Proper Post-exposure Prophylaxis Research Articles

Level of knowledge of prevention of blood-borne infectious diseases among Master’s degree students of nursing

Introduction. Blood-borne infections are a serious problem among medical staff, especially nursing staff, because nurses have the most frequent contact with patients. As future employees of health care, students of nursing are exposed to a number of hazardous factors. Work with patients of unknown serological status (during practical classes and apprenticeships) is associated with the risk of infection with various pathogens. Objective. The aim of the study was recognition of the level of knowledge concerning prevention of blood-borne infectious diseases among Master’s degree students of nursing. Material and Methods. The study was conducted in the second half of 2022 among 104 Master’s degree students of nursing, who were educated at the Radom School in Radom, by the method of a diagnostic survey, using an author-constructed questionnaire. Results. The majority of the examined students (96.2%) knew what diseases are transmitted through blood. More than a half of respondents (63.5%) evaluated their level of knowledge about blood-borne diseases as mediocre, and 19.2% - as low. A part of respondents (67.3%) had knowledge that trace amounts of blood are enough to cause infection with blood-borne diseases. All students in the study knew the main methods of prevention of infections transmitted via blood, and the deficit of knowledge concerned proper use of personal protection equipment (5.8%) and the observance of the procedure to be followed in the event of occupational exposure (3.8%). A large group of respondents (82.7%-100.0%) knew various risk factors of infection with blood-borne diseases. The majority of respondents (88.5%) knew that there is an effective vaccine against hepatitis B, but 43.3% of the students in the study did not know the main symptoms of infection with HBV. Students most often knew (90.4%) how to diagnose infection with HCV – anti-HCV test for the presence of antibodies against hepatitis C virus in blood; however, 26.9% of respondents were not aware that there is no vaccine against hepatitis C. The majority of the examined students (84.7%) knew early symptoms of infection with HIV, while the remainder had a deficit of knowledge in this area. A large group of respondents (82.0%-94.0%) knew various risk factors of infection with HIV. Conclusions. Students of nursing should be motivated to expand their knowledge concerning prevention of blood-borne diseases, observance of the principles of personal protection, prevention of occupational exposure, and proper post-exposure prophylaxis.

IJCM_413A: A cross sectional study to find out status of post exposure prophylaxis among animal bite cases in Raipur city Chhattisgarh.

Background: Rabies is a viral zoonosis that occurs in more than 100 countries and territories Although a number of carnivores and bat species serve as natural reservoirs, rabies in dogs is the source of 99% human infections and poses a potential threat to more than 3.3 billion people. In humans, rabies is highly fatal once clinical symptoms have developed. According to the World Health Organization, human rabies can be prevented completely by proper post exposure prophylaxis. In India alone, 20,000 deaths (i.e., about 2/100,000 population at risk) and 2 million bites, mostly by dogs, are estimated to occur annually. India has 36% global and 65% Asian rabies burden in terms of cases. Local treatment of wounds is of maximal value when applied immediately after exposure (within minutes if possible). Animal experiments have shown that local wound treatment can reduce the chances of developing rabies by up to 80%. Objectives: To find out the status of post exposure prophylaxis and associated factors among animal bite cases in Raipur city Chhattisgarh. Methodology: Type of study: A community based cross sectional survey Conducted at: Raipur District. Duration of study: Over a period of 3 months (November 2023- January 2024). Study Subjects: General Population. Inclusion criteria: General population, Raipur. Exclusion Criteria: 1) Patients who do not give consent. 2)Unconscious Very ill patients or patients with Mental illness. Results: Total of 1124 participants 41 had animal bite, 63.41% were males and 36.59% were females. Among the biting animals 83% were dogs, while cats were 15% and 2% were monkeys. Out of 41 cases 90.24% had Category II bite while 9.75% had Category III bite. 33 out of 41 i.e. 80.48% victims took Anti Rabies vaccine, while rest 19.52% preferred treatment from traditional healer. Conclusion: Majority of animal bite were of dog bite and were classified under Category II. Improved awareness, forestalling animal rabies, and better access to affordable and potent human rabies vaccines are essential for the elimination of human rabies.

