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

Q2 Multidisciplinary
AAS Open Research Pub Date : 2022-12-08 eCollection Date: 2021-01-01 DOI:10.12688/aasopenres.13311.3
Stevens Kisaka, Fredrick Makumbi, Samuel Majalija, Gloria Bahizi, S M Thumbi
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引用次数: 0

Abstract

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.

乌干达瓦基索和坎帕拉地区被狗咬伤的患者迟迟未开始狂犬病暴露后预防治疗。
背景 尽管被狗咬伤的患者可以通过及时启动暴露后预防 (PEP) 来预防狂犬病,但实现 PEP 仍存在许多障碍。本研究调查了乌干达两家狂犬病暴露后预防中心急诊科中被狗咬伤的患者启动狂犬病暴露后预防的延迟情况。方法 对前往两家选定的狂犬病 PEP 中心就诊的狗咬伤患者进行横断面研究。采用半结构式问卷收集数据。被咬伤 24 小时后才报告是否接受预防性治疗的定义为延迟接受预防性治疗。采用广义线性模型计算流行率和95%置信区间,以衡量延迟与患者因素之间的关联。结果 在 376 名参与者中,男性略高于半数(53.5%)。大多数参与者(54.0%)年龄在 15 岁或以上,28.5% 未受过正规教育。超过四分之三(77.9%)的参与者身上有二类狗咬伤。近 40% 的人延迟了接受预防性口腔感染治疗,从咬伤事件到就医的中位时间(四分位之间的范围)为 18 (41) 小时。与中等或以上教育水平的患者相比,未受过正规教育(adj. PR=4.06,95% CI:2.69 - 6.10)或小学教育(adj. PR=2.15,95% CI:1.37 - 3.35)、社会经济地位最低的患者与社会经济地位最高的患者相比(adj.PR=1.58,95% CI:1.10 - 2.28)、认识咬人狗的主人(adj.PR=1.30,95% CI:1.02 - 1.65)和有二类伤口(adj.PR=2.31,95% CI:1.43 - 3.71)都与延迟接受预防性治疗有关。结论和建议 延迟接受 PEP 很常见,与教育水平低或社会经济地位低、不知道狗主人是谁以及被咬伤口的严重程度较低有关。无论伤口的严重程度或对狗主人的了解如何,都应提倡寻求护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AAS Open Research
AAS Open Research Multidisciplinary-Multidisciplinary
CiteScore
2.90
自引率
0.00%
发文量
16
审稿时长
6 weeks
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