Epidemiology and surveillance of human animal-bite injuries and rabies post-exposure prophylaxis, in selected counties in Kenya, 2011-2016.
Epidemiology and surveillance of human animal-bite injuries and rabies post-exposure prophylaxis, in selected counties in Kenya, 2011-2016.
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DOI：
10.1186/s12889-018-5888-5
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发表时间：
2018-08-09
影响因子：
4.5
通讯作者：
Obonyo M
中科院分区：
文献类型：
--
作者：
Ngugi JN;Maza AK;Omolo OJ;Obonyo M
人类动物咬伤是一个严重的公共卫生问题，因为狂犬病病毒暴露的相关风险。动物咬伤，特别是狗咬伤是评估狂犬病病毒传播风险和狂犬病暴露后预防（PEP）需求的有用指标。了解动物咬伤的流行病学和监测以及狂犬病暴露后预防对于实施肯尼亚的国家狂犬病消除战略至关重要。我们的目的是描述人类动物咬伤的发生率，病人/咬伤动物的特点，狂犬病PEP的吸收和与动物咬伤事件相关的因素。我们审查了来自五个县的17个卫生机构的门诊和抗狂犬病疫苗（ARV）登记处的动物咬伤记录。动物咬伤被定义为2011年1月至2016年12月期间任何年龄段的人在登记册中记录的哺乳动物（包括人类）的动物咬伤。我们收集了人口统计学和PEP摄取的信息。我们计算了描述性统计量、比值比（OR）和95%置信区间（CI），以检查与成为动物咬伤病例患者相关的因素。我们还使用2016年卫生机构集水区人口作为分母计算了动物咬伤的发生率。我们分析了7307条记录。中位年龄为22岁（IQR = 31岁）;男性4019人（55%），年龄< 15岁的2607人（37%）。狗占6720（93%）的咬伤，其中78%是拥有自由漫游的狗。在5674例（88%）接受狂犬病PEP的病例中，2247例（40%）至少接受了三剂。从咬伤到就医的中位时间为2天（IQR = 4天）。头面部被咬伤（OR = 5.8; CI：3.3-10.2）、被自家流浪狗咬伤（OR = 1.7; CI：1.5-1.9）和男性（OR = 1.4; CI：1.3-1.5）与动物咬伤病例显著相关。在多变量logistic回归分析中，男性、头部/面部被咬伤和被自己的自由漫游狗咬伤仍然与动物咬伤病例-患者独立相关。所有县的咬伤发生率为289次/10万人。预防狗咬伤将最有效地减少咬伤，方法是改善15岁以下儿童的公共卫生教育，鼓励尽早开始和完成PEP，制定和实施负责任的狗所有权和动物行为教育方案，以及改善人类和兽医健康的联系。本文的在线版本（10.1186/s12889-018-5888-5）包含补充材料，可供授权用户使用。
Human animal-bite injuries are a serious public health problem due to associated risk for rabies virus exposure. Animal-bite injuries especially dog bites are useful indicators for assessing the risk of rabies virus transmission and need for rabies post exposure prophylaxis (PEP). Understanding the epidemiology and surveillance of animal bites and rabies post-exposure prophylaxis is critical in implementing Kenya’s national rabies elimination strategy. We aimed to describe the incidence of human animal-bite injuries, patient/biting animal characteristics, uptake of rabies PEP and factors associated with animal bite incidents. We reviewed animal bite records from outpatient and anti-rabies vaccine (ARV) registers of 17 health facilities from five counties. An animal bite was defined as an entry of an animal bite of the class mammal including humans in registers in a person of any age from January 2011 to December 2016. We collected demographic and information on PEP uptake. We calculated descriptive statistics, odds ratios (OR) and 95% confidence interval (CI) to examine factors associated with being an animal bite case-patient. We also calculated incidence of animal bites using health facility catchment population for year 2016 as the denominator. We analyzed 7307 records. The median age was 22 years (IQR = 31 years); there were 4019 (55%) male and age < 15 years were 2607 (37%). Dogs accounted for 6720 (93%) of bites of which 78% were owned free-roaming dogs. Of the 5674 (88%) cases that received rabies PEP, 2247 (40%) got at least three-doses. The median time from bite to seeking medical care was 2 days (IQR = 4 days). Being bitten on the head/face (OR = 5.8; CI: 3.3–10.2); being bitten by owned free-roaming dog (OR = 1.7; CI: 1.5–1.9) and being male (OR = 1.4; CI: 1.3–1.5) were significantly associated with being an animal-bite case-patient. Being male, being bitten on head/face and being bitten by owned free-roaming dog remained independently associated with being an animal bite case-patient at multivariable logistic regression. Bite-incidence was 289 bites /100,000 persons among all counties. Preventing dog bites would most effectively reduce bite injuries by improving public health education among children below 15 years, encouraging early PEP initiation and completion, development and implementation of responsible dog ownership and animal behaviour educational programmes as well as improving human and veterinary health linkages. The online version of this article (10.1186/s12889-018-5888-5) contains supplementary material, which is available to authorized users.
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影响因子：
3.8
作者：
Hampson K;Coudeville L;Lembo T;Sambo M;Kieffer A;Attlan M;Barrat J;Blanton JD;Briggs DJ;Cleaveland S;Costa P;Freuling CM;Hiby E;Knopf L;Leanes F;Meslin FX;Metlin A;Miranda ME;Müller T;Nel LH;Recuenco S;Rupprecht CE;Schumacher C;Taylor L;Vigilato MA;Zinsstag J;Dushoff J;Global Alliance for Rabies Control Partners for Rabies Prevention
通讯作者：
Global Alliance for Rabies Control Partners for Rabies Prevention
影响因子：
11.4
作者：
MacBean, Catherine E.;Taylor, David McD;Ashby, Karen
通讯作者：
Ashby, Karen
影响因子：
3.3
作者：
Fèvre, EM;Kaboyo, RW;Cleaveland, S
通讯作者：
Cleaveland, S
影响因子：
5.5
作者：
Joseph, Jessy;Sangeetha, N.;Rajoura, O. P.
通讯作者：
Rajoura, O. P.
DOI：
10.1016/s2214-109x(17)30321-2
发表时间：
2017-10
期刊：
The Lancet. Global health
影响因子：
--
作者：
Etheart MD;Kligerman M;Augustin PD;Blanton JD;Monroe B;Fleurinord L;Millien M;Crowdis K;Fenelon N;Wallace RM
通讯作者：
Wallace RM