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.
Rabies ; Post-Exposure Prophylaxis

Objectives: Leprosy is an infectious disease affecting the skin and nerves caused by Mycobacterium leprae. Closer physical distance was found to increase risk transmission. Thus, targeted provision of prophylactic medications to household contacts of patients with leprosy could possibly aid in decreasing its incidence in a cost-effective manner. This study aimed to determine the attitudes towards disclosure of the diagnosis of leprosy and acceptance of immuno- and chemoprophylaxis for household contacts of patients undergoing treatment in a dermatology outpatient clinic of a tertiary hospital in the Philippines. Methods: We conducted a prospective, single-center, cross-sectional and mixed methods study at a dermatology clinic of a tertiary hospital. All diagnosed leprosy patients, household contacts of leprosy patients, and individuals with no leprosy and no known contact with a leprosy case were invited. Eligible participants who gave consent were included in the cross-sectional survey, followed by in-depth interviews of selected participants. STATA 12 was used to analyze the data. Descriptive statistics were used to summarize information. Chi-square was computed to obtain a measure of association of important variables. The field notes and the verbatim transcriptions of the interviews and narratives were filed using an analytic memo system. Results: Fifty-five participants (22 Hansen’s disease patients, 13 household contacts, and 20 individuals unaffected by and unexposed to leprosy) were enrolled. Mean age of respondents was 38 years, 60% were female, and 85% were living in an urban setting. Majority of the patients with leprosy were borderline lepromatous (45%) to lepromatous type (27%) with mean treatment duration of 13 months. Overall, the respondents were willing to disclose the diagnosis of leprosy to their household members to facilitate provision of prophylaxis. They were also generally willing to receive prophylaxis despite potential side effects, expense, incomplete protection, and the need for yearly assessment for the development of leprosy. All respondents felt hopeful about the availability of medications that can prevent the development of leprosy and its complications, with some feeling anxious and only a few being embarrassed about receiving them. Conclusions Prophylactic medications were found to be generally acceptable despite some concerns. There is also a willingness to disclose the diagnosis of leprosy to facilitate the targeted provision of prophylaxis to household contacts.
Leprosy ; Post-Exposure Prophylaxis ; Attitude

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.
Animals ; Humans ; Korea ; Post-Exposure Prophylaxis ; Rabies*

There are many evidence-based methods to prevent human immunodeficiency virus (HIV) transmission. This review describes recent updates on the prevention of HIV infection via sexual contact, mother-to-child transmission, and occupational exposure. The use of antiretroviral therapy to prevent HIV has been a major accomplishment. Successful strategies for preventing the sexual transmission of HIV include the implementation of treatment for prevention, pre-exposure prophylaxis, and microbicides. Mother-to-child HIV transmission can be minimized by screening and administering pre-, intra-, and postpartum prophylaxis. Adherence to universal precautions and post-exposure prophylaxis are effective preventive measures for occupational exposure. The implementation of prevention strategies based on scientific evidence should decrease the spread of this epidemic.
Acquired Immunodeficiency Syndrome ; Anti-Infective Agents ; HIV Infections* ; HIV* ; Mass Screening ; Occupational Exposure ; Post-Exposure Prophylaxis ; Postpartum Period ; Pre-Exposure Prophylaxis ; Universal Precautions

