Dog Bite Victims Research Articles

Factors associated with poor compliance to rabies post-exposure prophylaxis among dog bite victims in Maswa District in Tanzania: a cross-sectional study

Factors associated with poor compliance to rabies post-exposure prophylaxis among dog bite victims in Maswa District in Tanzania: a cross-sectional study

A Study on Seasonal Trends among Animal Bite Victims Reported to a Tertiary Care Hospital, Jabalpur

Abstract Background: Rabies is a viral zoonotic disease that is 100% fatal, yet 100% preventable. It is estimated that 17.4 million exposures with 20,000 deaths due to animal bites occur every year in India, with higher cases in particular seasons. Hence, this study aimed to find out the seasonal trend among animal bite victims for the past 3 years. Subjects and Methods: It was a record-based retrospective study conducted in a tertiary care hospital, Jabalpur, for a period of 2 months (September 2022 to October 2022) for the years 2018, 2019, and 2020 among 1518 victims. Data were entered into MS Excel, and descriptive statistical analysis was done using IBM-SPSS version 23.0. Results: It was observed that, majority were dog-bite victims with maximum unprovoked bite showing decrease in trend from 2018 to 2019, and then increase in 2020. In this study, maximum bites were seen in winter (23.99% in 2018, 52.61% in 2019, and 50% in 2020), followed by monsoon (12.64%) in 2018 and summer in both 2019 and 2020. Conclusion: In the study, maximum bites were noted during winter, followed by the monsoon in 2018 and summer in 2019 and 2020, showing an increase in trend and then a downfall in 2020, maybe due to the COVID-19 period lockdown. This study will help policymakers formulate appropriate plans, activities, and logistic support for the management of animal bite victims.

A review of human dog-bite injuries in Kitui South subcounty, Kenya (2017-2021).

Dog bites continue to be a serious public health issue due to their association with the transmission of rabies virus. In Kenya, there are no studies estimating dog-bite incidence. Annual mortalities resulting from dog-mediated rabies are estimated at 523 (95% confidence interval 134-1100). The main objective of this study was to assess major risk factors associated with dog bites in Kitui South subcounty, Kenya, between 2017 and 2021. We recruited 387 dog-bite patients (cases) and 387 non-bite patients (controls) for the case-control study from the Mutomo Mission Hospital and the Ikutha Level 4 Hospital records. Multivariable logistic regression analysis evaluated the association between risk factors and dog-bite cases. In the final model, pairwise interactions among variables were evaluated. The model fit was evaluated using receiver operating characteristics and area under the curve. The study found that the dog-bite incidence was highest in Kanziko ward in Kitui South subcounty. Fifty-one percent (108 bites) of dog-bite victims were children under 15 years of age, with 53% (N = 68) being men and 36% (N = 77) being bitten on the limbs. Dog bites mostly (44%, N = 93) occurred between October and December (short rainy season). Age group and season were identified as the most significant variables for high dog-bite incidence in Kitui South subcounty. Promotion of responsible dog ownership and reinforcement of dog control policies may prove more effective in reducing dog-bite injuries in Kitui South subcounty.

Epidemiological pattern and management of dog bite injuries in Karachi, Pakistan: A cross-sectional study

BackgroundDog bite injuries are a common problem globally; however, little is known about the epidemiology of dog bite injury from a low-and-middle-income country like Pakistan. This study aims to determine the epidemiology of dog bite injuries among children and adults from a tertiary care hospital in Karachi, Pakistan. MethodsWe conducted a cross-sectional study on dog bite patients visiting the emergency department from November 2015 to August 2016 of a major public tertiary care hospital. Data was collected using a structured questionnaire on demographic details, bite history, and management of dog bite victims. Descriptive analysis was reported. Chi-square test was applied to check the associations between age-specific dog bite cases and independent variables. Results2178 participants were included in the analysis. 715 (38.8%) were children less than 18 years old, and 1463 (61.2%) were adults over 18 years. A majority of the patients were males (1909, 87.7%). Results show that most dog bite injuries (2052, 94.2%) tend to occur outside the house by stray dogs biting without provocation. People aged 18 years and above (61.2%) and males (children: 84.6%, adults: 89.1%) tend to be bitten more often. Lower limbs are most frequently bitten (children: 69.5%, adults: 85.8%). Free-roaming stray dogs (children: 73.4%, adults: 74.9%) were involved in reported biting cases. Many of the patients did not receive appropriate first aid and instead just washed the wound with soap and water (children: 45.1%, adults: 43.7%). 99% of the victims received Tetanus toxoid, Rabies vaccine, and immunoglobulins while in the emergency department. ConclusionThere is a high burden of dog bite injuries from stray dogs in Karachi, Pakistan. Efforts should be made to create awareness among the general public on the risks of dog bites and on seeking appropriate first aid and medical attention for a dog bite injury.