Deaths due to rabies in Shivamogga, India: Case series and review

Rabies is a fatal disease and deaths due to this have been on the increase. This is due to a lack of awareness leading to failure to obtain proper treatment. We report five cases confirmed to be rabies virus positive, with Negri bodies in their neuronal tissues. Due to a lack of awareness, the individuals are failing to take proper postexposure prophylaxis. The people are avoiding going to health care hospitals as a result of which, after varying incubatory periods the individuals eventually are succumbing to the illness. They are exhibiting characteristic encephalitic symptoms, as a result of this deadly disease. Proper prevention and management, along with awareness among the people can decrease the fatality. Effective programs and continuous surveillance of rabid dogs, to effectively control their population and vaccinate them on a consecutive basis, can combat the virus and stop its spread.

An 8-year-old child with encephalitis rabies due to delayed case finding, proper post-exposure prophylaxis for rabies infection: a case report

Background: Until April 2023, it has been documented about 31,113 cases of animal rabies-borne bites, of which 23,211 cases were given Post Exposure Prophylaxis (PEP) Anti Rabies Vaccine and 11 death cases in Indonesia, and 95% of them were caused by dog bite. This case report was conducted to describe a rare case of an 8-year-old child presenting with the late complication of encephalitis in Borong General Hospital due to the delayed case finding, management, and proper prophylaxis for Rabies infection. Case Presentation: One day before admission, an 8-year-old girl with irritability, aggressive behavior, and severe speech abnormalities was reported to the emergency room. These symptoms quickly escalated to confusion and disturbed mental status. One month before to presentation, the patient's parents stated that his right arm had been bitten by a stray dog. Because there were no obvious bite marks and the family was not aware of the dog bite, PEP was not requested. In the previous five days, her parents described experiences of hydrophobia, photophobia, and aerophobia. The patient's health deteriorated two hours after admission, and palpating the carotid artery revealed that there was no pulse. Despite performing cardiopulmonary resuscitation, ROSC was not reached. Conclusion: Animal rabies control and surveillance are essential, particularly in locations where the disease is endemic. PEP is extremely effective and ought to be given as soon as possible following exposure to reduce the high fatality rate.

Compliance to post-exposure prophylaxis among patients attending anti-rabies vaccination clinic in a tertiary health care centre in central India: a cross sectional study

Background: Rabies is a fatal but vaccine-preventable disease. Prevention of rabies in exposed individuals is possible by providing them with the proper post-exposure prophylaxis. This study aims to assess the compliance to post-exposure prophylaxis in animal bite cases and factors associated with it. Methods: A cross sectional study was conducted between September 2022 to November 2022 using a predesigned, pretested proforma to interview 300 patients attending anti-rabies vaccination clinic in a tertiary health care centre in central India. Results: Majority of the patients 268 (89.3%) suffered category 3 animal bite and 32 (10.7%) patients suffered category 2 animal bite. 125 (41.7%) patients washed the wound with water, soap and applied antiseptic. 234 (78%) patients completed their last dose of anti-rabies vaccine (ARV) while compliance to Rabies Immunoglobulin (RIG) was seen in 167 (63.3%) patients of all cases requiring it. Out of all the patients who took Equine RIG, 7 (4.5%) showed hypersensitivity reactions. Significant association was found between compliance to ARV with type of animal and status of animal after 10 days; and compliance to RIG with gender, socio-economic status, type of animal and type of wound. Conclusions: Compliance to ARV and RIG in our study was 78% and 63.3% respectively. Major reason for poor compliance to RIG was the price of immunoglobulin. Health education regarding significance of post-exposure prophylaxis is needed among the population.

