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Considerada uma das mais graves doenças tropicais negligenciadas (DTN) do mundo, a raiva promove grande impacto à saúde pública devido a sua evolução letal e ao elevado custo social e econômico. O objetivo desta pesquisa foi descrever o perfil epidemiológico das agressões por animais potencialmente transmissores de raiva, no estado de Mato Grosso do Sul, durante os anos de 2019 a 2021. Foi realizado um estudo epidemiológico retrospectivo, transversal, qualiquantitativo, com dados secundários codificados do Sistema de Informação de Agravos de Notificação: ano e mês, município e zona de ocorrência, idade, sexo, raça, escolaridade, tipo de exposição, região anatômica atingida, características do ferimento, espécie e condição do animal agressor e tratamento preconizado. Foram registradas 24.362 notificações de agressões, com prevalência média de 8,7/1.000 hab. Janeiro apresentou o maior número de notificações. Destacaram-se, entre os agredidos, crianças entre 1 e 9 anos de idade do sexo masculino. A zona de ocorrência de 89,5% dos agravos foi urbana e 81,7% foram provocados por cães. Dentre os indivíduos agredidos, 79,2% receberam tratamento antirrábico pós-exposição com uso de imunobiológico. O estado registrou baixa prevalência de agravos por animais. Notaram-se falhas de preenchimento das fichas de notificação e nos critérios de inclusão de agravos com animais potencialmente transmissores da raiva.
Considered as one of the most serious neglected tropical diseases (NTD) worldwide, rabies greatly impacts public health due to its lethal evolution and high social and economic cost. Given this scenario, this study describes the epidemiological profile of attacks by potential rabies-transmitting animals in the state of Mato Grosso do Sul, Brazil, from 2019 to 2021. A retrospective, cross-sectional, qualitative-quantitative epidemiological study was conducted with secondary data obtained from the Information System for Notifiable Diseases, namely: year and month; municipality and area of occurrence; age; gender; race; education; type of exposure; anatomical region affected; characteristics of the wound; species and condition of the animal; and recommended treatment. A total of 24,362 notifications of animal attacks were reported, with average prevalence of 8.7/1000 inhabitants. January registered the highest number of notifications. Among the victims, male children aged one to nine years stood out. Of the total injuries reported, 89.5% occurred in urban areas and 81.7% were done by dogs. Among the attacked individuals, 79.2% received post-exposure anti-rabies treatment with immunobiological drugs. The state recorded a low prevalence of animal attacks. Results revealed poorly filled out forms and issues with the inclusion criteria used for classifying injuries caused by potential rabies-transmitting animals.
Considerada una de las enfermedades tropicales desatendidas (ETD) más graves del mundo, la rabia tiene un gran impacto en la salud pública debido a su evolución letal y alto costo social y económico. El objetivo de esta investigación es describir el perfil epidemiológico de las agresiones por animales potencialmente transmisores de la rabia, en el estado de Mato Grosso do Sul (Brasil), durante los años de 2019 a 2021. Se realizó un estudio epidemiológico retrospectivo, transversal, cualicualitativo, con datos secundarios codificados del Sistema de Información de Enfermedades de Declaración Obligatoria que contienen: año y mes, municipio y zona de ocurrencia, edad, sexo, raza, nivel de educación, tipo de exposición, región anatómica afectada, características de la herida, especie y condición del animal agresor y tratamiento recomendado. Se registraron 24.362 notificaciones de agresiones, con una prevalencia media de 8,7/1.000 hab. Enero tuvo el mayor número de notificaciones. Entre las víctimas se destacaron niños de entre 1 y 9 años de edad y varones. El área donde ocurrieron el 89,5% de las lesiones fue urbana, y el 81,7% de ellas fueron causadas por perros. Entre los agredidos, el 79,2% recibió tratamiento antirrábico postexposición con uso de inmunobiológicos. El estado registró una baja prevalencia de lesiones causadas por animales. Se observaron fallas en el llenado de los formularios de notificación y en los criterios de inclusión de enfermedades con animales potencialmente transmisores de la rabia.
