogs (54%) and relied more upon home remedies thereby reporting late to government hospitals.

A Cross-Sectional Study of Attitude and Practices Regarding Animal Bite Among Attendees of Anti Rabies Clinic of a Teaching Hospital, Jaipur

Introduction: Rabies is a zoonotic disease having almost100% fatality. Proper and timely management of animal bitecases can prevent the fatal disease. We conducted this studyto assess the attitude and practices of animal bite victimregarding animal bite management at Anti rabies clinic, RDBPJaipuria hospital.Methods: This observational study was conducted among 107attendees of anti-rabies clinic of Govt. R.D.B.P. Jaipuriahospital associated with RUHS College of medical sciences,Jaipur from February 2018 to July 2018. Data was collectedusing a predesigned semi-structured questionnaire. Data wereanalysed using IBM SPSS software version 20.0.Results: 107 participants were enrolled in the study. Maximumparticipants were males (72%), from age group of 26–35 years(43%), urban area (72%), and studying in 10th standard(22.5%). 76% of the participants were having good attitude butonly 36% participants were having good practices regardingmanagement of animal bite cases. Good attitude regardingreaction after animal bite, seriousness of disease, whom toconsult, what to do immediately after bite of animal, vaccinationof bite victim, pet dog vaccination and vaccination of contactswas among 55.14%, 48.6%, 88.78%, 56.07%, 93.46%,66.35% and 37.38% respondents respectively. Only 56% werehaving practice of washing wound with soap and water while16.82% were practicing application of red chilli, 14% werepracticing lime application and 13% participants were havingpractice of applying nothing on animal bite wound. 44% victimsdid not wash the wound before visiting the clinic. Majority(98.13%) visited doctor after animal bite while 1.87% visited totraditional healers first.Conclusion: Practices of applying red chilli and lime on theanimal bite wound is widely prevalent in the community.Community health awareness campaign should involvepreventive measures of rabies and immediate actions afteranimal bite.

Demographic Profile of Acute Poisoning Cases Excluding Animal Bite at MBGH, Udaipur

Introduction: Poisons are the substances that can causesevere organ damage or death, if ingested, breathed, injectedinto the body or absorbed through the skin.1 The word poisonwas firstly used in 1200 A.D., which means a deadly potionor substance.2 This word was derived from Latin word‘potionem’ (a drinking of drink). Every substance may act aspoison and only the dose plays an important role. Aims andobjectives: 1) to study the demographic profile of poisoningin the patients admitted in MBGH, Udaipur. 2) To study theincidence of different types of poisoning.Material and methods: This study was hospital basedprospective study. The study was conducted from Jan, 2017to Jan, 2018; carried out in Department of Medicine RNTmedical college and MBGH hospitals Udaipur (Raj). 200patients were included who fulfilled the eligible criteria.Results: Males (54.50%) were affected more than females(45.50%).Maximum numbers of patients 34.00% were inthe age group between 21-30 years. Most of the people werefrom rural area (67.00%). Highest numbers were reportedamong agricultural worker (21.50%) followed by students(21.00%). Intentional poisoning was found among 159 cases(79.5%). Family problems (n=78, 39%) were contributingfactor for committing suicides. The leading poison wasOrganophosphorous group of compounds 33.00%. Highestmortality was seen in aluminum phosphide which constituted16 cases (51.61%).Conclusion: Acute poisoning is one of the common problemsin a clinical practice and our study suggests that Insecticidesare one of the most common agents causing this problem

Epidemiological profile of animal bite patients attending emergency department at a tertiary care health facility in a northern hilly Indian city

