Knowledge, Attitudes and Practices of Primary Care Physicians in the Franche‐Comte Region (France) Regarding the Risk of Rabies

Abstract

Impacts• Primary care physicians (PCPs) have some knowledge of the basic information about the risk of rabies (type of animal transmitting the disease, severity criteria for bites).• PCPs are not familiar with the indications for the rabies vaccine and rabies immunoglobulin.• PCPs' knowledge of how to manage and prevent rabies exposure often requires updating. SummaryRabies remains a public health concern and is associated with a mortality rate of nearly 100%. An observational survey was undertaken in 2010 to assess the knowledge, attitudes and practices of primary care physicians (PCPs) in our area regarding the risk of rabies. Standardized questionnaires were sent to a random sample of 400 PCPs practicing in the Franche-Comt e region (eastern France), requesting their voluntary and anonymous participation. The questionnaires requested socio-demographic details and self-evaluation. Seven clinical situations were selected to assess the attitudes of physicians. The response rate was 38.5%. Most of the PCPs were based in rural and semi-rural areas, 76% knew where their nearest rabies centre was located and 75% of them claimed their knowledge of the risk of rabies was poor. While most of them (>80%) knew which animals transmitted the disease as well as the severity criteria for bites, only 12% knew that there was no contraindication for the rabies vaccine in the event of exposure to the disease. Responses to the seven clinical situations showed that most of them did not know the precise indication for the rabies vaccine and rabies immunoglobulin. Primary care physicians are usually aware of the risk of rabies, but their knowledge of how to manage rabies exposure and prevention often requires updating. The health authorities should provide more detailed information to PCPs and to the general population about the risk of rabies.

Alveolar echinococcosis: how knowledgeable are primary care physicians and pharmacists in the Franche-Comté region of France?

“…Before the present study, two surveys investigating the level of knowledge of rabies (Jeanpetit 2014) and travel medicine (Piotte 2013) were performed in the same geographical areas. For each survey, anonymous questionnaires were sent to physicians by post and the response rate was similar (35.5% for PCPs in the present study, 37.5% for the rabies survey and 38.5% for the travel medicine one).…”

Evaluation of post-exposure prophylaxis practices to improve the cost-effectiveness of rabies control in human cases potentially exposed to rabies in southern Bhutan

“…For example, a study in a low rabies-risk area in Massachusetts, USA highlighted how large amounts of rabies PEP could be wasted in patients with low or non-existent risk of rabies exposure [23]. Studies in countries free of rabies [24] and in endemic areas [25][26][27] similarly reported insufficient rabies risk assessment due to clinicians' lack of familiarity with the recommendations, highlighting the need to update clinicians' knowledge [14]. Discordant rabies risk assessment and PEP practice was also apparent in our study.…”

Clinicians’ management of patients potentially exposed to rabies in high-risk areas in Bhutan: A cross-sectional study

“…Other studies on clinician’s knowledge and attitudes, conducted in the USA (Florida, Kentucky), showed an unsatisfactorily low level of compliance with national guidelines resulting in inappropriate PEP treatment [17-19]. Studies in countries free of rabies [20] or in endemic areas [21-23] similarly reported insufficient rabies risk assessment due to a lack of familiarity of clinicians with the recommendations, and highlighted the need for knowledge updating [14]. Lack of agreement between rabies risk assessment by clinicians and the guidelines was also apparent in our study, although only a low percentage resulted in subsequent inappropriate prescription.…”