BACKGROUND: This study aimed to identify the effects of a multifaceted needlestick injury (NSI) prevention program on changes in knowledge about bloodborne infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting pre- and post-intervention among nurses. METHODS: A total of 429 and 420 nurses participated in the pre- and post-intervention periods, respectively. The intervention was performed from April to September 2007, comprising NSI guideline education, the use of containers with enhanced engineering, and the supply of safety devices. RESULTS: The average score of knowledge about bloodborne infectious diseases increased significantly from 8.3 to 8.9 out of 14 points (P<0.001), but the change in score of knowledge about postexposure coping was insignificant. The average score of attitude toward postexposure reporting increased significantly from 8.9 to 9.6 out of 12 points (P<0.001). Preventive measures such as "gloves are provided whenever needed" (P<0.001), "use one-hand technique" (P<0.001), and "needle containers are provided whenever needed" (P=0.031) increased significantly. The number of NSIs decreased by 40.4%, and the postexposure reporting rate increased by 552.8%. CONCLUSION: The multifaceted NSI prevention program positively affected knowledge about infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting after intervention. Therefore, we recommend that this program be applied to various healthcare workers in hospitals.
Communicable Diseases ; Delivery of Health Care ; Incidence ; Needlestick Injuries ; Post-Exposure Prophylaxis

The incidence of AIDS and related disorders continues to rise sharply these days and anesthesologists may expect to encounter such patients more and more frequently during the performance of routine procedures on the seemingly healthy and during indicated procedures on the sick. AIDS is a disease for which there is no cure, and thus prevention becomes even more important. However, the dangers of this disorder should not be exaggerated. We experienced one case of a subcutaneous injury during spinal anesthesia caused by a stylet of an infected asymptomatic carrier. Postexposure prophylaxis was performed with zidobudine and lamibudine, and enzyme linked immunoassay (ELISA) testing for medical personnel has been repeated three times during last 6 months.
Anesthesia, Spinal ; HIV* ; Humans ; Immunoassay ; Incidence ; Needlestick Injuries* ; Post-Exposure Prophylaxis*

Rabies is a representative zoonotic disease caused by rabies virus. The discriminative features of rabies are broad range of hosts including humans, a wide variety of incubation periods ranging from a few weeks to more than a year, ability to bring about acute fetal consequence, and scare pathological lesions. Although rabies is fatal, it is preventable disease by vaccination and post-exposure prophylaxis (PEP). This review will focus on general features of rabies, and immunoglobulin and vaccines for PEP.
Humans ; Immunoglobulins ; Oligopeptides ; Post-Exposure Prophylaxis ; Rabies ; Rabies virus ; Vaccination ; Vaccines

Needlestick injury (NSI) is a serious occupational hazard against healthcare workers (HCWs) in a hospital setting with multiple implications, thus adherence to post-NSI management including follow-up protocol is crucial.This research was conducted to describe the distribution of NSI cases among HCWs working in Ministry of Health Malaysia (MOH)’s hospital in Selangor and adherence to a follow-up protocol, as well as the factors related to it.This was a cross-sectional quantitative study reviewing retrospectively all notified NSI cases in January-September 2016. Data were taken from Sharps Injury Surveillance (SIS) system and analyzed into descriptive and analytical statistics.There were 143 notified NSI cases. The majority of the cases were female(76.2%), Malay(60.1%), medical doctors(56.6%) and in a medical-based department (44.8%). The median age of NSI cases was 27 years old (IQR:5) and median years of employment was 1.5 (IQR:4.5). Most cases happened in a ward setting (58.7%) involving contaminated (95.8%) hypodermic needle (43.4%), occurred mostly during the procedure of drawing blood (23.1%). Only 86.7% of NSI cases were source-known and some were tested positive with blood borne pathogens. However, no occurrence of seroconversion among the injured HCWs detected. The overall adherence rate to the follow-up protocol was 72.3%. Multiple logistic regression yielded significant association between age, gender, department, device contamination, procedure conducted and source HBV status with adherence to follow-up of post-NSI protocol. Further comprehensive studies involving more determinants such as therapy-related factors and potential interventions are needed to optimize adherence rate to the follow-up protocol post-NSI.
guideline adherence ; needlestick injuries ; health personnel ; post-exposure prophylaxis ; blood-borne pathogens

Anti-HIV Agents/therapeutic use* ; HIV ; HIV Infections/prevention & control* ; Humans ; Post-Exposure Prophylaxis ; Public Health

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination