Characteristics and factors associated with post-exposure prophylaxis (PEP) treatment of dog and cat bites among left-behind children: a cross-sectional study in two cities of China

Abstract

ObjectiveAnimal injury is a significant cause of morbidity and mortality worldwide. Dog bites account for tens of millions of injuries annually and the highest risk is among children. However, children may not receive postexposure prophylaxis (PEP) treatment timely and appropriately after rabies exposure. This study aimed to investigate the characteristics and factors associated with PEP treatment of dog and cat bites among left-behind children.DesignA cross-sectional study using questionnaire was conducted in primary and high schools.SettingShenzhen and Shantou cities, Guangdong Province, China.ParticipantsA total of 9380 participants were included and 2236 of them were with a history of dog and cat bites.Results1188 (53.1%) boys and 1048 (46.9%) girls suffered from animal bites. Bitten in holidays was less likely to receive PEP treatment (OR 0.512, 95% CI 0.377 to 0.695) than those bitten in school days. Bitten while being with family (OR 1.418, 95% CI 1.040 to 1.934) and bitten at roadside (OR 1.842, 95% CI 1.297 to 2.171), bitten by unvaccinated animals (OR 1.745, 95% CI 1.246 to 2.443) tended to receive PEP treatment. Compared with unbroken skin, bleeding (OR 1.789, 95% CI 1.165 to 2.745) and laceration (OR 3.834, 95% CI 2.310 to 6.366) were showed as treatment prompting factors.ConclusionsBitten in holidays was found as a risk factor of receiving PEP treatment of animal bites. Certain measures should be taken to raise left-behind children’s awareness of receiving PEP treatment timely and appropriately after dog and cat bites.

Epidemiological study on animal bite cases referred to Haji Daii health Center in Kermanshah province, Iran during 2013–2017

“…In our study, the upper extremities were more involved than the lower extremities, and this difference was significant by the post hoc test. This finding is in line with the results of Shuzhen et al (2018) study in Shenzhen and Shantou cities in China and also Zohrevandi et al (2012) in Guilan, Northern Iran [23,33]. However, some studies reported lower extremities as the most common affected site [8,26,27,30,34].…”

Spatial inequality hides the burden of dog bites and the risk of dog-mediated human rabies

“…To describe responses to dog bite incidents, we used categorical values: sought healthcare and did not seek healthcare. We ran univariable and multivariable logistic regression to test variables previously found to be associated with seeking healthcare 27,28,35-37 38-42 . Based on our univariable analysis, the following covariates were used to build the model: amount of time living in the house, whether the bite was from the participant’s own dog, distance to closest healthcare facility, gender of the participant, and educational attainment.…”

“…Nearly 1 million people potentially exposed to rabies received PEP treatment annually just in the Americas 25 . However, dog bite victims typically neglect treating their wounds appropriately, if at all, and many fail to seek medical treatment 26 27 28 29 . In addition to the number of infected dogs, lack of access to appropriate medical treatment for rabies can also increase the risk of human rabies.…”

Dog bite Emergency department presentations in Brisbane metro south: Epidemiology and exploratory medical geography for targeted interventions

“…Dog bites are a globally recognized public health issue in both developed and developing nations in that resulting injuries are significant sources of morbidity and mortality worldwide [ 1 ]. The impacts of dog bites can be measured in terms of their health impacts to individuals affected, economic costs of treatment and health service resources and animal welfare repercussions [ 2 ].…”

“…Increasing awareness with regards to the epidemiology of animal bite injuries amongst both healthcare providers and the general community is critical to reducing their overall health burden [ 4 , 19 ]. Globally the health burden of dog bites translates into tens of millions of injuries annually, with children being the population subgroup most at risk [ 1 ]. In addition to the transmission of zoonotic diseases such as rabies, dog bites inflict disfiguring injuries often requiring reconstructive surgery, cause disfigurement, disability, infection, death [ 3 , 20 , 21 ], and can have lasting psychological effects [ 10 , 12 , [22] , [23] , [24] ].…”