Descriptive assessment of rabies post-exposure prophylaxis procurement, distribution, monitoring, and reporting in four Asian countries: Bangladesh, Bhutan, Cambodia, and Sri Lanka, 2017-2018
Descriptive assessment of rabies post-exposure prophylaxis procurement, distribution, monitoring, and reporting in four Asian countries: Bangladesh, Bhutan, Cambodia, and Sri Lanka, 2017-2018
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DOI：
10.1016/j.vaccine.2018.10.011
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发表时间：
2019-10-03
期刊：
影响因子：
5.5
通讯作者：
Hyde, Terri B.
中科院分区：
文献类型：
--
作者：
Li, Anyie J.;Sreenivasan, Nandini;Hyde, Terri B.
背景：亚洲每年约有35，000人死于狂犬病。狂犬病可以通过及时的暴露后预防（PEP）来预防，包括伤口清洗，狂犬病疫苗，在某些情况下，狂犬病免疫球蛋白（RIG）。然而，获得狂犬病PEP往往仍然局限于城市地区，成本高昂。关于狂犬病PEP的采购、分发、监测和报告的信息很少：我们在2017年3月至2018年5月期间采访了孟加拉国、不丹、柬埔寨和斯里兰卡各级公共部门的关键线人，使用描述性评估工具获得关于狂犬病PEP采购、分发、监测和报告的信息。这四个亚洲国家被选中展示一系列狂犬病PEP系统。国家狂犬病协调中心在每个国家进行了采访，协调中心帮助确定额外的关键线人在较低的levels.Results：共22个关键线人进行了采访，在各级（中央一级卫生设施水平），包括在每个国家的国家狂犬病协调中心。每个国家都有一个独特的系统来管理狂犬病PEP的采购、分配、监测和报告。对于那些有潜在狂犬病暴露的人，有不同程度的PEP访问。狂犬病PEP在孟加拉国、不丹和斯里兰卡全国各地的选定卫生设施提供。在柬埔寨，狂犬病PEP仅限于两个城市中心。在所有四个国家，RIG的可用性都是有限的。在这四个国家，狂犬病PEP分配系统的大部分方面独立于其他疫苗系统运行。然而，在不丹，狂犬病PEP疫苗和扩大免疫规划疫苗在一些地方共用冷链空间，处于最低水平。所有国家都有一个监测系统，但有有限的数据报告，特别是中央level.Conclusion：系统采购，交付，监测和报告狂犬病PEP是不同的国家。在各国之间更广泛地分享有关实践的信息可以帮助项目增加获得这种拯救生命的治疗的机会。(C)2018作者爱思唯尔有限公司出版
Background: There are approximately 35,000 human deaths from rabies in Asia annually. Rabies can be prevented through timely post-exposure prophylaxis (PEP) consisting of wound washing, rabies vaccine, and in some cases, rabies immunoglobulin (RIG). However, access to rabies PEP often remains limited to urban areas and is cost-prohibitive. There is little information on procurement, distribution, monitoring, and reporting of rabies PEP.Methods: We interviewed key informants in the public sector from various levels in Bangladesh, Bhutan, Cambodia, and Sri Lanka between March 2017 and May 2018 using a descriptive assessment tool to obtain information on procurement, distribution, monitoring, and reporting of rabies PEP. These four countries in Asia were chosen to showcase a range of rabies PEP systems. National rabies focal points were interviewed in each country and focal points helped identify additional key informants at lower levels.Results: A total of 22 key informants were interviewed at various levels (central level to health facility level) including national rabies focal points in each country. Each country has a unique system for managing rabies PEP procurement, distribution, monitoring, and reporting. There are varying levels of PEP access for those with potential rabies exposures. Rabies PEP is available in select health facilities throughout the country in Bangladesh, Bhutan, and Sri Lanka. In Cambodia, rabies PEP is limited to two urban centers. The availability of RIG in all four countries is limited. In these four countries, most aspects of the rabies PEP distribution system operate independently of systems for other vaccines. However, in Bhutan, rabies PEP and Expanded Programme on Immunization (EPI) vaccines share cold chain space in some locations at the lowest level. All countries have a monitoring system in place, but there is limited reporting of data, particularly to the central level.Conclusion: Systems to procure, deliver, monitor, and report on rabies PEP are variable across countries. Sharing information on practices more widely among countries can help programs to increase access to this life-saving treatment. (C) 2018 The Authors. Published by Elsevier Ltd.