Abstract
BackgroundRabies is invariably a fatal disease. Appropriate wound treatment and prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China.MethodologyThis cross-sectional study was conducted among animal bite victims visiting rabies prevention clinics (RPCs). We selected respondents by a multistage sampling technique. A face-to-face interview was conducted to investigate whether the wound was treated properly and the time disparity between injury and attendance to the RPCs. Determinants of improper wound treatment and delay of rabies PEP were identified by a stepwise multivariate logistic regression analysis.Principal findingsIn total, 1,015 animal bite victims (564 women and 451 men) responded to the questionnaire, and the response rate was 93.98%. Overall, 81.2% of animal bite victims treated their wounds improperly after suspected rabies exposure, and 35.3% of animal bite victims delayed the initiation of PEP. Males (OR = 1.871, 95% CI: 1.318–2.656), residents without college education (OR = 1.698, 95% CI: 1.203–2.396), participants liking to play with animals (OR = 1.554, 95% CI: 1.089–2.216), and people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096–2.270), were more likely to treat wounds improperly after an animal bite. Patients aged 15–44 years (OR = 2.324, 95% CI: 1.457–3.707), who were bitten or scratched by a domestic animal (OR = 1.696, 95% CI: 1.103–2.608) and people who knew the incubation period of rabies (OR = 1.844, 95% CI: 1.279–2.659) were inclined to delay the initiation of PEP.ConclusionsOur investigation shows that improper wound treatment and delayed PEP is common among animal bite victims, although RPCs is in close proximity and PEP is affordable. The lack of knowledge and poor awareness might be the main reason for improper PEP. Educational programs and awareness raising campaigns should be a priority to prevent rabies, especially targeting males, the less educated and those aged 15–44 years.
Highlights
Rabies is a fatal infectious disease, which causes severe neurological symptoms that unavoidably result in death
Our investigation shows that improper wound treatment and delayed postexposure prophylaxis (PEP) is common among animal bite victims, rabies prevention clinics (RPCs) is in close proximity and PEP is affordable
Improper post-exposure treatment of animal bite victims in China: Prevalence and determinants victims did not know the clinics in their communities could supply rabies vaccine
Summary
Rabies is a fatal infectious disease, which causes severe neurological symptoms that unavoidably result in death. Human rabies is currently untreatable [1], appropriate postexposure prophylaxis (PEP) can entirely prevent rabies [2,3]. Such PEP, which consists of local treatment of the wound, followed by vaccine (with or without rabies immune globulin [RIG] depending upon the type of exposure) should be initiated immediately after a suspected rabid bite. Modern cell-culture vaccines utilized in combination with RIG are nearly 100% effective in preventing human deaths if inoculated promptly to rabies virus-exposed victims following appropriate. Appropriate wound treatment and prompt rabies postexposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China
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