Study to assess incidence and type of congenital heart defect in children with down syndrome presenting to tertiary care teaching hospital of Southern Rajasthan

Background: Down syndrome occurs in people of all races and economic levels. Cardiac anomalies with a prevalence of about 50% are the most common anomaly responsible for death during the 1st two years of life in children with down syndrome. Objective of the study was to Assess the incidence and type of congenital heart disease in children with down syndrome presenting to a tertiary care hospital. Methods: Hospital based descriptive study. Participants: All children (0 to 18 years) diagnosed (clinically or on karyotyping) with Down syndrome, presenting in RNT Medical College, Udaipur Each patient was evaluated with a pre-set Performa which contained detailed sociodemographic profile, maternal and clinical history including age of conception, detailed physical examination to look for features of down syndrome. Degree of Intellectual / Developmental retardation was assessed by Vineland Social Maturity Scale. 2D- echo, karyotyping was done in all patient. CBC, thyroid profile, CXR, USG- abdomen, Invertogram were done as per need. Results: Total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77%) were aware about dog bite causes disease and among these 52 (46.8%) were aware that dog bite causes rabies. Among the participants, 138 (95.8%) were aware about the vaccine availability and 125 (90.5%) knew vaccine is available in Government Hospital. In the study 88% of dog bite victims received treatment. Conclusions: More than half of children with Down syndrome have congenital heart disease, mostly Acyanotic, more specifically VSD. Early screening and diagnosis re the key to avoid irreversible hemodynamic consequences.

Epidemiologic Survey Around Dog Bites in Plateau State, Central Nigeria

Rabies is a zoonotic viral fatal disease of warm-blooded animals and occurs due to the bites of animals like dogs, cats, hyenas, jackals against their victims. Rabies remains threat to more than half of the world’s population, killing more than 59,000 people yearly mostly in Asia and Africa whilst most of the victims are children. Domestic dogs are responsible for causing over 99% of all human cases. Rabies can be transmitted through biting, scratching wounds, licking of broken skin and mucous membrane from rabid animal saliva to humans and other animals. In this study, ten farmers were randomly chosen and participated from the list of willing farmers from 5 local government areas LGAs, making a total of 50 farmers from the Berom, Tarok and Fulani communities in Plateau state. The population of those farmers who had no form of education combine with those who had least form of education 29(58%) are higher than those who attended secondary and tertiary 21(42%). 36(72%) revealed that ruminants have been the major victim of dog bites cases in the various communities and only 8(16%) said dogs are the most victims. 25(50%) of the respondents says animal can survive and live a normal life after bitten by a dog and 40(80%) believe that human can survive and live a normal life after bitten by a dog. Only 25(50%) of the respondents take their human victims of dog bites to the hospital for proper medical attention; 13(52%) of them had no idea on what to do with their human victims to dog bites before visits to the hospital, 5(20%) wash and dress the wounds of dog bites only and 6(28%) of the respondents’ resorts to using traditional methods of caring to dog bites wounds before hospital visits. In conclusion, this present study revealed that dog bite is an indiscriminate public health menace in both humans and animals, with ruminants being the most affected. Majority of the farmers had no idea on what to do with the wounds of dog bite on humans and their animals and this require for more public enlightenment/awareness about the fatality of the disease, its transmission and how the virus persists amongst human and animal populations. The dangers and risks, dog bites pose to the public health in any given community must be clearly explained to the public across all communities in the state and the whole country