Implications of the antiviral drug favipiravir on rabies immunoglobulin for post-exposure prophylaxis of rabies in mice model with category III-like exposures

Rabies is a fatal zoonotic disease caused by the rabies virus (RABV), with almost 100% mortality if proper post-exposure prophylaxis (PEP), consisting of rabies immunoglobulin (RIG) and rabies vaccine, is not applied in a timely manner. However, this is challenged by the limited availability of RIG, especially in resource-constrained countries. In this study, we assessed the scope of the antiviral drug favipiravir to treat rabies-infected mice as an alternative to RIG. Category III-like wounds were induced in RABV-challenged mice treated with favipiravir instead of RIG in the PEP regimen. The use of favipiravir followed by rabies vaccine provided complete protection against rabies-related death in 100% of mice, even after RABV propagated to the central nervous system during infection. Additionally, the virus-neutralizing antibody titer in the favipiravir and vaccine group was significantly higher than that of the RIG and vaccine recipients. The use of favipiravir with rabies vaccine seemingly prevents fatal outcomes and even rescues the cases that already express clinical symptoms. A clinical trial of this approach is warranted, especially in countries with low RIG availability.

A Study on Clinico-Social Profile of Animal Bite Cases Attending an Anti-Rabies Clinic of a Tertiary Care Hospital, Odisha - A Cross Sectional Study

Background: Human rabies continues to be endemic in India and according to a recent estimate 20,000 people die of this disease every year. However at the same time, it is also 100% preventable through timely and proper post exposure prophylaxis. Aims and Objectives: The present study was undertaken to assess the socio-clinical profiles of animal bite cases attending the anti-rabies clinic of a tertiary care hospital of Odisha, to find out the association of socio-clinical factors with Category III bite cases and to study the first aid practices of such patients. Methodology: A hospital based cross section study was conducted at an anti-rabies clinic of S.C.B. Medical College & Hospital, Odisha between the months of January and March 2018. New animal bite cases that gave the consent to participate were included in the study. 20% of the new eligible cases i.e., 1200 were taken by using consecutive sampling of 15 patients per day. A pretested and predesigned questionnaire was used to collect the data. Analysis was done in SPSS. Results: In this study Males (70%). are predominantly affected. About 26% cases were children <15 yrs. Dog bite was seen in 80% cases. Lower limb (60%) was the most commonly the bitten site. A majority had category III (76%) exposure. About 75% bites were unprovoked bites. Most of the cases (55%) came from the rural area. 43% cases applied bitter gourd and turmeric paste on their wounds. Conclusion: From this study, we observed that males have a higher incidence of animal bite than females and most of the cases were >15 years age. The most common animal biting people is a dog. A majority had category III exposure.

Sedation-Paralysis as Cornerstone on Rabies Management (Milwaukee Protocol)

Rabies is a viral infection involving the central nervous system that is almost always fatal without proper post exposure prophylaxis. Here, we present a 38 years-old male with dog-bite and late attention whom, managed in intensive care unit. After 21 days, the disease progressed to serious neurologic and hemodynamic damage including motor disorders and imbalance in blood pressure and cardiac rhythm. Clinical management of the patient consisted of antiviral agents (Amantadine and Ribavirin), neuroprotection, sedation-paralysis and supportive care. Patient was survived 43 days from the clinical disease onset. Although our patient died in spite of intensive care, advances in the use of sedation-paralysis and early prescription of antiviral agents raised hopes that it may eventually be possible to save rabies patients.

A combination of two human monoclonal antibodies cures symptomatic rabies.

Rabies is a neglected disease caused by a neurotropic Lyssavirus, transmitted to humans predominantly by the bite of infected dogs. Rabies is preventable with vaccines or proper post‐exposure prophylaxis (PEP), but it still causes about 60,000 deaths every year. No cure exists after the onset of clinical signs, and the case‐fatality rate approaches 100% even with advanced supportive care. Here, we report that a combination of two potent neutralizing human monoclonal antibodies directed against the viral envelope glycoprotein cures symptomatic rabid mice. Treatment efficacy requires the concomitant administration of antibodies in the periphery and in the central nervous system through intracerebroventricular infusion. After such treatment, recovered mice presented good clinical condition, viral loads were undetectable, and the brain inflammatory profile was almost normal. Our findings provide the unprecedented proof of concept of an antibody‐based therapeutic approach for symptomatic rabies.

Concept mapping as a tool to improve medical student's learning about rabies surveillance.