Background: Rabies is a highly infectious zoonotic disease with a high case fatality rate. In India, approximately 20,000 deaths among 17.4 million exposed people occur every year. The data on animal bites is scarce and unreliable due to poor surveillance and hence, the projected figures are far less from the actual numbers. The present study was conducted to describe epidemiological characteristics of animal bite patients attending casualty department at a tertiary care Government health facility in Shimla, Himachal Pradesh.Methods: It was a retrospective study based on secondary data received from animal bite register for year 2017 at casualty department of the Indira Gandhi Medical College and Hospital, Shimla, Data of 1512 patients attending the casualty department with history of animal bite was included for the study purpose.Results: About 58% of victims were males and the maximum (22.6%) animal bites were seen in 21-30 years age group. Majority (51.6%) of patients were exposed to dog bites, followed by monkey bites (42.85%) and cat bite 49 (3.2%). About 69.9% of animal bites were in the lower limbs, followed by upper limbs (22.1%), abdomen (4.4%) and head and neck region (3.6%). Maximum bites were category III bites (74.6%) followed by of category II bites (12.9%).Conclusions: Study highlights the neglected but significant picture of animal bite in the Shimla city. Timely and correct post exposure prophylaxis for the animal bite victims is necessary to prevent rabies. This should be supplemented with a robust surveillance and reporting system. With the global aim of zero rabies deaths by 2030; it is time to strengthen the anti-rabies activities at every level.

Profile of animal bite victims reporting to intradermal rabies vaccination centre at a tertiary care government hospital: 10 years experience

Background: Rabies is acute, progressive encephalitis caused by a lyssavirus. Over 95% of rabies deaths in humans result from virus transmission through the bites of infected dogs. To provide Post Exposure Prophylaxis to the people, Anti Rabies Clinics have been established in many places, especially at tertiary care centres. The Anti-Rabies Clinic at Mandya Institute of Medical Sciences, Mandya, Karnataka state (ARC-MIMS) is one such centre, the first of its kind in Karnataka state more than ten years ago. We are presenting the clinical profile of the animal bite victims who sought treatment at our centre in the past 10 years.Methods: It was a retrospective record based study conducted at Mandya Institute of Medical Sciences with sample size of 44087 using purposive sampling from May 2018 to June 2018 and data was collected using data extraction sheet.Results: Among the 44087 animal bite victims majority i.e., 66.6% were males, most of them were in the age group of 16-60 years. Sixty percent of the animal bite victims were residing in rural areas. All the category 2 and category 3 bite victims were administered anti rabies vaccination and 15.4% of the category 3 bite victims were administered rabies immunoglobulin.Conclusions: Majority of animal bite victims were presented and treated within 1 day. The practice of giving health education periodically to the school children and making phone calls to remind follow up days which is being practiced should be promoted.

Clinical safety profile of Premi-Rab a new indigenous equine rabies immunoglobulin for cat III animal bite victims at anti rabies clinic of a tertiary care hospital, Karnataka

Background: WHO guidelines recommend for treating Cat III animal bite victims with local infiltration of Equine Rabies Immunoglobulin (ERIG) into and around animal bite wounds followed by anti-rabies vaccine (ARV).The main reason for non-use of ERIGs by medical profession is the fear of anaphylaxis and laborious process. The present study was taken up with the objectives to assess the clinical safety of a new ERIG, describe sociodemographic profile of ERIG recipients and compliance to Intra Dermal Rabies Vaccine (IDRV), who reported to Anti Rabies Clinic (ARC) of Mandya Institute of Medical Sciences (MIMS), Mandya.Methods: Descriptive study at ARC, MIMS, Mandya for a period of one year. The data was collected using structured questionnaire. The data was entered into Microsoft excel and results were expressed using descriptive statistics.Results: The study revealed that cat III animal bite victims were 3400 (56.3%), of these only 545 (16.0%) opted for the new ERIG. Skin Sensitivity Test (SST) showed positive results in 17 (3.1%) cases. Among the ERIG recipients 28 (5.1%) had mild adverse reaction to ERIG. The compliance rate was 49.2% for all 4 doses of IDRV.Conclusions: 3.1% showed positive result to SST. 5.1% had mild adverse reaction to ERIG.

