Pattern of animal bites and post exposure prophylaxis in rabies: A five year study in a tertiary care unit in Sri Lanka

Abstract

BackgroundRabies is a global problem which occurs in more than 150 countries and territories including Sri Lanka, where human deaths from rabies are in decline whilst resources incurred for prevention of rabies are in sharp incline over the years. In this backdrop, we aim to audit the post-exposure treatment (PET) in rabies and the pattern of animal bites in a tertiary care hospital in Sri Lanka.MethodsThis study was carried out at Teaching Hospital Peradeniya (THP), in the Central Province of Sri Lanka from 2007-2012 where a registry of all PET has been maintained. The data from registries were extracted after obtaining permission from the hospital authority for analysis.ResultsThere were 19 661 cases of animal exposure presented to the THP over the study period of 5 years. Of them, the majority-17431(88.66 %) were definitive animal bites whilst scratches accounted for 2147(10.92 %) and 83(0.42 %) were miscellaneous exposures. According to the severity grading of injuries, 7 362(37 %) were major bites and 12 226(62 %) were minor bites. The domestic unvaccinated dogs and cats were responsible for 10,662 (54 %) and 3,982 (20 %) of exposures respectively. The total cost incurred for both anti-rabies vaccine and anti rabies serum during the study period is 24,795,888.00 Sri Lankan rupees (190,737.60US$).ConclusionsThe pattern of animal bite shows high dominance of domestic dogs and cats exposures. The age of victims ranged from infancy to old-age with higher incidence among children. Even though PET is costly, continued surveillance and rabies control is still necessary along with public education and vaccination of domestic pets.

Risk of human exposure to animal bites in China: a clinic‐based cross‐sectional study

“…The present study shows that domestic animals contributed to 87% of the exposure. This finding is inconsistent with previous studies, which reported that stray and/or roaming animals accounted for most incidents, and is in line with other studies that indicated that domestic animals were responsible for most exposures . Due to the well‐implemented China Stray Pet Care Project and overcrowded cities, there are few stray animals in the streets and communities.…”

“…Earlier studies on the epidemiology of animal bites in India, Iran, Ethiopia, Pakistan, Bhutan, and Spain reported that stray animals caused the overwhelming majority of animal bites. Several recent studies in India, Sri Lanka, and Nigeria indicated that domestic animals were responsible for most exposures. Some studies reported that animal bites were mainly provoked, while other studies indicated that most animal bites were unprovoked …”

One-year descriptive analysis of patients treated at an anti-rabies clinic—A retrospective study from Kashmir

“…In Kashmir, males usually go out more frequently for work or for social visits as compared to females. Most of the available literature on dog bites has reported a male predominance [13,14,[17][18][19][20][21][22]. The percentage of child victims varies across studies from 25% to 72% [13-20, 23, 24].…”

Preliminary survey on knowledge, attitudes and practices regarding rabies

“…2 Exposures recorded in Sri Lanka are mainly from domestic or stray animals with very little exposure from wild animals. 2 Therefore, elimination of rabies in the domestic and stray animal population would lead to a marked decline in the number of cases in Sri Lanka.…”