CONTEXT:Rabies is a viral zoonotic infection of the central nervous system. Annually more than 59,000 people die of rabies worldwide; human rabies can be prevented by using proper postexposure prophylaxis. A major component of successful rabies surveillance is well-educated medical professional.AIMS:The aim of this study is evaluate the effect of concept mapping as an active teaching method on medical students’ knowledge about rabies prophylaxis.SUBJECTS AND METHODS:It was a pre- and post interventional study carried out on 80 medical interns. Our intervention included Group 1 – trained by concept maps – and Group 2: – trained by book reading. Data gathering tool was the researcher-made questionnaire that consisted of seven open-ended questions that assessed the interns’ knowledge about animal bite surveillance.STATISTICAL ANALYSIS USED:Students’ scores of pre- and posttests have been analyzed with paired t-test and independent t-test.RESULTS:Comparing the pre- and posttest scores of students in two groups by paired t-test showed that interventions have been effective in both the groups; posttest scores of both groups had increased significantly (P < 0.001). Score mean difference in concept map group was significantly higher than book reading group based on independent t-test (P = 0.001).CONCLUSIONS:It seems that concept mapping as a visual training tool for transferring the concepts to medical students is more appropriate than the other traditional ones like book reading, but more research is needed to be sure that active methods are better than traditional ones.

Pattern of exposure among victims of suspected rabid animal attending anti-rabies clinic of tertiary care hospital

Background: Rabies, a neglected tropical disease, is vaccine preventable and occurs in more than 150 countries. It is almost always fatal. About 40% of deaths due to rabies occur in children under the age of 15 years. Objectives were to study the pattern of injury following exposure to canine bite, bear maul and rabid cow among the attendees of Antirabies clinic of SMHS hospital, Srinagar and to classify the type of exposure using WHO guidelines for initiation of post exposure prophylaxis.Methods: The study was conducted over a period of three months from 1st June 2016 to 31st August 2016, in Anti Rabies Clinic of Department of Community Medicine, Government Medical College, Srinagar. It was a descriptive Study and included all victims of canine bite and rabid cow. A total of 134 patients were received.Results: Most [83 (61.9%)] of the patients were males with mean age of 36.63 years. Legs were the most common [57 (43.2%)] site of exposure followed by hands [15 (11.2%)] and thigh [13 (9.7%)]. Contact with a rabid cow was present in 5 (3.7%). Class II exposure was most frequently encountered [83 (61.9%)]. Class III exposure was seen in 49 (36.6%). All patients who attended anti rabies clinic for post exposure prophylaxis received free Antirabies Vaccine. Combined Antirabies vaccine and immunoglobulin was received by 49 (36.6%).Conclusions: Dog bite related injuries happen frequently in Srinagar. There is proper post exposure prophylaxis in place in SMHS hospital. There is need for curbing the ever increasing dog population and enforcing rabies vaccination in dogs.

Knowledge and practices about animal bite management among government doctors posted at primary health-care settings of district Patiala in Punjab

Background: Approximately 36% of the world's rabies deaths occur in India, three-fourth of them in rural areas. Out-of-pocket expenses and lack of transportation from rural areas prevent many of the poorest people in India from accessing primary health-care services, leaving them to carry the burden of rabies. Rabies incidence in India has been constant for a decade, without any obvious declining trend, this situation is due to general lack of awareness of preventive measures, which includes insufficient dog vaccination, an uncontrolled canine population, poor knowledge of proper post-exposure prophylaxis on the part of many medical professionals, and an irregular supply of antirabies vaccine and immunoglobulin, particularly in primary-health-care facilities. The present study was done to assess the skill and knowledge about animal bite management among primary health care providers health-care providers at peripheral health institutes of district Patiala. Materials and Methods: A cross-sectional survey was done using pretested and validated, self-administered questionnaire. Overall awareness was assessed based of sum score of each outcome according to blooms cutoff point, P Results: Out of 103 government doctors, rural medical officers (RMOs) constitute 32 (31%) and Punjab civil medical services (PCMS) 71 (69%). RMO Cadre has more mean age (34.06 ± 3.95), than PCMS (29.02 ± 5.98). Both cadres have many gaps in their knowledge. Median score of both groups is 13. Almost 45% have low knowledge-practice (K-P) score and the difference in K-P score of RMOS and PCMS are not statistically significant. Conclusion: Both groups lack knowledge on how to manage common clinical scenarios frequently seen in rural areas. There is urgent need for upgrading the knowledge and skills of doctors working at the peripheral health facilities. State health department must coordinate with medical colleges for training by organizing continued medical education for the success of national rabies control programme.

