Improving the provision of rabies post-exposure prophylaxis

Cauchemez, Simon; Bourhy, Hervé

doi:10.1016/s1473-3099(18)30606-6

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…More generally, district councils may vary in terms of follow up, levels of staff training and availability of funds that affects the quality of operations. These points likely apply to other LMIC settings and should be considered if efforts are made to improve PEP access and introduce IBCM (30). Nonetheless, once trained, both health workers and LFOs were able to fully implement IBCM independent of the research team, and IBCM activities were mostly adopted and integrated within routine duties.…”

Section: Discussionmentioning

confidence: 97%

One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania

Lushasi

Steenson

Bernard

et al. 2020

Front. Public Health

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Section: Discussionmentioning

confidence: 97%

One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania

Lushasi

Steenson

Bernard

et al. 2020

Front. Public Health

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“…In addition to increasing dog rabies vaccination coverage, investigation of animal bites can provide information to support administration of PEP and help reduce rabies among the dog population [ 22 ]. An IBCM approach in Hunan Province could include increasing laboratory capacity to diagnose animal rabies (including introducing sensitive and specific point of care tests for laboratory diagnosis), training of animal surveillance officers and bite investigators, along with the use of equipment for safe animal capture [ 11 , 22 , 23 ]. Following a report of a patient seeking care for an animal wound in county A, for example, investigators could locate and either euthanize the animal for testing or confine the animal for observation [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Improving diagnostic testing for rabies [ 22 ] and implementing dog vaccination campaigns [ 24 ] are also needed. Although these steps are important components of rabies elimination, this project highlights the importance of ensuring access and quality delivery of rabies PEP and RIG following possible exposures [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing clinicians’ Post-Exposure Prophylaxis recommendations for rabies virus exposures in Hunan Province, China

et al. 2021

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Background Timely and appropriate administration of post-exposure prophylaxis (PEP) is an essential component of human rabies prevention programs. We evaluated patient care at rabies clinics in a high-risk county in Hunan Province, China to inform strategies needed to achieve dog-mediated human rabies elimination by 2030. Methods We collected information on PEP, staff capacity, and service availability at the 17 rabies clinics in the high-risk county during onsite visits and key staff interviews. Additionally, we conducted observational assessments at five of these clinics, identified through purposive sampling to capture real-time information on patient care during a four-week period. Wound categories assigned by trained observers were considered accurate per national guidelines for comparison purposes. We used the kappa statistic and an alpha level of 0.05 to assess agreement between observers and clinic staff. Results In 2015, the 17 clinics provided PEP to 5,261 patients. Although rabies vaccines were available at all 17 clinics, rabies immune globulin (RIG) was only available at the single urban clinic in the county. During the assessment period in 2016, 196 patients sought care for possible rabies virus exposures. According to observers, 88 (44%) patients had category III wounds, 104 (53%) had category II wounds and 4 (2%) had category I wounds. Observers and PEP clinic staff agreed on approximately half of the assigned wound categories (kappa = 0.55, p-value< 0.001). Agreement for the urban county-level CDC clinic (kappa = 0.93, p-value<0.001) was higher than that of the rural township clinics (kappa = 0.16, p-value = 0.007). Using observer assigned wound categories, 142 (73%) patients received rabies vaccinations and RIG as outlined in the national guidelines. Conclusion Rabies PEP services were available at each town of the project county; however, gaps between clinical practice of PEP and recommendations of national rabies guidelines were identified. We used these findings to develop and implement a training to rabies clinic staff on wound categorization, wound care, and appropriate use of PEP. Additional risk-based approaches for evaluating human rabies virus exposures may be needed as China progresses towards elimination.

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“…By mutating, viruses become better adapted to their environment and the physiological status of various hosts [2]. More than 6% of infectious diseases that affect human beings originate from animals, and more than half of animal diseases can be transmitted to humans; as such, researchers pay particular attention to such diseases [3]. The zoonotic disease studied in this paper is rabies, which is caused by the rabies virus and can damage the central nervous system in humans.…”

Section: Introductionmentioning

confidence: 99%

Application of a Mathematical Model in Determining the Spread of the Rabies Virus: Simulation Study

Huang

2020

JMIR Med Inform

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Background Rabies is an acute infectious disease of the central nervous system caused by the rabies virus. The mortality rate of rabies is almost 100%. For some countries with poor sanitation, the spread of rabies among dogs is very serious. Objective The objective of this paper was to study the ecological transmission mode of rabies to make theoretical contributions to the suppression of rabies in China. Methods A mathematical model of the transmission mode of rabies was constructed using relevant data from the literature and officially published figures in China. Using this model, we fitted the data of the number of patients with rabies and predicted the future number of patients with rabies. In addition, we studied the effectiveness of different rabies suppression measures. Results The results of the study indicated that the number of people infected with rabies will rise in the first stage, and then decrease. The model forecasted that in about 10 years, the number of rabies cases will be controlled within a relatively stable range. According to the prediction results of the model reported in this paper, the number of rabies cases will eventually plateau at approximately 500 people every year. Relatively effective rabies suppression measures include controlling the birth rate of domestic and wild dogs as well as increasing the level of rabies immunity in domestic dogs. Conclusions The basic reproductive number of rabies in China is still greater than 1. That is, China currently has insufficient measures to control rabies. The research on the transmission mode of rabies and control measures in this paper can provide theoretical support for rabies control in China.

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Improving the provision of rabies post-exposure prophylaxis

Cited by 8 publications

References 8 publications

One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania

One Health in Practice: Using Integrated Bite Case Management to Increase Detection of Rabid Animals in Tanzania

Assessing clinicians’ Post-Exposure Prophylaxis recommendations for rabies virus exposures in Hunan Province, China

Application of a Mathematical Model in Determining the Spread of the Rabies Virus: Simulation Study

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