A cross sectional study on pattern of animal bites and their post exposure management in a tribal district of Mayurbhanj, Northern Odisha, India

Background: Rabies is an enzootic and epizootic disease of worldwide. Rabies is a fatal but preventable viral disease. Rabies is one of the neglected tropical diseases that predominantly affects poor and vulnerable populations who live in remote rural locations. Objectives of current study was to assess the prevalence of animal bite cases and its associated factors in a tribal district of Northern Odisha and to study the first aid management of people after dog bite. Methods: It was a cross sectional study. This study was conducted at PRM medical college, Baripada, Odisha in anti-rabies vaccination (ARV) OPD clinic. The study period was March 2021 to September 2021. The sampling techniques was consecutive sampling. The study population was all animal bite case attending ARV clinic. Data was analyzed by appropriate statistical tool. Results: Majority 54.9% victims are dog bite victims and the most common site of bite was lower limb (53.6%). The main source of information was family and friends followed by doctors and health workers. Conclusions: Majority of people especially in rural and tribal area were illiterate and they don’t have any knowledge about animal bite or its management. This study had found that those who are literate had done a proper wound management before coming to ARV clinic. So, literacy proved to have a major impact on wound management. Behavior changes communication (BCC) along with health education is a vital weapon for controlling rabies especially in developing country like India.

Factors Associated with Delayed Rabies Post-Exposure Prophylaxis among Dog Bite Victims in Nyagatare District, Rwanda, 2017 to 2019

BackgroundRabies is an incurable zoonotic disease of public health concern. After exposure the only effective intervention is Post-Exposure Prophylaxis (PEP). Surveillance data in Rwanda shows that a high number of dog bites do not get PEP in time.ObjectivesDetermine factors associated with delays in post-exposure prophylaxis among victims of dog bites.MethodsThe retrospective cross-sectional study was conducted in Nyagatare District. It targeted people bitten by dogs and who attended Nyagatare district from January 2017 to December 2019. Review of registers and interview with victims were used to collected data using excel and analyze them using STATA version 15. Odds ratio (OR) and confidence interval (CI) were reported.ResultsAmong 412 dog bite victims, 161 (39%) delayed getting PEP. The more likely to delay in getting PEP, were people living in rural areas, AOR = 3.54, 95%CI [2.12, 5.90], and those without medical insurance, AOR = 4.40, 95%CI [1.82-10.62].ConclusionSeeking PEP among dog bites victims is subject to delay in Nyagatare district. Local leaders should establish initiatives to support people to get medical insurance while public health officers need to prioritize sensitization for PEP for people living in rural areas.Rwanda J Med Health Sci 2023;6(1):61-70

Modelling modifiable factors associated with the probability of human rabies deaths among self-reported victims of dog bites in Abuja, Nigeria.

Canine-mediated rabies kills tens of thousands of people annually in lesser-developed communities of Asia, Africa, and the Americas, primarily through bites from infected dogs. Multiple rabies outbreaks have been associated with human deaths in Nigeria. However, the lack of quality data on human rabies hinders advocacy and resource allocation for effective prevention and control. We obtained 20 years of dog bite surveillance data across 19 major hospitals in Abuja, incorporating modifiable and environmental covariates. To overcome the challenge of missing information, we used a Bayesian approach with expert-solicited prior information to jointly model missing covariate data and the additive effects of the covariates on the predicted probability of human death after rabies virus exposure. Only 1155 cases of dog bites were recorded throughout the study period, out of which 4.2% (N = 49) died of rabies. The odds for risk of human death were predicted to decrease among individuals who were bitten by owned dogs compared to those bitten by free-roaming dogs. Similarly, there was a predicted decrease in the probability of human death among victims bitten by vaccinated dogs compared to those bitten by unvaccinated dogs. The odds for the risk of human death after bitten individuals received rabies prophylaxis were predicted to decrease compared to no prophylaxis. We demonstrate the practical application of a regularised Bayesian approach to model sparse dog bite surveillance data to uncover risk factors for human rabies, with broader applications in other endemic rabies settings with similar profiles. The low reporting observed in this study underscores the need for community engagement and investment in surveillance to increase data availability. Better data on bite cases will help to estimate the burden of rabies in Nigeria and would be important to plan effective prevention and control of this disease.

