Determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending a rural tertiary care hospital of Haryana

Abstract

Introduction : Rabies is a fatal but vaccine-preventable viral disease. Animal bite victims who report in primary and secondary level health care lack some measures which can help in protecting and preventing deaths due to rabies. The most important factor for prevention of death due to rabies is the timely administration of post-exposure prophylaxis (PEP) among animal bite victims. Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delay in PEP initiation. Objective: To determine the determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending anti-rabies clinic of a ruraltertiary care hospital in Sonepat, Haryana. Method: This cross-sectional study was conducted at an Immunization-cum-antirabies clinic of Bhagat Phool Singh Government Medical Collegefor Women, Khanpur Kalan, Sonepat, Haryana. A pre tested, structured questionnaire was used to collect information among 410 participants after taking consent. The Institutional Ethics Committee of institute approved the study. The groups were compared with Chi-square test for categorical data. Results: Delay was present among 27.3% of participants. Significant factors of delay were no local wound treatment, any treatment taken prior to anti-rabies vaccine administration, rabies clinic closed on holidays, unawareness about PEP, non-availability of accompaniment, transportation issues and money problem for transportation. Knowledge also played significant role as delay was significantly more among the participants not having knowledge regarding source of infection, mode of transmission and incubation period of rabies. Conclusions: Delay ininitiation of PEP was common and were significantly associated with lack of knowledge and unawareness, closure of rabies clinic on Sundays/holidays, non-availability of accompaniment and money problem during transportation.