Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies.
Thousands of human deaths from rabies occur annually despite the availability of effective vaccines following exposure, and for disease control in the animal reservoir. Our aim was to assess risk factors associated with exposure and to determine why human deaths from endemic canine rabies still occu...
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ftdoajarticles:oai:doaj.org/article:29ea41aee6a645238722e27f81f9457c 2023-05-15T15:12:01+02:00 Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. Katie Hampson Andy Dobson Magai Kaare Jonathan Dushoff Matthias Magoto Emmanuel Sindoya Sarah Cleaveland 2008-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000339 https://doaj.org/article/29ea41aee6a645238722e27f81f9457c EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2582685?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000339 https://doaj.org/article/29ea41aee6a645238722e27f81f9457c PLoS Neglected Tropical Diseases, Vol 2, Iss 11, p e339 (2008) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2008 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000339 2022-12-31T05:31:16Z Thousands of human deaths from rabies occur annually despite the availability of effective vaccines following exposure, and for disease control in the animal reservoir. Our aim was to assess risk factors associated with exposure and to determine why human deaths from endemic canine rabies still occur.Contact tracing was used to gather data on rabies exposures, post-exposure prophylaxis (PEP) delivered and deaths in two rural districts in northwestern Tanzania from 2002 to 2006. Data on risk factors and the propensity to seek and complete courses of PEP was collected using questionnaires. Exposures varied from 6-141/100,000 per year. Risk of exposure to rabies was greater in an area with agropastoralist communities (and larger domestic dog populations) than an area with pastoralist communities. Children were at greater risk than adults of being exposed to rabies and of developing clinical signs. PEP dramatically reduced the risk of developing rabies (odds ratio [OR] 17.33, 95% confidence interval [CI] 6.39-60.83) and when PEP was not delivered the risks were higher in the pastoralist than the agro-pastoralist area (OR 6.12, 95% CI 2.60-14.58). Low socioeconomic class and distance to medical facilities lengthened delays before PEP delivery. Over 20% of rabies-exposed individuals did not seek medical treatment and were not documented in official records and <65% received PEP. Animal bite injury records were an accurate indicator of rabies exposure incidence.Insufficient knowledge about rabies dangers and prevention, particularly prompt PEP, but also wound management, was the main cause of rabies deaths. Education, particularly in poor and marginalized communities, but also for medical and veterinary workers, would prevent future deaths. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 2 11 e339 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Katie Hampson Andy Dobson Magai Kaare Jonathan Dushoff Matthias Magoto Emmanuel Sindoya Sarah Cleaveland Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Thousands of human deaths from rabies occur annually despite the availability of effective vaccines following exposure, and for disease control in the animal reservoir. Our aim was to assess risk factors associated with exposure and to determine why human deaths from endemic canine rabies still occur.Contact tracing was used to gather data on rabies exposures, post-exposure prophylaxis (PEP) delivered and deaths in two rural districts in northwestern Tanzania from 2002 to 2006. Data on risk factors and the propensity to seek and complete courses of PEP was collected using questionnaires. Exposures varied from 6-141/100,000 per year. Risk of exposure to rabies was greater in an area with agropastoralist communities (and larger domestic dog populations) than an area with pastoralist communities. Children were at greater risk than adults of being exposed to rabies and of developing clinical signs. PEP dramatically reduced the risk of developing rabies (odds ratio [OR] 17.33, 95% confidence interval [CI] 6.39-60.83) and when PEP was not delivered the risks were higher in the pastoralist than the agro-pastoralist area (OR 6.12, 95% CI 2.60-14.58). Low socioeconomic class and distance to medical facilities lengthened delays before PEP delivery. Over 20% of rabies-exposed individuals did not seek medical treatment and were not documented in official records and <65% received PEP. Animal bite injury records were an accurate indicator of rabies exposure incidence.Insufficient knowledge about rabies dangers and prevention, particularly prompt PEP, but also wound management, was the main cause of rabies deaths. Education, particularly in poor and marginalized communities, but also for medical and veterinary workers, would prevent future deaths. |
format |
Article in Journal/Newspaper |
author |
Katie Hampson Andy Dobson Magai Kaare Jonathan Dushoff Matthias Magoto Emmanuel Sindoya Sarah Cleaveland |
author_facet |
Katie Hampson Andy Dobson Magai Kaare Jonathan Dushoff Matthias Magoto Emmanuel Sindoya Sarah Cleaveland |
author_sort |
Katie Hampson |
title |
Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
title_short |
Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
title_full |
Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
title_fullStr |
Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
title_full_unstemmed |
Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
title_sort |
rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2008 |
url |
https://doi.org/10.1371/journal.pntd.0000339 https://doaj.org/article/29ea41aee6a645238722e27f81f9457c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 2, Iss 11, p e339 (2008) |
op_relation |
http://europepmc.org/articles/PMC2582685?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000339 https://doaj.org/article/29ea41aee6a645238722e27f81f9457c |
op_doi |
https://doi.org/10.1371/journal.pntd.0000339 |
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PLoS Neglected Tropical Diseases |
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11 |
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e339 |
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