Knowledge, attitudes, and practices regarding dogs and dog bites in Indigenous northern communities: A mixed methods study.

The singular relationship developed over the years between northern Indigenous peoples and dogs has been profoundly changed through historical trauma, settlements and increased use of snowmobiles. Issues related to dogs have become increasingly complex and worrisome with the endemic presence of the rabies virus among Arctic fox populations, and given the fact that northern Indigenous peoples may have a higher risk of dog bites than the general population. This study aimed to investigate factors related to the risk of dog bites in Naskapi and Innu communities located in northern Quebec (Canada) by (1) describing the knowledge, attitudes and practices (KAP) regarding dogs and dog bites in these communities, and (2) analyzing experiences of inhabitants and health professionals with regard to dog bites and their management. A mixed methods study design that combined an observational cross-sectional survey and individual interviews was used. The survey collected data on KAP regarding dogs and dog bites among 122 respondents. Individual interviews (n = 37) were then conducted with victims of dog bites, owners of dogs that have bitten a person before, and health professionals. Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed. Results highlighted that 21% of respondents have had a dog bite in their lifetime. Most respondents were not aware of the risk of contracting rabies following a dog bite, although rabies risk perception was associated with risk perception of dogs (linear regression: coefficient = 0.69, 95% CI = 0.36-1.02). The odds of being more knowledgeable on rabies were higher (logistic regression: OR = 2.92, 95% CI = 1.07-7.98) among young adults. Dogs were perceived as both threats and protectors by community members. When the fear of dogs was present, it affected the quality of life of some inhabitants. There was confusion about responsibilities in the management of biting dogs, although protocols to follow after a bite were clear for health care professionals. This study revealed a lack of awareness and knowledge about dog bites and rabies risks in both communities. Results provide important knowledge for the development of interventions adapted to northern Indigenous communities.

Survival of 21 Dogs after Post-exposure Prophylaxis using Intra-dermal Rabies Vaccine in the Pre-scapular Region and Emergency Use of Expired Equine Rabies Immunoglobulin for Local Wound Infiltration in Victims of a Rabid Dog Bite using One Health Approach

Rabies is a 100% fatal zoonotic disease and is preventable through timely and adequate Post-Exposure Prophylaxis (PEP). World Organization for Animal Health (WOAH) haven’t issued any guidelines for PEP for rabies in animals, still in certain Indian states like Himachal Pradesh (HP) PEP regimen with active immunization on 0,3,7,14 and 28 days mostly by Intramuscular Rabies Vaccine (IMRV) is being followed. Recently in Rampur Bushahar, a suspected rabid dog later laboratory confirmed had bitten 21 dogs, 2 cows, and 2 men. We employed PEP in animals using Raksharab vaccine intra-dermally (IDRV) (0.2 ml, pre-scapular region) on days 0, 3,7,14, and 28 along with only local wound infiltration of eRIG in 8 out of 11 bitten dogs with Category III exposure. Furthermore, 3 noncooperative dogs with Category III exposure were given IMRV (1ml) on day 0,3,7,14,28 with only wound infiltration of eRIG. 2 Cows were administered 0.2 ml IDRV in the skin at the middle of the neck with only wound infiltration of eRIG. Human bite victims also received 0.1 ml IDRV at 2 sites in the deltoid region on days 0,3, and 7 along with wound infiltration of eRIG at the nearby health center. Serum samples were collected for Rapid Fluorescent Focus Inhibition Test (RFFIT) for estimation of Rabies Vaccine Neutralizing Antibody (RVNA) titer after day 14 for 8 dogs, 2 cows, and human bite victims, and all had RVNA titer >0.5 IU/ml on day 14 except one in IMRV group. None of the bitten victims had clinical manifestations of rabies even after 1 year of follow-up. This indicates wound infiltration with eRIG along with the vaccine could be a life-saving protocol. Also using expired eRIG in emergencies was safe and life saving in animals. Expired eRIG used was later tested and was found to be potent.

