Compliance to post-exposure prophylaxis among animal bite patients – A hospital-based epidemiological study

Abstract

Background and Objectives: Although rabies is a 100% fatal disease, it is preventable with appropriate and timely post-exposure prophylaxis (PEP). A hospital-based study was conducted among 360 animal bite patients in the Anti-Rabies Clinic (ARC) of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi (VMMC and SJH). Materials and Methods: A predesigned, pretested, structured questionnaire was administered by the interview technique to assess the compliance to PEP among the animal bite patients attending the ARC, which comprised assessment of wound washing practices adopted by the animal bite patients, administration of rabies immunoglobulin (RIG), and compliance to full course of anti-rabies vaccination (ARV). Results: Out of 360 study participants, 131 (54.4%) had washed the wound using soap and water and 216 (89.6%) had washed the wound for less than 5 min. The compliance to the full course of ARV was seen among 172 (47.8%) study participants, whereas 164 (45.5%) were found to be non-compliant and 24 (6.7%) were found to be delayed compliant. Conclusions: It was observed that a considerable segment of the study population did not practice the correct wound washing practices, and only about half of the total study participants (172; 47.8%) were found to be compliant to the full course of ARV. As rabies is a 100% preventable disease, increasing awareness pertaining to appropriate PEP may prove to be beneficial in improving the compliance to PEP and reducing the burden of mortality.

Compliance with Post-exposure Prophylaxis following Animal Bites among Rural Population attending a Rabies Clinic in Delhi

“…In our current study, we observed a predominance of male individuals, constituting approximately three-fourths (280, 65.3%) of the study population. These findings align with previous investigations conducted by Khokar 15,17,18 These discrepancies can likely be attributed to variations in the characteristics of the study populations and the specific geographical contexts in which the studies were conducted. The study conducted by Panda and Kapoor was done in a tertiary care hospital, so more category III patients might have sought care.…”

“…Furthermore, our study revealed a preponderance of participants below the age of 30 years, a pattern consistent with the findings reported by Kinge and Supe, Ganasva et al, and Gadekar and Dhekale [12][13][14]. Similarly, the majority of bites (318, 74.1%) in our study were attributed to dogs, which is in accordance with the observations reported in a study conducted by Panda and Kapoor 15. In the present study, a significant proportion of cases were categorized as category II (74.8%) and category III (15.6%), accounting for a cumulative total of 90.4% of cases.…”

“…These findings are consistent with the results of investigations conducted by Panda and Kapoor, Pavithra et al, and Parmar et al, which reported comparable proportions of 66.1%, 70%, and 60.1%, respectively, for victims presenting with dog bites on the lower limb. 15,16,19 The lower limb's susceptibility to dog bites may be attributed to its increased exposure and proximity to the animals during encounters.…”

“…Conversely, Sahu et al observed a more favorable scenario, with nearly 50% of the population completing the recommended PEP regimen 21. Notably, studies conducted by Panda and Kapoor, and Patil et al in urban areas demonstrated higher levels of PEP compliance 15,17. These contrasting findings may be indicative of varying levels of awareness and access to healthcare services across different geographical settings.…”

Rabies vaccination adherence and associated factors among rabies-exposed patients in Shenzhen, China: a hospital-based cross-sectional study

“…Previous studies have mostly explored the adherence of rabies-exposed patients seeking PEP and rabies vaccination in areas where medical resources are scarce or in rural areas [ 15 , 16 ]. However, studies have shown that residents of urban areas in China have poor knowledge of rabies and that compliance with PEVs among rabies-exposed patients in urban areas is suboptimal [ 17 , 18 ]. This study combined the characteristics of animal injury occurrence and the level of rabies prevention knowledge, attitude, and practice (KAP) in rabies-exposed patients, aiming to illustrate the factors influencing adherence to PEV by rabies-exposed patients throughout the standardized process in Shenzhen and to provide data support and theoretical basis for improving rabies vaccination adherence among urban residents and standardizing the PEP and disposal process of rabies.…”