Abstract

BackgroundRabies is a public health problem in developing countries like India accounting for the second-highest number of rabies-related deaths worldwide. Anti-rabies vaccine (ARV) is the only proven and effective way of preventing death in this 100% fatal disease. However, compliance is a real concern. This study aims to assess the compliance of ARV and rabies immunoglobulin (RIG) among the ARV-clinic beneficiaries and also the knowledge of the health workers regarding animal bite management.MethodsA cross-sectional study was conducted in an ARV clinic of a community health centre in a rural Odisha (Eastern India) between February and April 2019. All the beneficiaries attending the ARV clinic were followed up for 28 days to assess their ARV and RIG compliance. Data were collected using a pre-designed semi-structured questionnaire and analysis was performed using SPSS v.22 (IBM Corp, Armonk, NY, USA). Proportion was calculated for categorical variables and mean for continuous variables. Chi-square test was applied to test for significance of categorical variables.ResultsA total of 468 beneficiaries were followed up. More than half (59.8%) of the animal bite victims had a category-II bite, followed by 33.4% having category-III, and 6.8% having a category-I bite. Around three-fourth were exposed to dog bite. Only 52.3% of the patients were compliant with ARV, and 49.4% were compliant with RIG. Knowledge of the health workers regarding wound management was found to be sub-optimal.ConclusionPoor ARV compliance was seen among the beneficiaries. Awareness activities need to be strengthened further to improve health-seeking behaviour. The significant gap in knowledge of the health workers indicates the need for professional training at regular intervals.

Highlights

  • Rabies is a zoonotic disease with 100% fatality and is a public health burden

  • 52.3% of the patients were compliant with Anti-rabies vaccine (ARV), and 49.4% were compliant with rabies immunoglobulin (RIG)

  • Our study revealed that compliance to ARV was poor among the beneficiaries, where only half of them remain compliant to all four doses

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Summary

Introduction

Rabies is a zoonotic disease with 100% fatality and is a public health burden. 23,000-25,000 people die due to the extremely fatal disease in this region, which accounts for 45% of the rabies death worldwide [1]. Around 36% of the world’s rabies death occur in India each year [2]. Rabies fatalities in India are the highest in Asia and the second highest in the world [4]. It is endemic throughout the country with the exception of Andaman & Nicobar and Lakshadweep Islands [5]. Rabies is a public health problem in developing countries like India accounting for the second-highest number of rabies-related deaths worldwide. This study aims to assess the compliance of ARV and rabies immunoglobulin (RIG) among the ARV-clinic beneficiaries and the knowledge of the health workers regarding animal bite management

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