Delays in initiating rabies post-exposure prophylaxis among dog bite victims in Wakiso and Kampala districts, Uganda.

Background Although rabies in dog bite patients is preventable through timely initiation of post-exposure prophylaxis (PEP), a number of barriers to achieving PEP exist. This study investigated the delays to initiation of PEP among dog bite patients in the emergency departments of two PEP centers in Uganda. Methods A cross-sectional study was conducted among dog-bite patients that presented to two selected rabies PEP centers. A semi-structured questionnaire was used to collect data. Delay to receive PEP was defined as reporting for PEP beyond 24 hours after the bite event. Generalized linear models were used to calculate prevalence ratios and the 95% confidence intervals as a measure of association between delay and patient factors. Results Out of 376 participants, just over half (53.5%) were males. The majority of participants (54.0%) were 15 years or older and 28.5% had no formal education. Just over three-quarters (77.9%) had category II dog bite wounds. Nearly 40% delayed to receive PEP, and median (inter quartile range) lag time between bite event and seeking medical care of 18 (41) hours. Compared to education level of secondary or above, patients with no formal education (adj. PR=4.06, 95% CI: 2.69 - 6.10) or primary education (adj.PR=2.15, 95% CI: 1.37 - 3.35), belonging to the lowest socio-economic tertile as compared to the highest (adj.PR=1.58, 95% CI: 1.10 - 2.28), knowing the owner of the biting dog (adj.PR=1.30, 95% CI: 1.02 - 1.65) and having category II wounds (adj.PR=2.31, 95% CI: 1.43 - 3.71) were all associated with delayed presentation for PEP. Conclusions and recommendations Delays to receive PEP are common and are associated with poor level of education or low socio-economic status, knowledge of who the dog owner is and less severity of bite wounds. Seeking care irrespective of wound severity or knowledge of dog owner should be promoted.

The Lived-In Experience and Psychological Recount of Dog Bite Victims Visiting the Anti-Rabies Clinic in Kashmir: A Qualitative Study

Introduction: There is a necessitated need for canvassing and prioritizing measures towards rabies elimination beyond existing statuesque post-exposure prophylaxis. Moreover, there is a need to characterize the psychological and intrusive experiences of dog-bite victims to portray a picture beyond the public health perspective. Objective: To get an expressive understanding of the psychological and lived-in experience of dog bite victims' to complement existing concepts. Method: The study was conducted at the anti-rabies clinic(ARC) of SMHS hospital which receives animal bite cases from the whole of Kashmir valley. Participants were selected purposefully based on the inclusion criteria, and data saturation was reached with eleven participant interviews. One to one in-depth interviews were conducted with eleven (11) dog bite victims, using a preformed interview guide. Data analysis was performed using Colaizzi's phenomenological method to describe the individualistic experiences faced in peculiar conditions with familiar phenomena embedded in them. Results: Data analysis yielded three overarching themes and nine subthemes viz:-1.Spiritual and emotional ineffectualness. (Suffering and affliction, Spiritual sulkiness, Emotional emergence) 2. Flashbacks of being hindered and defenseless. (Lack of focus in one's work, lacking the courage to protect, Being shaky)3. Social and economical implications. (Financial loss, group and peer detachment, preferring isolation) Conclusion: The results of this study showed that dog bite patients experience an unpleasant phenomenon in the face of being bitten by the dogs and are subjected to severe psychological pressures that require attention and support of medical professionals, psychologists and government authorities.

Hospitalization for dog bites in Poland between 2006-2020.