A cross sectional study to assess awareness regarding rabies amongst medical students of Rajindra hospital, Patiala, Punjab

Background: Rabies is a preventable enzootic endemic disease in India, it is a viral disease caused by Lysavirus causing acute inflammation of brain in humans and other warm blooded animals. It is typically transmitted through bites from infected animal. Human rabies deaths are almost entirely preventable through prompt delivery of post-exposure prophylaxis (PEP) to victims of bites by rabid animal. Appropriate knowledge regarding rabies and its prevention among medical students is very important to prevent rabies deaths. The aims and objectives of the study were to assess awareness regarding rabies amongst medical students.Methods: This was a cross sectional study which was conducted in month of April 2018. There were total of 496 students, we could obtain the information from 373 students as the questionnaire was given during a theory class and some of the students were absent. A pretested, structured questionnaire was administered to assess their knowledge about rabies, classification and management of bite wounds, including different vaccination schedules, site and dose. The data was entered using Microsoft excel and statically analysed by Epi Info 7.Results: Almost all (97.32%) students knew that rabies is a fatal disease and 78.02% knew that dog was the primary transmitting animal. Only 41.29% students were aware that head, neck and face to be the danger site of bite. Almost all 98.6% students were aware about washing the wound with soap and water as the primary first aid measure following dog bite whereas 0.27% said suturing as first aid measure.Conclusions: Awareness of medical students regarding cause of rabies and its fatality were good but they had less awareness about the danger sites of animal bite.

Fatal case of human rabies infection: A case report

Rationale: Rabies, as an acute viral disease of the mammal's central nervous system (CNS), with a high mortality rate, is transmitted to humans through the bite of a rabid animals, especially canine and feline. Patient concerns: An Afghan man, aged 50 years was bitten by a fox in a farm around the Qom-Tehran road, Central Iran in 2018. The patient visited the doctor after the bite, however the period between incidence and hospital visit was not established and no indication was given whether the bite site injury was thoroughly washed. The patient was neither referred to the health center for vaccination (post-exposure prophylaxis) nor an effective therapeutic measures was applied. Forty-five days post-exposure, the patient presented with symptoms such as headache, fever, tingling and burning sensation and was referred to the Centers for Disease Control and Prevention (CDC) unit of Qom Provincial Health Center. Diagnosis: Rabies infection. Interventions: Forty-five days after the animal bite, in CDC of Qom Health Center, he received rabies post-exposure prophylaxis treatment was referred to an infectious diseases physician. Based on the history of animal bites, the patient was classified as probable case of rabies. The clinical symptoms of rabies appeared in patient after hospitalization. Outcomes: Ultimately the patient died in hospital 4 days after hospitalization (50 days after the occurrence of animal bite). After referring the patient to the CDC, the patient's saliva (0.5-1 mL) was sampled three times every 3-6 hours and tested by PCR. Human rabies was confirmed by Department of Virology in the Pasteur Institute of Iran. Lessons: Physicians and clinicians have responsibilities to be critical in observations and take prompt actions in case of animal bites, as rabies usually develops within 7 to 14 days, and delayed intervention after the onset of symptoms, vaccine and serum injections cannot lead to the survival of the patient.

Fatal case of human rabies infection: A case report

Rationale: Rabies, as an acute viral disease of the mammal's central nervous system (CNS), with a high mortality rate, is transmitted to humans through the bite of a rabid animals, especially canine and feline. Patient concerns: An Afghan man, aged 50 years was bitten by a fox in a farm around the Qom-Tehran road, Central Iran in 2018. The patient visited the doctor after the bite, however the period between incidence and hospital visit was not established and no indication was given whether the bite site injury was thoroughly washed. The patient was neither referred to the health center for vaccination (post-exposure prophylaxis) nor an effective therapeutic measures was applied. Forty-five days post-exposure, the patient presented with symptoms such as headache, fever, tingling and burning sensation and was referred to the Centers for Disease Control and Prevention (CDC) unit of Qom Provincial Health Center. Diagnosis: Rabies infection. Interventions: Forty-five days after the animal bite, in CDC of Qom Health Center, he received rabies post-exposure prophylaxis treatment was referred to an infectious diseases physician. Based on the history of animal bites, the patient was classified as probable case of rabies. The clinical symptoms of rabies appeared in patient after hospitalization. Outcomes: Ultimately the patient died in hospital 4 days after hospitalization (50 days after the occurrence of animal bite). After referring the patient to the CDC, the patient's saliva (0.5-1 mL) was sampled three times every 3-6 hours and tested by PCR. Human rabies was confirmed by Department of Virology in the Pasteur Institute of Iran. Lessons: Physicians and clinicians have responsibilities to be critical in observations and take prompt actions in case of animal bites, as rabies usually develops within 7 to 14 days, and delayed intervention after the onset of symptoms, vaccine and serum injections cannot lead to the survival of the patient.

