Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data.
Animal bite
Post-exposure prophylaxis
Rabies
Tunisia
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
27 Sep 2021
27 Sep 2021
Historique:
received:
15
09
2020
accepted:
15
09
2021
entrez:
28
9
2021
pubmed:
29
9
2021
medline:
30
9
2021
Statut:
epublish
Résumé
Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011). We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included. A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = - 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared. Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease.
Sections du résumé
BACKGROUND
BACKGROUND
Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011).
METHODS
METHODS
We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included.
RESULTS
RESULTS
A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = - 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared.
CONCLUSION
CONCLUSIONS
Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease.
Identifiants
pubmed: 34579662
doi: 10.1186/s12879-021-06700-9
pii: 10.1186/s12879-021-06700-9
pmc: PMC8477457
doi:
Substances chimiques
Rabies Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1013Informations de copyright
© 2021. The Author(s).
Références
Rev Sci Tech. 2018 Aug;37(2):617-627
pubmed: 30747148
East Mediterr Health J. 2015 Sep 28;21(8):591-7
pubmed: 26446531
Zoonoses Public Health. 2011 Mar;58(2):110-8
pubmed: 20042063
Vet Med Sci. 2021 May;7(3):686-696
pubmed: 33570258
BMC Infect Dis. 2018 Jan 3;18(1):6
pubmed: 29295708
Acad Emerg Med. 2000 Feb;7(2):157-61
pubmed: 10691074
PLoS Negl Trop Dis. 2016 Feb 12;10(2):e0004461
pubmed: 26871689
PLoS Negl Trop Dis. 2017 Jul 24;11(7):e0005787
pubmed: 28742094
Vet Q. 2017 Dec;37(1):212-251
pubmed: 28643547
PLoS Negl Trop Dis. 2010 Feb 23;4(2):e626
pubmed: 20186330
J Trop Pediatr. 2016 Feb;62(1):55-62
pubmed: 26510700
PLoS Negl Trop Dis. 2017 Jan 6;11(1):e0005271
pubmed: 28060935
East Mediterr Health J. 2017 Aug 27;23(7):507-513
pubmed: 28853135
J Glob Infect Dis. 2015 Jan-Mar;7(1):1-2
pubmed: 25722611
Rev Sci Tech. 2017 Dec;36(3):831-838
pubmed: 30160705
Bull World Health Organ. 2005 May;83(5):360-8
pubmed: 15976877
PLoS Negl Trop Dis. 2015 Apr 16;9(4):e0003709
pubmed: 25881058
Epidemiol Infect. 2018 Nov 15;147:e46
pubmed: 30428942
Front Vet Sci. 2017 Apr 13;4:52
pubmed: 28451589
World Health Organ Tech Rep Ser. 2013;(982):1-139, back cover
pubmed: 24069724
PLoS Biol. 2009 Mar 10;7(3):e53
pubmed: 19278295
PLoS One. 2018 Oct 31;13(10):e0205833
pubmed: 30379899
Int J Infect Dis. 2006 May;10(3):248-54
pubmed: 16458565
Glob J Health Sci. 2012 Aug 09;4(5):132-9
pubmed: 22980386