Determinants of delay in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: Hospital based study
Determinants of delay in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: Hospital based study
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DOI：
10.1016/j.vaccine.2013.10.067
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发表时间：
2013-12-17
期刊：
影响因子：
5.5
通讯作者：
Rajoura, O. P.
中科院分区：
文献类型：
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作者：
Joseph, Jessy;Sangeetha, N.;Rajoura, O. P.
背景：印度是狂犬病高度流行的地区。虽然狂犬病是致命的，但它是一种可以预防的疾病。有几个因素会干扰人群中暴露后预防 (PEP) 的及时利用。有必要探讨导致 PEP 启动延迟的因素。 目的：研究在德里一家医院门诊部 (OPD) 的抗狂犬病诊所就诊的动物咬伤病例中延迟启动 PEP 的相关因素。 材料和方法：对 200 名在抗狂犬病诊所就诊的患者进行了一项横断面医院研究。在获得知情同意后，使用预先测试的半结构化问卷对患者进行访谈，以找出 PEP 启动延迟及其相关因素。 结果：发现最常见的咬伤动物是狗（96%）。在研究对象 (n = 200) 中，134 名 (67%) 为男性，123 名 (61.5%) 来自农村地区，61 名 (30.5%) 为文盲。 41% 的研究对象发现 PEP 启动延迟（疫苗启动时间超过或等于 48 小时）。研究对象每次访问所花费的平均时间为 3.46 小时 (SD 1.60)。居住在距疫苗接种中心 10 公里以上 (p < 0.001) 且家庭月收入低于 5000 印度卢比 (p = 0.004) 的人群中，延迟接种的可能性更大。随着年龄的增长，延迟呈增加趋势（p = 0.041）。受访者（n = 82）最常提到的无法提前接种疫苗的原因包括工作障碍（42.68%）、狂犬病诊所周日/国定假日休息（36.59%）以及不了解及时的PEP（31.71%）。 结论：交通便利和经济状况较差是延迟开始狂犬病预防PEP的主要因素。 (C) 2013 Elsevier Ltd. 保留所有权利。
Background: India is highly endemic for rabies. Although fatal, rabies is a preventable disease. Several factors interfere with the timely utilization of post exposure prophylaxis (PEP) in the population. There is a need to explore the factors leading to delay in PEP initiation.Objective: To study the factors associated with delay in initiation of PEP among animal bite cases attending anti-rabies clinic in the out-patient department (OPD) of a hospital in Delhi.Materials and methods: A cross-sectional hospital based study was conducted among 200 patients attending the anti-rabies clinic. After obtaining informed consent, the patients were interviewed using a pre-tested, semi-structured questionnaire to find out the delay in initiation of PEP and the factors associated with it.Results: Most common biting animal was found to be dog (96%). Out of the studied subjects (n = 200), 134 (67%) were males, 123 (61.5%) were from rural areas and 61 (30.5%) were illiterate. Delay in initiation (vaccine initiation in more than or equal to 48 h) of PEP was found among 41% of the studied subjects. The mean time spent during each visit by the study subjects were 3.46 h (SD 1.60). Delay was more likely in people living at a distance of more than 10 km from the vaccination centre (p < 0.001) and with a monthly family income less than 5000 INR (p = 0.004). Delay showed an increasing trend with age (p = 0.041). Most commonly cited reasons by the respondents (n = 82) for the inability to come early for vaccination included work related barriers (42.68%), anti-rabies clinic being closed on Sundays/national holidays (36.59%) and unawareness about timely PEP (31.71%).Conclusion: Accessibility and lower economic status were the major factors associated with delay in initiation of PEP for rabies prevention. (C) 2013 Elsevier Ltd. All rights reserved.