Treatment compliance of self-reported dog bite cases attending outpatient department of Tertiary Care Hospital, Maharashtra

Abstract

Objectives: To assess treatment compliance of self-reported dog bite cases and to assess associated demographic and exposure factors. Materials and Methods: The present prospective study was conducted during January 2013 to July 2013 among 260 dog bite cases by purposive sampling at the outpatient department of a tertiary hospital. After obtaining verbal informed consent, a predesigned questionnaire was used. The assessment of treatment compliance of postexposure prophylaxis (PEP) regimen was considered on the basis of intramuscular anti-rabies vaccine (ARV) regimen by classifying completed PEP and defaulted PEP. At the end of PEP regimen of every participant, we obtained information about received ARV doses using telephone survey method. Data were analyzed using statistical software Epi info Version 7. Results: Of 260 dog bite cases, 76.5% cases were completed PEP. The majority, 22.3% cases from age group ≤10 years, 56.2% males, 48.1% from urban area, 25% had primary school education, 32.7% students, 53.8% had bite mark on lower limb, 58.5% were category III exposure, and 70.8% who had received previously immunization against rabies, were completed PEP. The bite due to 54.6% pet dog, 58.1% observable dog, 40% provoked bite, 71.9% cases who had not known about the rabid status of the dog, were completed PEP. The unconditional logistic regression analysis found that demographic and exposure factors were not independently associated with treatment compliance (P > 0.05) except literacy status (P < 0.05). The present study showed maximum completed PEP cases, however, it showed the demographic and exposure factors of dog bite cases were not independently associated with treatment compliance except literacy status.

Anti Rabies Vaccination compliance: A longitudinal study amongst patients attending Anti Rabies Vaccination OPD in a tertiary care hospital

“…This is much lower as compared to other similar studies done in the past. In study by Domple et al (76.5% cases completed PEP) (7) , Shankaraiah et al (the compliance rate for IMRV was 60% and for IDRV was 77%) (8) , Krishna et al (compliance was 65%) (9) , Anandaraj et al(compliance 82.6%) (10) and Sumit et al (62.97% received completed treatment) (5) had higher compliance rates. It was lowest in study by Seenivasan et al (compliance rate being just 6% for intramuscular regimen) (11) .…”

“…(6) Human rabies is endemic in India. (7) In India more than 90% cases of rabies are due to dog bites. It is one of the most important zoonotic diseases in India and has been recognized in India since the Vedic period (3) .…”

“…The reasons given for not reporting, completing, or adhering to PEP include poor awareness about the danger of the disease, small size of the injury, reluctance of the dog owner to pay for treatment costs, and not being advised to take PEP. (7) Rabies remains a neglected disease in terms of policy formulations throughout most of the developing countries. (7) Rabies is 100% fatal, at the same time 100% preventable if managed appropriately and timely (5) .…”

“…(7) Rabies remains a neglected disease in terms of policy formulations throughout most of the developing countries. (7) Rabies is 100% fatal, at the same time 100% preventable if managed appropriately and timely (5) . Hence this study was undertaken to know the compliance rate among the patients attending ARV OPD for animal bite cases.…”

To study the treatment compliance among the animal bite patients attending anti rabies clinic in a tertiary care hospital, Solapur

“…2 Prevention of rabies is possibly by providing the exposed person with the proper post exposure prophylaxis (PEP), PEP in rabies exposed persons includes wound toilet, post exposure vaccination, and administration of rabies immunoglobulin. 3 The Indian Government has adopted its "National Guidelines for Intra dermal Vaccination" from World Health Organization guidelines. IDRV requires a smaller quantity of vaccine to be injected into the skin.…”