Rabies post-exposure prophylaxis compliance of bite patients: The San Lazaro Hospital Animal B.I.T.E. (Bite Injury Treatment Experience) study

Background@#Post-exposure prophylaxis (PEP) is the most important means of preventing rabies. Intradermal PEP was developed to improve compliance, still, many recipients fail to complete this regimen@*Objective@#To determine the non-monetary factors contributing to non-compliance to PEP among patients in the Animal Bite Treatment Center (ABTC) of San Lazaro Hospital (SLH).@*Methods@#This was an analytical, cross-sectional study. The authors randomly reviewed patient records of SLH-ABTC for one-year period. We characterized the cases according to World Health Organization (WHO) parameters. They determined the day intervals between exposure, first consultation, PEP initiation and follow-up visits. Statistical analyses used were descriptive statistics, χ2 test for independence and binary logistic regression.@*Results@#The authors evaluated 667 records. Patients mostly had Category III exposures (76.91%, 95%CI: 73.92%80.62%). The chances of completing active immunization were more likely among patients exposed to unvaccinated animals (OR=1.85, 95%CI: 1.21-2.84, p=0.004). The chances of receiving passive immunization were higher for injuries on the head/neck regions (OR=8.18, 95%CI: 2.4-27.9, p=0.001). Overall, compliance to PEP was 70.21% and 40.70% for Categories II and III exposures, respectively. PEP compliance was moderately dependent on the exposure category (χ2=38.14, df=1, p<0.001, φ=0.25.@*Conclusion@#Category II exposure patients had better compliance than Category III, since rabies immunoglobulins are not required. The authors did not identify any factors that significantly affected Category II regimen compliance. Among Category III patients, compliance was better if the injuries were bite-inflicted while those who were exposed from “healthy”looking animals were less likely to comply.

Wound management and vaccination following animal bite: a study on knowledge and practice among people in an urban area of Pondicherry, India.

Background: Correct wound management and vaccination following animal bite prerequisite for prevention of rabies. Objective: To find out knowledge and practice about the correct wound management and vaccination following animal bite among the individuals in a selected urban area of Pondicherry. Methods: This explorative study was conducted in the field practice area of a tertiary care institution in urban Pondicherry. A total of 156 individuals one each from 156 households were selected and included after obtaining verbal informed consent. Using a pretested semi structured questionnaire, we obtained information on knowledge about wound care following animal bite and vaccination against rabies, and details of animal bite to any household members anytime in the past. Results: Only 19% of the respondents could name “Rabies” as the cause of death following animal bite. All the respondents had known about immediate initiation of anti-rabies vaccine following animal bite and its free availability in government hospitals. However, only one third of the respondents were aware of immediate washing of wound with soap and water following animal bite. The last one year incidence of animal bite was found to be 0.87% (6/682). Majority of the animal bite cases belonged to Class II (58%) and, involved dogs (88%), males (79.2%) and people from low socio-economic status (96%). All the individuals with animal bites had initiated anti-rabies vaccine within 24 hours of bite, however only two third had washed their wound with soap and water immediately following animal bite. About 17% of the animal bite victims had applied oil or turmeric over the wound. Conclusions: Incorrect immediate wound care following animal bite is a concern for prevention of rabies in this area. Health education should be strengthened on certain aspects like disease causation, wound care following animal bite and before coming in contact with a health facility to this population.

A retrospective epidemiological study of delay for updated Thai red cross intradermal anti-rabies vaccination schedule amongst animal bite cases attending ARV clinic at a tertiary care centre.

