Perfil epidemiológico do atendimento antirrábico humano em Porto Alegre, RS, Brasil

Abstract

As mordeduras animais são injúrias que se destacam pela possibilidade de transmissão da raiva, sendo esta uma doença com letalidade de 100%. O objetivo deste trabalho foi caracterizar o perfil epidemiológico do atendimento antirrábico humano pós-exposição e analisar a adequação de sua indicação. Foi realizado estudo transversal, tendo como fonte de dados a ficha de notificação do SINAN preenchida nos serviços de saúde pelos profissionais responsáveis pelo atendimento no segundo semestre de 2006. Entre os 2.223 casos investigados, 50,3% dos indivíduos eram do sexo masculino; a faixa etária com mais agressões foi a de 20 a 59 anos (47,6%); a forma de agressão responsável pela maior número de atendimentos foi a mordedura (87,4%) e 35,3% das agressões ocorreram nos membros inferiores. A espécie animal predominante foi a canina (91,7%). Em relação ao tratamento prescrito, 78,1% dos sujeitos receberam indicação de vacina e 6,4%, soro. Foram considerados como adequadamente indicados 96,2% dos tratamentos. Embora os tratamentos tenham sido corretamente prescritos, faz-se necessária a valorização da observação do animal agressor para diminuir o número de tratamentos dispensados.

Raiva humana: avaliação da prevalência das condutas profiláticas pós-exposição no Ceará, Brasil, 2007-2015

“…These studies found that 96.2%, 93.9% and 92.0% of the attendances had adequate procedures in the cities of Porto Alegre (2006), Curitiba (2010) and Maringá (1997), respectively, showing a low percentage of inadequate procedures. 1,10,11 In Southern Brazil, no human rabies cases have been reported since 1987, and Paraná was the first Brazilian state to control rabies. 11 Prescription of anti-rabies treatment in excess of what is necessary may possibly be due to fear of patients becoming ill.…”

“…Human rabies is a highly prevalent anthropozoonosis transmitted to humans by inoculation of the rabies virus present in saliva or secretions of an infected animal, mainly by biting. 1 This disease continues to be a public health problem due to its serious clinical consequences, high fatality and costs of post-exposure treatment and medical care. 2 Between 2009 and 2011, there were 592,000 antirabies attendances per year in Brazil.…”

Avaliação da profilaxia no primeiro atendimento pós-exposição ao vírus da raiva

“…(12) A study in the city of Porto Alegre, also in the southern region of Brazil, observed that 96.20% of the visits were adequate, (13) demonstrating a reduced percentage of inadequate treatment, as advocated by the Technical Standards for the Prevention of Human Rabies. In contrast, this study found that 41.56% of anti-rabies visits were inadequate, with 13.44% having excessive treatment and 28.11% deficient treatment, and the principal excessive treatment was animal observation (51.36%), while for deficient treatment, animal observation and dispensing with vaccination (51.31%) were the most frequent.…”

“…(11) The failure to complete the data in the database of the national computerized system is a problem for research. (11,12) The surveillance system is faulty and there is a need to fix it, so that the information regarding the outcome of cases is conclusive. There is also a need to standardize the locations of records of indication and application of the prophylactic vaccine, because with the fragmentation of these locations, information regarding treatment is lost.…”

“…This initiative would provide improved quality of records and information, reducing the risk of abandonment of treatment. (12) Even so, the computerized system, Sinan, presents reliability of information contained in the Anti-rabies Attendance Sheets for the performance of data analysis. (17) The results of this study allowed us to reflect on the need for training of health professionals, in order to improve the correct treatment indicated in primary care and a reduction in unnecessary prescriptions, avoiding adverse reactions and public spending on vaccines and anti-rabies serums.…”