Subject(s)
Animals , Rabies , Behavior, Animal , Aggression , Disease Prevention , Neglected Diseases , Health Information Systems , Animals, WildABSTRACT
Rabies is an acute viral zoonotic disease that affects all warm-blooded animals including mammals and occurs in more than 150 countries and territories. Although rabies is a 100% fatal disease, it can be pre-vented by the use of potent anti-rabies vaccines (ARV). The present study was a hospital based descrip-tive longitudinal study conducted during February 2019 to July 2020 amongst the animal bite patients attending the Anti -Rabies clinic (ARC) of Vardhman Mahavir Medical College and Safdarjung Hospital (VMMC & SJH), New Delhi, to study the adverse events (vaccine reactions) if any following administra-tion of the ARV. The age of the study participants ranged from 2 to 65 years and the mean age was (29.315.2) years. No severe or serious adverse events were reported. Of the minor reactions, the most commonly reported symptom was pain at the injection site (34; 9.4%) followed by occurrence of tingling sensation (29; 8.1%), headache (22; 6.1%) and itching at the injection site (19; 5.3%). These findings corroborate with those found in previous studies in the literature. It was concluded that although there are possible local or mild or systemic adverse reactions to rabies vaccination, but once initiated, rabies prophylaxis should not be interrupted or discontinued.
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Background: Atherosclerosis affects multiple vascular beds, accounting for nearly all of coronary heart disease and some proportion of ischemic strokes. Serum lipid levels have an effect on the short-term mortality due to strokes. But in some studies, there was no dyslipidemia in patients who presented with acute stroke. It is important to evaluate the serum lipid levels in both the types of strokes to guide lipid lowering therapy which can reduce incidence of stroke and related mortality. This study is undertaken to evaluate the role of serum lipids in patients of stroke in our centre.Methods: It is a cross sectional study, conducted on 176 patients of stroke, who were assessed by NIHSS stroke scale clinically. Serum lipid profile was measured in all patients. Data was entered in Microsoft Excel and analysed by descriptive statistics. Chi Square test was used for association of qualitative variables. A p value<0.05 was considered statistically significant.Results: In this study conducted on 176 patients, LDL values were deranged more in CVA-bleed group compared to CVA-infarct group. BMI was the best anthropometric measure that correlated with LDL. LDL was also the most common parameter that was deranged in nonsmokers (61.8%) whereas in smokers, total cholesterol (66.3%) was most commonly deranged. Triglyceride and VLDL values were deranged more commonly in diabetic group than in non-diabetic group. A total of 123 out of 145patinets with CVA- infarct, had deranged lipid profile and among patients with CVA- bleed 24 out of 32 had deranged lipid profile.Conclusions: Results of this study shows significant derangement in lipid profile especially in LDL cholesterol levels in both infarct and bleed group, therefore starting statin therapy would prove to be beneficial in preventing recurrence of stroke.
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Complete postexposure prophylaxis with 4 doses of anti-rabies vaccine (ARV) in a previously vaccinated (nonna飗e) individual results in administration of two extra ARV doses resulting in wastages of precious resources comprising vaccine logistics, human resources, physician, and patient time. This cross-sectional study conducted in a secondary care hospital in Delhi among 175 incident animal bite cases observed 39 (22.3%) had an animal-bite history within the previous 5 years. A total of 19 (10.8%) cases reported a history of complete ARV vaccination during a previous animal-bite exposure. However, in the absence of supportive patient medical documentation, all the animal bite cases without exception were prescribed a full course of ARV irrespective of their previous exposure status. Rabies immunoglobulins (anti rabies serum) were also re-administered in 13 (81.2%) cases. National guidelines for rabies prophylaxis should, therefore, consider the inclusion of an explicit decision-making algorithmic mechanism when the health-care provider is confronted with this situation carrying the potential for hidden vaccine wastage.