Background: Rabies is an acute viral disease, which causes encephalomyelitis in virtually all the warm blooded animals, including man. Almost 20000 deaths occur in India. The present study conducted with objective to analyze the delays and compliance for anti-rabies vaccination as per schedule and its some factors among the animal bite cases. Methods: Retrospective cross sectional record based study of cases attended Anti-Rabies Vaccination (ARV) clinic during the period of April 2012 to March 2013. The data extracted from records included socio-demographic variables, animal bite history treatment received and completion of ARV schedule. Data entered and analyzed using SPSS 21. Results: Total of 3548 animal bite cases attended the ARV clinic. Out of these cases, 18.2 %, 20.3% and 14.2% of cases not reported on scheduled date for 2nd, 3rd & 4th dose of ARV respectively. Only 34.3% of cases completed the schedule. Delay for receiving ARV among women, cases from rural area & class II animal bite was statistically significant. Conclusions: Counselling regarding follow up of ARV schedule at the time of first visit to the anti-rabies vaccine clinic must be strengthened to avoid poor compliance and delaying of schedule.

Profile of Patients Attending an Animal Bite Management Clinic in Rural Pondicherry, India.

Aims: In India, annual incidence of animal bite is estimated as 1.7 per 100 population and that of human rabies as 1.7 per 1,00,000 population. Since rabies is universally fatal it requires prevention through timely management by wound care, Anti-Rabies Vaccine (ARV) and rabies immunoglobulin. Study Design: Retrospective record review. Place and Duration of Study: Animal Bite Management (ABM) clinic of a Primary Health Centre in rural Pondicherry, south India, between January and December, 2011. Methodology: This study is a secondary analysis of data collected at an Animal Bite Management (ABM) clinic in a primary health centre in rural Pondicherry. The study population was mainly rural and agrarian. All victims of animal bite, who sought treatment from the ABM clinic between January and December, 2011 were included. Wound washing and administration of ARV through intramuscular route was provided for all victims. Data on factors like age, gender, place of residence, biting animal was collected. Means and proportions were calculated. Chi square test for categorical and t-test for continuous variables were applied. Results: A total of 767 victims sought treatment from ABM clinic. The mean age was 29 years (1 to 84 years). Mean distance of travel to ABM clinic was 2.1 km. About a third of all cases occurred during summer (March to May). Majority of victims were bitten by dog (85%) followed by cat (9%) and monkey (6%). Only 61.7%, 32.2%, 0.8% and 0% turned up for day 3, day 7, day 14 and day 28 doses of ARV schedule. Of those who came, only 70% came on due day. There was no statistically significant difference in treatment seeking based on gender and distance from ABM clinic. Conclusion: The high dropout rate for Day 3 and subsequent doses of the ARV and the delayed administration of Day 3 and Day 7 are worrying facts because only a full and timely ARV course will provide complete protection against rabies. Aims: In India, annual incidence of animal bite is estimated as 1.7 per 100 population and that of human rabies as 1.7 per 1,00,000 population. Since rabies is universally fatal it requires prevention through timely management by wound care, Anti-Rabies Vaccine (ARV) and rabies immunoglobulin. Study Design: Retrospective record review. Place and Duration of Study: Animal Bite Management (ABM) clinic of a Primary Health Centre in rural Pondicherry, south India, between January and December, 2011. Methodology: This study is a secondary analysis of data collected at an Animal Bite Management (ABM) clinic in a primary health centre in rural Pondicherry. The study population was mainly rural and agrarian. All victims of animal bite, who sought treatment from the ABM clinic between January and December, 2011 were included. Wound washing and administration of ARV through intramuscular route was provided for all victims. Data on factors like age, gender, place of residence, biting animal was collected. Means and proportions were calculated. Chi square test for categorical and t-test for continuous variables were applied. Results: A total of 767 victims sought treatment from ABM clinic. The mean age was 29 years (1 to 84 years). Mean distance of travel to ABM clinic was 2.1 km. About a third of all cases occurred during summer (March to May). Majority of victims were bitten by dog (85%) followed by cat (9%) and monkey (6%). Only 61.7%, 32.2%, 0.8% and 0% turned up for day 3, day 7, day 14 and day 28 doses of ARV schedule. Of those who came, only 70% came on due day. There was no statistically significant difference in treatment seeking based on gender and distance from ABM clinic. Conclusion: The high dropout rate for Day 3 and subsequent doses of the ARV and the delayed administration of Day 3 and Day 7 are worrying facts because only a full and timely ARV course will provide complete protection against rabies.