Rabies post-exposure prophylaxis compliance of bite patients: The San Lazaro Hospital Animal B.I.T.E. (Bite Injury Treatment Experience) study
- Author:
Don B. Maldo
1
;
Jason T. Suquila
2
;
Efren M. Dimaano
3
;
Ferdinand S. De Guzman
4
Author Information
- Publication Type:Other Types
- Keywords: Animal bite
- MeSH: Rabies; Post-Exposure Prophylaxis
- From: The Filipino Family Physician 2019;57(2):70-75
- CountryPhilippines
- Language:English
-
Abstract:
Background:Post-exposure prophylaxis (PEP) is the most important means of preventing rabies. Intradermal PEP was developed to improve compliance, still, many recipients fail to complete this regimen
Objective:To determine the non-monetary factors contributing to non-compliance to PEP among patients in the Animal Bite Treatment Center (ABTC) of San Lazaro Hospital (SLH).
Methods:This was an analytical, cross-sectional study. The authors randomly reviewed patient records of SLH-ABTC for one-year period. We characterized the cases according to World Health Organization (WHO) parameters. They determined the day intervals between exposure, first consultation, PEP initiation and follow-up visits. Statistical analyses used were descriptive statistics, χ2 test for independence and binary logistic regression.
Results:The authors evaluated 667 records. Patients mostly had Category III exposures (76.91%, 95%CI: 73.92%80.62%). The chances of completing active immunization were more likely among patients exposed to unvaccinated animals (OR=1.85, 95%CI: 1.21-2.84, p=0.004). The chances of receiving passive immunization were higher for injuries on the head/neck regions (OR=8.18, 95%CI: 2.4-27.9, p=0.001). Overall, compliance to PEP was 70.21% and 40.70% for Categories II and III exposures, respectively. PEP compliance was moderately dependent on the exposure category (χ2=38.14, df=1, p<0.001, φ=0.25.
Conclusion:Category II exposure patients had better compliance than Category III, since rabies immunoglobulins are not required. The authors did not identify any factors that significantly affected Category II regimen compliance. Among Category III patients, compliance was better if the injuries were bite-inflicted while those who were exposed from “healthy”looking animals were less likely to comply. - Full text:PAFP-Journal-2019-2-6-11.pdf
