Abstract
Despite a reported socioeconomic gradient in health, little is known about relationship between socioeconomic status (SES) and frequency of dog-bite injuries. The primary objective of this study was to compare the frequency of dog-bite injuries, using data on dog-bite injury hospitalizations (DBIH), across different SES areas in Manitoba, Canada. The secondary objective of the study was to assess if frequency and pattern of DBIHs are similar to those of non-canine bite injury hospitalizations (NCBIH) and rabies post-exposure prophylaxis (PEP). SES grouping in this study was defined through rurality and area-wide income quintile groups. Rural and urban Manitoba neighbourhoods were ranked according to average area-level incomes into five levels (quintiles) with equal numbers of people in each income level. Prevalence was defined as the number of cases of hospitalizations (whether dog-bite injury or non-canine bite injury) or PEP reported in the years 1984-2006, divided by the total population during the same time period and expressed as the number of cases per 100 000 population per SES grouping. The 95% confidence intervals (CI) were calculated using the approach for Poisson distribution. During 1984-2006, Manitoba's prevalence (CI) of DBIH (3.19 (2.97, 3.41) per 100 000 population) was lower than prevalence of NCBIH (4.08 (3.84, 4.32)) and PEP (7.24 (6.92, 7.57)). Prevalence of DBIH was higher in rural than in urban areas (DBIH: 3.58 (3.24, 3.92) vs 2.87 (2.59, 3.15), p<0.01) and higher in the lowest income quintile areas than in the highest, whether rural (5.18 (4.24, 6.26) vs 3.29 (2.55, 4.17), p<0.0001) or urban (3.65 (2.97, 4.44) vs 2.24 (1.73, 2.87), p<0.01). The patterns of relationship between SES (rurality and income levels) and prevalence of NCBIH and PEP were similar to those between SES and DBIH. Although only a descriptive study, the results suggest that policies for control of dog-bite injuries should be area-specific. Prevention efforts could perhaps be improved by focussing not only on families, but also on neighbourhood regions.
Highlights
Despite a reported socioeconomic gradient in health, little is known about relationship between socioeconomic status (SES) and frequency of dog-bite injuries
Prevalence in this study was defined as the number of hospitalizations or post-exposure prophylaxis (PEP) reported during the study period divided by the total population during the same period and expressed as the number of hospitalizations or Physician billing claims in the Medical Services database and the Manitoba Immunization Monitoring System (1984/85 – 2006/07) (MIMS) were searched to identify rabies post-exposure vaccine tariff codes, given as AB-post rabies vaccine 8751 and IGrabies immune globulin 8768
Prevalence of dog-bite injury hospitalizations (DBIH) was lower than prevalence of non-canine bite injury hospitalizations (NCBIH) and rabies PEP in Manitoba
Summary
Despite a reported socioeconomic gradient in health, little is known about relationship between socioeconomic status (SES) and frequency of dog-bite injuries. The secondary objective of the study was to assess if frequency and pattern of DBIHs are similar to those of non-canine bite injury hospitalizations (NCBIH) and rabies post-exposure prophylaxis (PEP). While a handful of studies exist that suggest that dog-bite injuries occur at higher rates in rural areas[9,10], very few reports have attempted to explore the relationship between lower SES and higher frequency of dog-bite injuries. Such a study would uniquely add to the existing body of world literature on dog-bite injuries and would be valuable information for understanding how to prevent severe dog-bite injuries in people, especially children
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