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Background: Rabies is a highly fatal viral disease, yet preventable through timely administration of post-exposure prophylaxis (PEP). Anti-rabies clinic (ARC) plays an important role in providing PEP. Evaluation is a systematic way to improve current activities and by careful selection of alternative ways for better planning of future. Objective: The study was done with the intention to identify the gaps in the patients’ care in terms of patient satisfaction at ARC of a tertiary care center, Bengaluru. Materials and Methods: A cross-sectional study was conducted among 260 animal bite victims who visited outpatient department of ARC. The study tool comprised three sections; socio-demographic profile, details of animal bite, and patient satisfaction scale (PS-18) which was scored using 5-point Likert scale. T-test, analysis of variance and Pearson’s correlation was used to assess the relationship between quality dimensions and PS-18 scores. Results: The mean age of the study participants was 37.33 (17.71) years and majority were males. The overall mean score of PS-18 was 4.15 (0.42). The highest and lowest mean scores of PS-18 among the components were given to communication, 4.36 (0.61) and accessibility, 3.56 (0.75), respectively. There was significant association between religion, frequency of visit, category of bite, and cost incurred with mean scores of PS-18. Out of 260, about 62.7% of them gave good scoring for PS-18. Conclusions: The study findings showed that more than half of the patients visiting the outpatient department shared a positive experience. Although the mean scores for overall PS-18 scale belonged to the grade of good scoring; due interest to be taken to improve accessibility and convenience which was the least scored among the components of PS-18.
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Background: Animal bites cause a big burden in terms of morbidity and mortality throughout the world. These bites could be caused by rabid animals causing rabies. Annually about 59,000 persons die of rabies, of which 20,000 is from India alone. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound wash, anti-rabies vaccination (ARV) and rabies immunoglobulin. The objectives of the present study was to describe the demographic profile of animal bite cases and to assess the management practices of animal bite cases reporting to dedicated anti-rabies clinic (ARC) of a tertiary care hospital, Hassan, Karnataka.Methods: A cross-sectional study was conducted from the inception of anti-rabies clinic (12th October 2017) to August 2018 among animal bite cases reported to ARC. They were interviewed by using a semi-structured, pre-designed and pre-tested proforma. Data regarding socio-demographic profile were collected from the animal bite victims. All the animal bite cases were managed as per WHO guidelines.Results: The total number of animal bite victims reported to ARC during the study period was 3500. Majority of the bite victims belonged to adult population (20-60 years). Majority were males (66.2%). 77% belonged to the rural population. Dogs (97.1%) were the most common biting animal. 79% of the bites were provoked. Turmeric powder was the most commonly used irritant. Most bites belonged to Category III (84%). Category I, II, III bites were managed appropriately according to WHO guidelines.Conclusions: Knowing the burden, socio-demographic characteristics and the management of animal bite victims in the dedicated ARC of HIMS has helped the programme officer in implementing the National Rabies Control Programme in Hassan district.
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Background: Rabies being a preventable disease with no treatment available once onset starts but can be easily prevented by post-exposure among all animal bite victims. So it is essential to take the full course of vaccination for complete protection.Methods: The present study was a hospital based cross sectional study and was carried out in rural health training centre in Maner, Patna.Results: Our study included 340 patients who attended anti rabies clinic for post exposure prophylaxis. Among them 65% were children (<15 years) comprising mostly males (69%) and mostly of category III exposure. Direct cost of post exposure vaccination when compared with the cost of pre exposure prophylaxis is one-third (approx).Conclusions: Compliance to anti-rabies vaccination for post-exposure prophylaxis is still low and they are still at risk of developing rabies. Reasons being irregular supply of vaccine and immunoglobulin in government hospitals, loss of wages, forgotten dates, cost incurred to buy from outside and distance from the hospital if referred to other centre. Seeing the current scenario, planning and prioritizing areas to achieve our goal and lessen economic burden is need of the hour. We infer that pre exposure prophylaxis may be a cost effective strategy which can aid in the control and elimination of rabies in endemic settings.
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Background: The rabies postexposure prophylaxis (PEP) is provided through anti-rabies clinics in the country. It was considered important to assess their facilities under a nationwide multi-centric survey. Objectives: The objective of this study is to assess the facilities available for PEP at the anti-rabies clinics and to ascertain the PEP provided at the anti-rabies clinics. Methods: The cross-sectional assessment was made from May 2017 to January 2018 in selected seven states of India. Thirty-five anti-rabies clinics from both Government and private; urban and rural areas from the states were assessed by an expert team using a pretested checklist for facilities and services available for PEP. Results: On an average, 10 new animal bite cases were attended at each anti-rabies clinic per day. The cold chain facilities for rabies biologicals were satisfactory. The facilities for wound washing (54.3%) and the use of antiseptics to animal bite wounds were not adequate. Rabies vaccines were administered by intramuscular in 54.3% and by intradermal route in 45.7% of the cases. The vaccine stock-outs were reported only in the government sector (18.5%). The type of rabies immunoglobulin (RIG) used was equine (63.2%) and human (36.8%); given free of cost in 40% of Anti rabies clinics. The local wound infiltration of RIG was in practice at 58.6% of anti-rabies clinics. The stock-out of RIG was more in private (50%) hospitals than in Government (40.7%) hospitals. Conclusion: The facilities available for PEP at the anti-rabies clinics were inadequate and have to be improved across the country.