Owning a dog or spending time around a dog have many benefits, but also pose a risk of being bitten or attacked. Currently, publications on dog bites and related factors come from both high-income countries and low- and middle-income countries. So far, no attempt has been made to assess this phenomenon in Poland. The aim of this study was to determine the number of such events and evaluate hospital medical assistance provided to dog bite victims in Poland in the period of 15 years between 2006-2020. This cross-sectional study was based on the data from the Nationwide General Hospital Morbidity Study and cases with the code W54 (ICD-10) as the cause of hospitalization. As part of the analysis, victim demographical data, with an emphasis on city- and country-dwellers, as well as treatment variables were assessed. Between 2006-2020, 4,145 cases of hospitalizations for dog bites were found, of which approx. 42% occurred in 2020 during the COVID-19 pandemic and lockdowns. Most of the victims were children aged 0-9, and this is especially common among boys living in the countryside. It was found that regardless of the place of residence, there was a systematic decrease in hospitalization of men as they were older. In women, however, the decrease in hospitalization concerned only the age groups 0-39. Among older women, the percentage of hospitalization increased, especially among rural women aged 60 and over. Hospital discharge records report a small number of dog bites. These are only the tip of the iceberg. The problem has a multi-factorial nature and requires epidemiological monitoring and further research on correlates and determinants, as well as preventive measures.

Perception of canine rabies among pupils under 15 years in Kwara State, North Central Nigeria.

Rabies is an endemic, highly fatal, and vaccine-preventable disease with severe socio-economic implications. Most (99%) human rabies cases are transmitted through dog bites. Children under 15 years account for 40% of all dog bite victims and 35–50% of all rabies deaths. Rabies awareness among this vulnerable group is critical to rabies prevention. However, there is a paucity of data on rabies awareness among pupils under 15. Hence, this study assessed the awareness and attitude of pupils under 15 years towards canine rabies in Kwara state in Nigeria. The study was conducted as a cross-sectional survey of 1,388 pupils across the state using a structured questionnaire that was administered as a one-on-one interview using the Open Data Kit on Android phones in December 2019. Of the 1388 pupils included in this study, only 21.7% (n = 301) of them were aware of rabies. The mean rabies score was 1.7±0.8 and only 29.2% (n = 88/301) of the pupils had adequate knowledge of canine rabies. The dog ownership rate was 18.7% (n = 259) with an average of 1.93 dogs per household. Approximately 5% (n = 66) of the pupils have been previously bitten by a dog. One-third of the dog bite victims (35%, n = 23/66) were managed and treated at home and only 12% (n = 8/66) were treated in a health facility. The result of the multivariable logistic regression showed that students aged between 13–15 years were more likely (OR: 1.93; 95% CI: 0.72–3.01; p < 0.001) to have adequate knowledge of rabies than the younger pupils. Similarly, pupils that have dogs in their households (OR: 2.09; 95%CI: 1.49–2.75; p < 0.001) and those that reside in Kwara South (OR:1.78 95% CI:1.29, 2.44; p < 0.001) were more likely to be aware and have adequate knowledge of canine rabies respectively. Finally, Pupils from non-dog-owning households were more likely (OR:2.2; 95% CI: 1.45, 4.42; p < 0.001) to have been bitten by dogs than those from dog-owning households. The awareness and attitude of pupils under 15 to canine rabies was poor. We advocate the introduction of rabies lessons into the school curriculum in Kwara State to reduce the incidence of dog bites and prevent dog-mediated human rabies.

Awareness, Knowledge, and Perceptions Regarding Rabies Prevention Among Rural Communities in Masaka District, Central Uganda: A Qualitative Study.

