Assessing the burden of human rabies in India: results of a national multi-center epidemiological survey
Assessing the burden of human rabies in India: results of a national multi-center epidemiological survey
复制标题
DOI：
10.1016/j.ijid.2005.10.007
复制
发表时间：
2007-01-01
影响因子：
8.4
通讯作者：
Gangaboraiah
中科院分区：
文献类型：
--
作者：
Sudarshan, M. K.;Madhusudana, S. N.;Gangaboraiah
目的：人类狂犬病自古以来一直是印度的地方病，从未对该病的真实发病率和全国流行病学因素进行过研究。本研究的主要目的是估计每年的发病率在印度的基础上，社区调查，并描述其显着的流行病学features.Methods：该协会的预防和控制狂犬病在印度（APCRI）进行了一项全国性的多中心调查的帮助下，在2003年2月至8月期间的21所医学院。这项基于社区的调查覆盖了印度大陆1 080万代表性人口。还从22家传染病医院获得了基于医院的数据。安达曼群岛，尼科巴岛，和Lakshadweep，报告为免费的狂犬病，也进行了单独的调查。结果：人类狂犬病的年发病率估计为17 137（95%CI 14 10920 165）。根据专家小组的建议，在此基础上增加了20%，以包括麻痹/非典型形式的狂犬病，估计有20 565例，即每10万人口约有2例。大多数受害者是来自农村地区的成年配偶，未接种疫苗。咬伤的主要动物是狗（96.2%），其中大多数是流浪狗。最常见的咬伤部位是四肢。疾病潜伏期为两周到六个月。临床表现以恐水症为主。许多受害者在被动物咬伤后求助于土著形式的治疗，其中只有大约一半人寻求医院治疗。这些患者中约有10%接受了Semple或细胞培养疫苗的部分疗程。安达曼，尼科巴，和Lakshadweep的岛屿被发现是免费的狂犬病。结论：人类狂犬病继续在印度流行的安达曼，尼科巴，和Lakshadweep的岛屿除外。狗仍然是主要的储存库。由于缺乏对接触后适当免疫接种的认识，这种疾病正在对成年男子和儿童造成损害，其中大多数来自农村地区。成功进一步减少印度狂犬病的关键在于提高现代狂犬病疫苗的覆盖率，控制犬狂犬病，并加强对该疾病的公众教育。(c)2006年国际传染病学会。出版社：Elsevier Ltd. rights reserved.
Objective: Human rabies has been endemic in India since time immemorial, and the true incidence of the disease and nationwide epidemiological factors have never been studied. The main objectives of the present study were to estimate the annual incidence of human rabies in India based on a community survey and to describe its salient epidemiological features.Methods: The Association for Prevention and Control of Rabies in India (APCRI) conducted a national multi-center survey with the help of 21 medical schools during the period February-August 2003. This community-based survey covered a representative population of 10.8 million in mainland India. Hospital-based data were also obtained from the 22 infectious diseases hospitals. A separate survey of the islands of Andaman, Nicobar, and Lakshadweep, reported to be free from rabies, was also undertaken.Results: The annual incidence of human rabies was estimated to be 17 137 (95% CI 14 10920 165). Based on expert group advice, an additional 20% was added to this to include paralytic/ atypical forms of rabies, providing an estimate of 20 565 or about 2 per 100 000 population. The majority of the victims were mate, adult, from rural areas, and unvaccinated. The main animals responsible for bites were dogs (96.2%), most of which were stray. The most common bite sites were the extremities. The disease incubation period ranged from two weeks to six months. Hydrophobia was the predominant clinical feature. Many of the victims had resorted to indigenous forms of treatment following animal bite, and only about half of them had sought hospital attention. Approximately 10% of these patients had taken a partial course of either Semple or a cell culture vaccine. The islands of Andaman, Nicobar, and Lakshadweep were found to be free of rabies.Conclusion: Human rabies continues to be endemic in India except for the islands of Andaman, Nicobar, and Lakshadweep. Dogs continue to be the principal reservoir. The disease is taking its toll on adult men and children, the majority from rural areas, due to lack of awareness about proper post-exposure immunization. The keys to success in the further reduction of rabies in India ties in improved coverage with modern rabies vaccines, canine rabies control, and intensifying public education about the disease. (c) 2006 International Society for Infectious Diseases. Published by Elsevier Ltd. All. rights reserved.