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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.
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Background: Rabies is one of the deadliest diseases of mankind, and has terrified since antiquity. It is 100 per cent fatal, however, 100% preventable. In India, rabies causes an estimated 20,565 deaths with 17.4 million exposures to animal bites, mainly dog bites, occurring every year. In India a person is bitten by an animal in every 2 seconds and someone dies from rabies every 30 second. Complete post-exposure prophylaxis is necessary among the animal bite cases for complete protection. Hence this study aims to determine the patient’s compliance for intradermal anti-rabies vaccination and also to determine the constraints for compliance.Methods: A retrospective record based study was conducted in the ARC of S.M.S.M.C, Jaipur where patients were provided intradermal rabies vaccination (updated Thai Red Cross regimen) for post-exposure prophylaxis. The records maintained at ARC-SMSMC under department of community medicine from March 2016- February 2017 were analysed. The total number of patients was 8873 from which 8590 subjects were recruited for the study after excluding category I cases, pre-exposure cases rat bite, human bite, re-exposure and pre-exposure cases. The major constraints were found out by interviewing the patient/guardian through the telephone.Results: The compliance rate for intradermal rabies vaccination (IDRV) is 81.87%. The major constraints were timings not convenient, personal or social workload, long distance from the hospital, forgotten the dates.Conclusions: The compliance rate for rabies vaccination is considerably low for this highly fatal disease. Considering these major constraint factors, the animal bite victims should be motivated effectively through health education at the time of initiation of vaccination course to attain the goal of rabies free India.
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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.
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Background Among other applications, immunotherapy is used for the post-exposure treatment and/or prophylaxis of important infectious diseases, such as botulism, diphtheria, tetanus and rabies. The effectiveness of serum therapy is widely proven, but improvements on the immunoglobulin purification process and on the quality control are necessary to reduce the amount of protein aggregates. These may trigger adverse reactions in patients by activating the complement system and inducing the generation of anaphylatoxins. Herein, we used immunochemical methods to predict the quality of horse F(ab)2 anti-botulinum AB, anti-diphtheric, antitetanic and anti-rabies immunoglobulins, in terms of amount of proteins and protein aggregates. Methods Samples were submitted to protein quantification, SDS-PAGE, Western blot analysis and molecular exclusion chromatography. The anticomplementary activity was determined in vitro by detecting the production of C5a/C5a desArg, the most potent anaphylatoxin. Data were analyzed by one-way ANOVA followed by Tukey's post-test, and differences were considered statistically significant when p 0.05. Results Horse F(ab)2 antitoxins and anti-rabies immunoglobulin preparations presented different amounts of protein. SDS-PAGE and Western blot analyses revealed the presence of protein aggregates, non-immunoglobulin contaminants and, unexpectedly, IgG whole molecules in the samples, indicating the non-complete digestion of immunoglobulins. The chromatographic profiles of antitoxins and anti-rabies immunoglobulins allowed to estimate the percentage of contaminants and aggregates in the samples. Although protein aggregates were present, the samples were not able to induce the generation of C5a/C5a desArg in vitro, indicating that they probably contain acceptable levels of aggregates...