Rabies is a zoonotic disease that is mainly transmitted to humans through dog bites. It remains a major public health threat in many Asian and African countries, including Uganda. The main objective of this study was to investigate awareness, knowledge, and perceptions of communities toward human and dog health related to rabies prevention, as well as dog management practices within Masaka district, central Uganda. Data collection involved nine key informant interviews (KIIs) and six focus group discussions (FGDs). Methods used during focus group discussions included qualitative interviews (using open-ended questions), simple ranking, and proportional piling. Data from KIIs and FGDs were analyzed using content analysis in NVivo (version 12.0). This study reveals that community members in the rural settings uses herbal concoctions in replacement or as an alternative to dog vaccination. Furthermore, the study reveals that dogs play the vital roles in the households like as they offer protection to people and household properties, despite being ranked second least among the household animals. The commonest livelihood activity was a small-scale mixed farming. Most of the households kept dogs, but they are ranked at second lowest in terms of economic value among all domestic animals. Free roaming and tethering were the common dog-keeping systems, and home-based feed (food leftovers, bones) was provided mainly to the tethered dogs. Rabies, also locally known as “Eddalu Lyembwa” (that can be translated as “madness of the dogs”), was ranked as the disease of most important among dogs, besides other common diseases such as skin diseases, venereal diseases, worm infestations, and tick infestations. Inadequate vaccination services for both humans and dogs were reported, and dog bite victims traveled a long distance to seek for post-exposure prophylaxis after dog bites. It can be concluded that there is a clear request for periodic mass vaccination campaigns against rabies among dogs, and access to vaccines within reasonable distances by humans after a rabies exposure, but also pre-emptive vaccination for those at high risk, such as veterinarians, needs to be improved.

Dog Bite Wounds and Their Management Prospective View from Lady Reading Hospital MTI Peshawar KPK, Pakistan

Background: Dog bite and dog bitten wound are serious health care problem. The stray dog, non-vaccinated domestic dog, free-roaming known dogs has worsened the problem here, lack of awareness, poor finances is major hindrance for receiving post-exposure prophylaxis as well as timely wound management for rabies. Aim: To highlight the most common victim, wounding pattern, most common anatomical region wounded and wound management from our setup. Methods This is a single center-based analytical cross-sectional study. Conducted from December 2021 till March 2022 spanning a duration of three months at academic tertiary care hospital situated in Peshawar city of Khyber Pakhtunkhwa province of Pakistan. N=277 victims of dog bitten victims with different wound patterns and from different central and peripheral areas reported to us. Chi-square test used for categorical data relationships. A P-value less than 0.05 was considered significant. SPSS version 22 was deployed to analyze the results. Mean standard deviation was used to illustrate numerical data. Results The majority of dog bite victims reported to us were from sub-urban areas of Peshawar, the majority were male 207(74.7%), and female 64(23.1%). The most common victims were under 15 years of age majority had 37.2% 272(98.2%) arrived with an intact primary survey. 93.5% had an unprovoked bite and 6.5% reached with the obviously contaminated wound. 96% had washed their wound at home soap and water and other antiseptic solution 5% of them needed fluid resuscitation and intravenous analgesia. 242(81.4%) were category III wounds. Conclusion: Controlling free-roaming and stray dog’s population is a cornerstone for preventing these disfiguring wounds. Adequate lavage and selective debridement can minimize the scar. For Wounds larger than 3 cm combined efforts with general surgery and plastic surgery/maxillofacial surgery can give a better outcome. Keywords: Stray dog, laceration puncture, soft tissue, soft tissue loss, healing by secondary intension, primary closure

Roles of traditional medicine and traditional healers for rabies prevention and potential impacts on post-exposure prophylaxis: A literature review.

