Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers.
Animals
Bites and Stings
/ therapy
Disease Eradication
/ methods
Dog Diseases
/ prevention & control
Dogs
Health Knowledge, Attitudes, Practice
Health Personnel
/ psychology
Health Services Needs and Demand
Humans
Kenya
/ epidemiology
Mass Vaccination
/ veterinary
Post-Exposure Prophylaxis
/ supply & distribution
Rabies
/ epidemiology
Rabies Vaccines
/ supply & distribution
Rural Health
awareness
knowledge
post-exposure-prophylaxis
rabies
rabies immunoglobulin
Journal
Frontiers in public health
ISSN: 2296-2565
Titre abrégé: Front Public Health
Pays: Switzerland
ID NLM: 101616579
Informations de publication
Date de publication:
2022
2022
Historique:
received:
02
09
2021
accepted:
31
01
2022
entrez:
31
3
2022
pubmed:
1
4
2022
medline:
2
4
2022
Statut:
epublish
Résumé
In Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya. We interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed. Rabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% ( The availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.
Sections du résumé
Background
In Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya.
Methodology
We interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed.
Results
Rabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% (
Conclusion
The availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.
Identifiants
pubmed: 35356016
doi: 10.3389/fpubh.2022.769898
pmc: PMC8960031
doi:
Substances chimiques
Rabies Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
769898Subventions
Organisme : FIC NIH HHS
ID : D43 TW011519
Pays : United States
Organisme : Wellcome Trust
ID : 110330/Z/15/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 207569/Z/17/Z
Pays : United Kingdom
Informations de copyright
Copyright © 2022 Chuchu, Kitala, Bichanga, Ksee, Muturi, Mwatondo, Nasimiyu, Maritim, Mutono, Beyene, Druelles, Hampson and Thumbi.
Déclaration de conflit d'intérêts
SD is an employee with Sanofi and may hold shares and/or stock options in the company. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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