Subject(s)
Animals , Antitoxins/analysis , Horses/immunology , Immunoglobulin Fab Fragments/analysis , Proteins/analysis , Protein AggregatesABSTRACT
Among other applications, immunotherapy is used for the post-exposure treatment and/or prophylaxis of important infectious diseases, such as botulism, diphtheria, tetanus and rabies. The effectiveness of serum therapy is widely proven, but improvements on the immunoglobulin purification process and on the quality control are necessary to reduce the amount of protein aggregates. These may trigger adverse reactions in patients by activating the complement system and inducing the generation of anaphylatoxins. Herein, we used immunochemical methods to predict the quality of horse F(ab′)2 anti-botulinum AB, anti-diphtheric, antitetanic and anti-rabies immunoglobulins, in terms of amount of proteins and protein aggregates. Methods Samples were submitted to protein quantification, SDS-PAGE, Western blot analysis and molecular exclusion chromatography. The anticomplementary activity was determined in vitro by detecting the production of C5a/C5a desArg, the most potent anaphylatoxin. Data were analyzed by one-way ANOVA followed by Tukey's post-test, and differences were considered statistically significant when p < 0.05. Results Horse F(ab′)2 antitoxins and anti-rabies immunoglobulin preparations presented different amounts of protein. SDS-PAGE and Western blot analyses revealed the presence of protein aggregates, non-immunoglobulin contaminants and, unexpectedly, IgG whole molecules in the samples, indicating the non-complete digestion of immunoglobulins. The chromatographic profiles of antitoxins and anti-rabies immunoglobulins allowed to estimate the percentage of contaminants and aggregates in the samples. Although protein aggregates were present, the samples were not able to induce the generation of C5a/C5a desArg in vitro, indicating that they probably contain acceptable levels of aggregates. Conclusions Anti-botulinum AB (bivalent), anti-diphtheric, antitetanic and anti-rabies horse F(ab′)2 immunoglobulins probably contain acceptable levels of aggregates, although other improvements on the preparations must be carried out. Protein profile analysis and in vitro anticomplementary activity of F(ab′)2 immunoglobulin preparations should be included as quality control steps, to ensure acceptable levels of aggregates, contaminants and whole IgG molecules on final products, reducing the chances of adverse reactions in patients.(AU)
Subject(s)
Animals , Male , Female , Immunoglobulins/immunology , Immunoglobulin Fab Fragments/isolation & purification , Botulinum Antitoxin/isolation & purification , Rabies Vaccines/analysis , Immunoglobulins , Horses/immunologyABSTRACT
Aims: To evaluate the role of delayed primary suturing in prevention of sepsis and achieving better cosmetic appearance in animal bite injuries over the head and neck areas. Study Design: Prospective observational study. Place and Duration of Study: Department of Otorhinolaryngology at Govt. Medical College, Nanded, Maharasthra, (India) from a period of Jan 2009 to Dec 2013. Methodology: A prospective observational study of 70 cases of patients presented to us in the form of injury to head and neck area by animal bites. In all patients we followed the standard norm for delayed primary closure in form of: • Thorough wound toileting • Equine Rabies Immunoglobulin at the site of wound in all patients • Anti-Rabies vaccination • Daily dressing • Delayed primary suturing after 10 days All patients were routinely followed up and assessed for wound sepsis, cosmesis and function. Results: Among the animal bites, dog bite injuries were found to be most common facial injuries followed by swine and cat. In our study group of 70 patients which was dominated by males from second decade onwards showed a faint line of demarcation in sex distribution in children. Cosmetic outcome on comparing our study of delayed primary closure with Paschos NK et al. study healing by secondary intention, delayed primary suturing exhibited significantly better result with the mean score of (1.50) for VSS compared to healing by secondary intention group with mean score of (3.05) for VSS was recorded (p= 0.000) (95% CI 0.1516-0.1494). Conclusion: Delayed primary closure exhibited improved cosmetic appearance when compared with healing by secondary intention.
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Complete post-exposure prophylaxis is necessary to prevent rabies among all animal bite victims. It is essential for the bite victims to complete the full course of vaccination as recommended for complete protection. The present study was conducted to determine the compliance rate for anti-rabies vaccination by both intramuscular route and intradermal route and to determine the major constraints. The study was done at two municipal corporation hospitals in Bangalore, India. The compliance rate for intramuscular rabies vaccination was 60.0% and for intradermal rabies vaccination 77.0%. The major constraints were loss of wages, forgotten dates, cost incurred and distance from the hospital. Hence, the present study showed that the compliance to anti-rabies vaccination for post-exposure prophylaxis is low and is a cause of concern, as animal bite victims who do not complete the full course of vaccination are still at risk of developing rabies.