Human rabies in India: a problem needing more attention

1yet in countries of south-eastern Asia the disease is still an important public health problem. An estimated 45% of all deaths from rabies occur in that part of the world. 2 The situation is especially pronounced in India, which reports about 18 000 to 20 000 cases of rabies a year and about 36% of the world’s deaths from the disease. 3 Rabies incidence in India has been constant for a decade, without any obvious declining trend, and reported incidence is probably an underestimation of true incidence because in India rabies is still not a notifiable disease. 4 This situation is rooted in a general lack of awareness of preventive measures, which translates into insufficient dog vaccination, an uncon trolled canine population, poor knowledge of proper post-exposure prophylaxis on the part of many medical professionals, and an irregular supply of anti-rabies vaccine and immunoglobulin, particularly in primary-health-care facilities. In India, rabies affects mainly people of lower socio-economic status and children between the ages of 5 and 15 years. 4

Stray dog trade fuelled by dog meat consumption as a risk factor for rabies infection in Calabar, southern Nigeria.

Rabies is a preventable zoonosis with the highest case fatality of any disease in the world. In the developing world, it is transmitted mainly by dog bites. In parts of southern Nigeria, dog meat is a delicacy. To highlight trade in stray dogs as a major risk factor for rabies in animals and humans in south-south Nigeria. Patients admitted into the University of Calabar Teaching Hospital (UCTH) with a diagnosis of rabies between July and October 2012 were analysed for risk factors, post exposure prophylaxis (PEP), health seeking behaviour and outcome. Focused group interview were also conducted among traders/handlers of stray dogs. Ten cases of rabies in subjects aged 3 to 52 years were recorded in these five months period. Eight of the cases were male and apparently got infected directly or indirectly through the trade in stray dogs for human consumption. None had proper PEP and all patients died. Stray dog trade, fuelled by eating of dog meat, is a risk factor for human and animal rabies in Calabar, southern Nigeria. Culling of stray dogs, control of stray dogs' trade and public enlightenment on PEP is recommended.

Cases of Dog Bite in Aba, Abia State Nigeria and Its Public Health Significance

Background: Dog bite cases poses a major public health threat in Nigeria. Majority of rabies infection in humans are due to bites from rabid dogs which are mainly local breed. Research carried out in Nigeria has established that some apparently healthy dogs excrete rabies viral antigen in their saliva without showing clinical signs. Aim: This study was carried out to evaluate cases of dog bite in Aba, Abia state Nigeria and its public health significance Methodology: Cases of dog bite in humans reported at the Zonal Veterinary Clinic Aba, Abia state Nigeria from 2007 to 2012 were retrieved. Data on cases of dog bites from the Veterinary clinic record were extracted using a structured questionnaire designed for the study. Results: Out of 215 reported cases of dog bite, 11.6% were victims less than 15 years of age and 44.7% were victims greater than 30 years of age. Local breed of dogs (50.7%) were most involved in the bites, with cross breed (12.6%) being the least. Majority (78.1%) of the dogs involved in the bites were unvaccinated against rabies, with 11.6% having unknown anti-rabies vaccination status. There was no association (X2 =7.38, P > 0.05) between breed and vaccination status of the offending dogs. Dog bite victims were more of males (62.8%) than females (37.2%) with seasonal index showing the greatest values between the months of October to December. Most of the bites (63.7%) occurred arround the lower extremities with bites around the abdominal region (2.8%) being the least. Conclusion: Reports of dog bite cases in humans indicate the need for public health enlightenment campaign programs aimed at educating the public on the need to seek proper post-exposure prophylaxis treatment from health care facilities when bitten by dogs and the need for dog owners to vaccinate their dogs yearly against rabies.

