Demographics of animal bite victims & management practices in a tertiary care institute in Mumbai, Maharashtra, India
Demographics of animal bite victims & management practices in a tertiary care institute in Mumbai, Maharashtra, India
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动物咬伤受害者的人口统计
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
U. Thatte
中科院分区：
文献类型：
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作者：
N. Gogtay;A. Nagpal;A. Mallad;K. Patel;S. Stimpson;A. Belur;U. Thatte
背景和目标：狂犬病是全球重要的公共卫生问题，每年有超过 55,000 人死于该疾病。孟买爱德华国王纪念医院是一家三级转诊中心，狂犬病诊所 24 小时开放。鉴于缺乏有关城市环境中疾病人口统计的信息，进行了本研究。方法：收集了 2010 年 15 周内向该研究所报告的 1000 名连续动物咬伤受害者的数据。专门为获取信息而创建了一个电子数据库，该数据库以 2005 年世界卫生组织狂犬病专家磋商会提供的信息为模型。从患者角度来看，经济负担是使用直接成本和间接成本来计算的。结果：受害者主要是男性（771 名受试者）。狗是主要的咬伤动物（891，89.1%）。咬伤主要为 III 类（783 起，78.3%）。一百二十三名受试者仅使用本土疗法进行局部伤口护理。在 III 类咬伤中，783 名患者中只有 21 名 (2.7%) 服用了人狂犬病免疫球蛋白 (HRIG)，该疫苗主要用于严重咬伤或靠近面部或面部的咬伤。共有 318 名患者没有完成完整的埃森疫苗接种方案。患者每咬一口的平均成本为 220 美元（3.5 美元）。解释和结论：我们的研究结果表明，HRIG 的使用率较低，只有不到 2% 的 III 类患者服用该药物。由于疫苗和 HRIG 仍然昂贵，皮内疫苗、萨格勒布方案等较短的方案和单克隆抗体可能会在未来提供更安全且具有成本效益的选择。需要在全国不同地区进行进一步的研究。
Background & objectives: Rabies is an important public health problem worldwide and more than 55,000 people die annually of the disease. The King Edward Memorial Hospital, Mumbai, is a tertiary referral centre where a rabies clinic runs 24 hours. In view of lack of information about the demographics of the disease in an urban environment the present study was carried out. Methods: Data on 1000 consecutive animal bite victims presenting to the institute in 2010 were collected over a 15 wk period. An electronic database was specially created for capturing information and was modelled on the information available from the WHO expert consultation on rabies, 2005. Economic burden from the patients’ perspective was calculated using both direct and indirect costs. Results: The victims were largely males (771 subjects). The dog was the major biting animal (891, 89.1%). Bites were mainly of Category III (783, 78.3%). One twenty three subjects used indigenous treatments only for local wound care. Of the Category III bites, only 21 of 783 (2.7%) patients were prescribed human rabies immunoglobulin (HRIG) which was primarily for severe bites or bites close to or on the face. A total of 318 patients did not complete the full Essen regime of the vaccine. The median cost to the patient per bite was 220 (3.5 USD). Interpretation & conclusions: Our findings showed that the use of HRIG was low with less than 2 per cent of the Category III patients being prescribed it. As vaccine and HRIG continue to remain expensive, the intradermal vaccine, shorter regimes like the Zagreb regime and monoclonal antibodies may offer safer and cost-effective options in the future. Further studies need to be done in different parts of the country.