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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.
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O estudo objetivou analisar o perfil do tratamento profilático antirrábico de crianças e adolescentes de zero a 15 anos atendidas no município de Maringá-PR. Os dados foram coletados do Sistema de Informação de Agravos de Notificação (Sinan) no período de janeiro a dezembro de 2010. Realizaram-se frequências simples e absolutas para as variáveis categóricas, e, para associações de interesse, análises univariadas por meio do teste do qui-quadrado de Pearson, com intervalo de confiança de 95% e nível de significância <0,05 em todas as análises. Do total de 311 atendimentos realizados, 101 deles eram de fichas de atendimento antirrábico de crianças e adolescentes. Em relação ao tratamento indicado, das 101 indicações, 37 (36,6%) apresentaram-se entre zero a < dez anos e 64 (63,4%) entre os ≥ dez a <15 anos. O tratamento indicado apresentou associação estatisticamente significativa com a idade (p= 0,0288). É preciso um trabalho educativo com crianças, pais e a população em geral, conscientizando-os sobre os riscos e a gravidade da raiva, além da atualização e atenção para a indicação da conduta terapêutica aos profissionais da saúde
The present study aimed to analyze the profile of anti-rabies prophylactic treatment of children and adolescents aged between zero and 15 years old, in the city of Maringá, state of Paraná, Brazil. Data were collected on the Brazilian Notification Aggravation Information System (SINAN) from January to December 2010. Simple and absolute frequencies were performed for categorical variables, and, for associations of interest, univariate analyzes were carried out through Pearson's chi-square test, with confidence interval of 95% and level of confidence set at <0.05 for all analyzes. Among all 311 care services performed, 101 involved anti-rabies care records of children and adolescents. Regarding treatment prescriptions, out of 101, 37 (36.6%) were made to subjects aged between 0 and 10 years old, and 64 (63.4%) to those aged ≥ 10 and < 15 years old. The treatment prescribed presented statistically significant association with age (p= 0.0288). There is a need for an educative work with children, parents and the general population, toward raising their awareness on the risks and seriousness of rabies, besides the update of and attention to the therapeutic method employed by health professionals
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Background: Rabies is an enzootic and epizootic disease worldwide. In India it is estimated that the number of death due to rabies may be 10 times more than those reported. There are many myths and false beliefs associated with dog bite. 99% of all human deaths due to rabies are occurring in the developing countries. The present study was conducted to study awareness and perception about dog bite cases in the rural area of Maharashtra. Objectives: 1) To determine the knowledge of people about dog bites. 2) To assess the awareness of people pertaining to rabies and anti-rabies vaccination. 3) To study the behavioural practices of people after the dog bites. Methods: A Cross-sectional study was conducted in the rural field practice area of a medical college, Pune, Maharashtra. Study was conducted with the help of pre-tested, semi-structured questionnaire for the period of one month and people attending RHTC OPD were included in the study. All individuals above the age of 18 years were included in to the study. Informed consent was taken prior to conduct of the study. Results: Total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77%) were aware about dog bite causes disease and among these 52 (46.8%) were aware that dog bite causes rabies. Among the participants, 138 (95.8%) were aware about the vaccine availability and 125 (90.5%) knew vaccine is available in Government Hospital. In the study 88% of dog bite victims received treatment. Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
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O objetivo do presente trabalho foi descrever e avaliar a mordedura canina e o atendimento antirrábico humano em Minas Gerais, de 1999 a 2004, correlacionando fontes de informação e áreas de risco predeterminadas para raiva humana transmitida por cão. Realizou-se um estudo observacional descritivo retrospectivo, utilizando-se, de forma adaptada, a análise exploratória de prontuários dos atendimentos da Superintendência de Epidemiologia da Secretaria de Estado da Saúde de Minas Gerais (339.012 de atendimentos), do Sistema de Informação de Notificação de Agravos, do Sistema de Informações sobre Mortalidade, do Sistema de Informações Hospitalares e do Programa Nacional de Imunizações (132.452 fichas). Para a classificação dos agravos, usou-se o Código Internacional de Doenças (10ª revisão). Os dados foram armazenados e analisados com auxílio dos softwares Epi-Info, Tab-Win e Office®. Verificou-se que o tratamento antirrábico humano é excessivo nas áreas de baixo e médio risco para raiva e, ao contrário, reduzido nas áreas de alto risco. O perfil do paciente é estudante masculino, menor de 14 anos, residente em área urbana de baixo risco para raiva humana transmitida por cão, com mordedura única nos membros, provocada por cão sadio e observável. Os sistemas de informação não oferecem a confiabilidade necessária ao médico responsável para a prescrição do tratamento antirrábico adequado. A profilaxia da raiva deve ter um aspecto multicêntrico, com interfaces na atenção tanto à saúde humana quanto à animal, o que não tem ocorrido, propiciando falhas na vigilância e no atendimento do agravo.