IntroductionGlobally, traditional medicine is widely used to treat a variety of injuries and illnesses, including dog bites, and exposures that are risky for rabies. However, efficacy of most traditional remedies used for rabies prevention or treatment has not been demonstrated in controlled trials or proven in community-based surveys.MethodsSix databases were searched including the terms rabies, traditional treatment, traditional remedy, traditional therapy, traditional medicine, and medicinal treatment to review traditional remedies used in the prevention and treatment of rabies. In addition, published literature of rabies transmission dynamics was used to estimate statistical likelihood of dog bite victims developing rabies to provide clarity as to why traditional healers have a high apparent success rate when preventing death from rabies in victims bitten by suspected rabid dogs.ResultsLiterature review yielded 50 articles, including three controlled experiments, that described use of traditional remedies for rabies prevention and treatment. Traditional remedies for rabies ranged from plant- or animal-based products to spiritual rituals; however, only a few controlled mice trials were conducted, and none of these trials demonstrated efficacy in preventing or treating rabies. Risk of dying from rabies after a bite from a dog with unknown rabies status is low, 1.90% (0.05%-29.60%). Therefore, traditional healers had a 98.10% (70.40%-99.95%) apparent success rate in preventing death from suspected rabid dog bites despite inefficaciousness of herbal remedies.ConclusionThere was no universal plant species or route of administration that was consistently used for rabies prevention or treatment across countries. No traditional remedy was efficacious in the prevention or treatment of rabies in randomized controlled experiments. Understanding the cultural context under which traditional remedies are used may facilitate collaboration of traditional healers with the modern medical system to ensure timely and appropriate use of proven therapies for prevention and clinical management of rabies.

An Eight-Year Review of the Frequency and Outcome of Dog Bite and Clinical Rabies in a Teaching Hospital in North Central Nigeria

Introduction: Rabies is a neglected tropical disease that is highly fatal and yet it is under-reported in the developing countries like Nigeria. The domestic dog is the primary reservoir host as well as the most important source of infection usually conveyed by saliva through bites. Aim: This study sought to determine the frequency and outcome of dog bite injury and clinical rabies presented to the Accident and Emergency unit of Benue State University Teaching Hospital Makurdi, Benue State, Nigeria. Methods: This retrospective hospital-based study reviewed the medical records of all patients with dog bite who presented over an eight-year period from August 2014 to July 2022. Rabies virus infection was diagnosed on clinical basis. A structured proforma was used to extract relevant information and data was analysed using the statistical package for social sciences (SPSS) version 21. Result: Mean and median age was 27.03 ± 10.98 and 29 years respectively, range of 2 - 47 years and 11 (73.3%) were males. There were 15 cases of dog bite out of 17,187 patients making frequency of 1.14 per 1000 persons constituting 0.09% or about 2 cases yearly. Seven (46.7%) of this total number had clinical rabies infection with 7 (100.0%) mortality. All 7 (100.0%) with clinical rabies had a furious (encephalitic) form. Rabies immunoglobulin was prescribed in 8 (53.3%), 6 (40.0%) received them while 13 (86.7%) received post-exposure rabies vaccine. Conclusion: Dog bite is an uncommon reason for Accident and Emergency visit in our facility with male preponderance. However, about 46.7% of the dog bite victims developed clinical symptoms suggestive of furious (encephalitic) form of rabies with 100.0% fatality.

Rabies: knowledge, attitudes and practices in the Suhum municipality of Ghana

Aim: The world is racing behind time to get dog-mediated human rabies eradicated by 2030. In response, Ghana has developed a rabies control strategy that awaits implementation. The Ghana chapter of Rabies in West Africa piloted a 3-year One Health rabies control programme in Suhum Municipality of the Eastern Region, Ghana. Questionnaires were administered as part of the exercise to gather information on local rabies-related perceptions and practices, with the aim of identifying knowledge, attitude, and practice gaps that may antagonise control efforts and endanger human life. Methods: A cross-sectional study was conducted from March to November 2020. The study involved 316 conveniently sampled households (individual per household) from three randomly selected sub-municipalities in Suhum Municipality. Data were analysed with IBM SPSS version 26. Results: Of the 316 households interviewed, 82% (n = 259) of respondents were aware of rabies, of which 78.8% (n = 204) were found to have good knowledge about rabies. Rabies awareness was significantly associated with age (P = 0.004), sex (P = 0.042), and level of education (P = 0.0405). Although a majority (76.8%) of dog bite victims reported to the hospital, only 7.1% practiced wound cleansing while a significant number (32.2%) were involved in several myth-laden traditional remedies. Conclusion: This study found that most of the respondents are aware and have good knowledge about rabies. However, their practices in disease prevention and control were poor. Continued and strengthened education through One-Health collaboration of stakeholders and the cooperation of the local community will be required for effective rabies control.