Prophylaxis of human hydrophobia in South Korea.

Domestic human hydrophobia has not been reported since the one case of 2004 in South Korea, but still a few animal rabies occur persistently since the reemerging stage of rabies from 1993. The government has made efforts to control animal rabies in many aspects, but whether prophylactic strategy for human hydrophobia is performed adequately is in question. The rate of proper post-exposure prophylaxis for animal bite case in 'high-risk region' of rabies is very low with 20% between 2011 and 2013. The National Animal Bite Patient Surveillance targeting 'high-risk region' is missing out animal bite cases who visit directly to hospitals in 'suspect-risk region' of rabies. Little data seems to exist for pre-exposure prophylaxis of domestic hydrophobia. Danger of reoccurrence of human hydrophobia always remain in South Korea. The medical personnel needs to have greater interest on the matter and the government strengthen the management system.

Occupational exposure to blood borne viruses among healthcare workers in a tertiary care referral hospital in tehran.

Dear Editor, Occupational exposure to blood-borne viruses (BBVs) is a major concern in the health care setting. The BBVs of primary concern are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Health care workers (HCWs) can be exposed to these viruses through needle-stick and other injuries through contaminated material with blood and other infectious body fluids. Nurses, health technicians, cleaning personnel and physicians are potentially targets for such accidents. The Center for Disease Control and Prevention (CDC) estimates that hospital-based healthcare personnel sustain an estimated 385,000 percutaneous injuries (needle-sticks and other sharp-devices) (1) annually. In Iran, the annual incidence of occupational exposure to BBVs is unknown due to the limited data in this area. The World Health Organization (WHO) estimates that more than two million injuries causes about 66,000 HBV, 16,000 HCV and about 1,000 HIV infections among 35 million HCWs each year (2). The key in reducing accidental exposure to BBVs is through promoting educational awareness of health care staff on suitability of HBV vaccination, in house training courses concerning preventive measures of such accidents and implementing proper postexposure prophylaxis (PEP) and following-up. Here, we reviewed case notes of 193 HCWs accidently exposed to BBVs over four-years, from January 2009 to January 2013. The data were reviewed in Labbafinejad hospital, which is a specialized 231 bed public tertiary care referral hospital with a total number of 915 HCWs who are potentially at accidental risk of acquiring BBVs. The study was approved by the ethics committee in the hospital. The reviewed HCWs cases (193) were classified into 75 nurses, 39 medical doctors, 35 cleaning personnel, 30 medical technicians (17 surgical operation technicians, 10 lab technicians and 3 radiology technicians), 13 nursing students and 1 medical student. In this study, the nurses were in top list of accidental exposure, which is in line with other studies (3, 4). Injuries were categorized as follows; 150 had needle-stick injuries, 22 cases had sharp cuts like scalpel and broken glasses and 21 cases had blood splashes on their eyes. Among these 193 cases, 132 HCWs were exposed to known serologically tested HIV, HBV and HCV negative patients, 24 had exposure to HBsAg positive patient, 5 had exposure to anti-HCV positive patients and two were exposed to HIV seropositive patient (one was co-infected with HCV infection). A total of 30 HCWs had occupational exposures to unknown sero-status patients. Anti-HBs antibody titer of the 24 HCWs, who had HBV exposure, was higher than 200 mIU/mL. Therefore, no intervention was done for them expect one who, despite being vaccinated had low anti-HBs titer. Thus, he was treated with hepatitis B immunoglobulin (HBIG) with another full course of hepatitis B vaccine, as routine schedule. Six patients were exposed to HCV seropositive patients; they underwent lab investigations, the result of that was normal for everyone. In these patients, follow up 2 weeks RT-PCR was negative. Thereafter, 1, 3, 6 months lab investigations were repeated and results were negative. One HCW was exposed to seropositive HIV patient, as the result of which he received PEP for HIV infection and underwent follow up and the result was negative. Another HCW was exposed to seropositive HIV coinfected with HCV. He also received PEP for HIV and underwent follow up lab investigation for HCV infection and lab results were negative. Hence, no further action was advised. PEP therapy has been shown to reduce the risk of transmission of HIV following accidental exposure by 80% (5). In conclusion, avoiding accidental occupational exposure to BBVs is an important safety issue, which can be achieved to some extent by health awareness of the problem and further by strengthening health control measures and providing a safe hospital work environment.