The objective of the present paper is describe and evaluate dog bite and some aspects of anti-rabid human care in Minas Gerais during five years, correlating the sources of information and epidemiological risk areas defined for human rabies transmitted by dogs in the State. We performed an observational retrospective study by adapted exploration form analysis, from 1999 to 2004, using databases of Epidemiology of Minas Gerais and National Information Systems of reportable disease, Immunization, Mortality, Hospitalization, International Code of Diseases (10th revision). The areas of risk for human rabies transmitted by dogs were pre determined. The dog bite is still the main complaint that leads to care. The profile of the patient is a male student, under 14 years of age, with a single wound in members, resident in an urban low risk area for human rabies transmitted by dogs, and is healthy and observable. The treatment is excessive in areas of low and medium risk. In high-risk areas, there is a low indication of treatment. Information systems do not offer the reliability required by the doctor responsible for prescribing the appropriate anti-rabies treatment. Rabies prophylaxis should have a multi-centre aspect, with interfaces in attention to health and veterinary, which has not occurred, providing surveillance failures.
Subject(s)
Animals , Dogs , Rabies/immunology , Rabies/prevention & control , Rabies/veterinary , Epidemiology/statistics & numerical data , Vaccination Coverage , Medical Records/statistics & numerical dataABSTRACT
A raiva é uma doença endêmica no Brasil, com letalidade de 100 por cento. O número de casos tem diminuído, porém o de tratamento pós-exposição continua elevado, assim como o de abandono. O objetivo do estudo foi investigar as causas do abandono do tratamento antirrábico humano pós-exposição em Porto Alegre (RS), no segundo semestre de 2006. Foi utilizado o delineamento de série de casos, sendo selecionados 280 casos por amostragem aleatória sistemática entre os 962 registrados no Sinan como abandono de tratamento. Os dados foram coletados em entrevistas domiciliares, utilizando-se questionário específico. Segundo os entrevistados, 66,4 por cento concluíram o número de vacinas prescritas, não estando esses dados registrados no Sinan. Entre aqueles que foram confirmados como abandono (94/280), 24,5 por cento referiram não ter considerado necessário completá-lo, e 13,8 por cento não se sentiram orientados sobre como proceder. Somente em 19,1 por cento dos casos houve a busca ativa dos faltosos pelos serviços de saúde. O registro no Sinan apresenta falhas. Estas ocorrem devido ao fato de o paciente iniciar o tratamento em um serviço de saúde e dar continuidade em outro, não havendo retroalimentação do sistema com dados sobre a sua conclusão.
In Brazil, rabies is an endemic disease with a fatality rate of 100 percent. The number of cases has decreased, but the number of cases for treatment after exposure and treatment dropout is still high. This study investigated the causes of anti-rabies treatment abandon, after exposure, in Porto Alegre (RS, Brazil), from July to December 2006. A case series was designed. Two hundred and eighty abandon cases were selected through randomized systematic sampling, out of 962 registered in Sinan. Data was collected in people's homes through interviews, by means of a questionnaire. According to the interviewees, 66.4 percent concluded the prescribed number of vaccines. This information was not registered in Sinan. Among the subjects confirmed of abandoning the treatment (94/280), 24.5 percent reported that they thought it was not necessary to complete the treatment, while 13.8 percent felt that they did not receive clear guidelines about what to do. Health services attempted to contact absents in only 19.2 percent of the cases. Data entered in Sinan present failures. These occurred because patients started treatment at one health service and continued in a different one. As a consequence, information about the conclusion of the treatment was not entered into the system.