Cost–benefit analysis of controlling rabies: prioritizing areas in rural setting of Maner: a cross sectional study

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.

Compliance to Anti-rabies Vaccination in Post-exposure Prophylaxis.

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.

Perfil do tratamento profilático antirrábico humano no sul do Brasil / Profile of human anti-rabies prophylactic treatment in southern Brazil

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