Rabies, Still Neglected after 125 Years of Vaccination

Rabies is a viral zoonotic infection of the central nervous system caused by a lyssavirus. The disease is fatal without proper post exposure prophylaxis (PEP). In July 1885, Louis Pasteur obtained his first success against rabies by vaccinating Joseph Meister, a 9-year-old boy presenting with multiple deep bite wounds [1]. After more than 700 successful inoculations, Pasteur launched an international subscription and opened the world's first research institute dedicated to the prevention of rabies and other infectious diseases. The Institut Pasteur was born. Due to substantial advances during the 20th century, safe and effective human and animal vaccines based on tissue culture methodologies are available today. Today, 125 years later, Institut Pasteur is at the core of an international network of 30 institutes. Through its numerous institutions established in enzootic areas, the worldwide contribution of the Institut Pasteur International Network to rabies surveillance and control is still of paramount importance. Each year, the International Network is responsible for PEP administration to more than 180,000 exposed patients, mainly in Southeast Asia and Africa. Scientists and health staff are also involved in various national committees that work on the development and successful implementation of rabies control programs.

Occupational Risks and Hepatitis B Vaccination Status of Dental Auxiliaries in Nigeria

Objective: To assess the occupational exposure to needlestick and sharps injuries and hepatitis B vaccination status among dental auxiliaries. Subjects and Methods: A descriptive cross-sectional survey of 83 dental auxiliaries was conducted that included 12 technologists, 11 therapists, 53 nurses/surgical assistants, and 7 record officers. The survey included demography, history of needlestick and sharps injury, hepatitis B vaccination, knowledge and attitude towards HIV-infected patients, and the dental auxiliaries’ information needs on HIV-related issues. Results: Of the 83 dental auxiliaries, 34 (41%) had experienced needlestick and sharps injury in the last 12 months. At the time of the study, only 43 (51.8%) had been immunized against hepatitis B. 62 (74.7%) of the respondents thought that it was easier to contract HIV than hepatitis B through needlestick in a dental clinic. 21 (25.3%) would not assist dentists treating HIV-positive patients. However, 76 (91.6%), a majority, agreed that they needed more information on HIV-related issues, with 59 (71.1%) specifying a single area of need and 17 (20.5%) more than one area of need. The single areas of need specified in descending order were infection control (n = 22, 26.5%), HIV counseling (n = 12, 14.5%), oral manifestations of HIV/AIDS (n = 11, 13.3%), postexposure prophylaxis (n = 9, 10.8%), and antiretroviral therapy (n = 5, 6.0%). Conclusion: The data from this survey underscore the urgent need for educational interventions to encourage safe work practices. Hepatitis B vaccination, HIV-related knowledge and proper postexposure prophylaxis are needed to prevent occupational transmission of blood-borne viruses.

Human immunodeficiency virus knowledge and attitudes among hospital-based healthcare professionals in Guangxi Zhuang Autonomous Region, People's Republic of China.

Since the discovery of human immunodeficiency virus (HIV) on the Chinese mainland in 1985, the virus has spread to all provinces and autonomous regions. Although much research emphasis has been placed on studying behaviors and transmission knowledge among high-risk populations, especially drug abusers and commercial sex workers, little has been done to measure understanding within other risk groups. The objective of this study was to investigate HIV/acquired immunodeficiency syndrome (AIDS) knowledge and attitudes among hospital-based healthcare professionals in Guangxi Zhuang Autonomous Region in southern China. Data were gathered through a questionnaire completed by a convenience sample of individuals from three diverse hospitals. Insufficient knowledge of the disease and its transmission resulted in more than 90% of the respondents expressing apprehension about contracting the virus and nearly 24% expressing reservations about caring for infected patients. Uncorrected, such attitudes and knowledge deficiencies have the potential to impact negatively on the quality of care, patient-practitioner safety, and proper postexposure prophylaxis.