RESUMO
Rabies is a deadly zoonotic disease most often transmitted to humans through a dog bite. Human mortality from endemic canine rabies is estimated by WHO to be around 55,000 deaths annually, with over 31,000 deaths in Asia alone, mostly children. Most of these deaths could be prevented through post-exposure prophylaxis (PEP), including immediate wound washing, rabies immunoglobulin administration and vaccination. Unfortunately, at-risk populations are not well-informed of the risk of rabies and what to do in the event of an animal bite. In order to identify the main gaps in rabies information and better define the most urgent information actions to be undertaken, the Asian Rabies Expert Bureau (AREB) conducted a multicentre, multi-country survey of patients seeking rabies post-exposure prophylaxis in rabies prevention centres from 1 July 2007 to 31 January 2008, in Bangladesh, China, India, Indonesia, Pakistan, the Philippines, Sri Lanka, and Thailand. Questionnaires were completed for 4377 subjects in the eight countries. Data was collected regarding the patient, former rabies exposures, the present wound, rabies exposure management, and rabies awareness. Two major issues were identified where active information of the population could make a difference: the necessity to apply appropriate wound care and to consult the nearest rabies prevention centre as soon as possible.
Assuntos
Atitude Frente a Saúde , Mordeduras e Picadas/virologia , Raiva/prevenção & controle , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Animais , Ásia , Doenças do Gato/transmissão , Doenças do Gato/virologia , Gatos , Doenças do Cão/transmissão , Doenças do Cão/virologia , Cães , Feminino , Humanos , Imunoglobulinas/administração & dosagem , Imunoglobulinas/imunologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Raiva/epidemiologia , Raiva/fisiopatologia , Raiva/terapia , Vírus da Raiva/imunologia , Classe Social , Inquéritos e Questionários , Organização Mundial da Saúde , Adulto JovemRESUMO
The total costs to all payers, i.e., a societal perspective, of four rabies post-exposure regimens were evaluated in two dog bite centres and four local health centres in India. Results showed that the Thai Red Cross intra-dermal regimen (TRC-ID), which uses only one-fifth of the IM dose of purified vero cell vaccine (PVRV) was at most 20% more expensive than use of Purified Chick Embryo Cell (PCEC) vaccine at one-tenth of the IM dose: this cost difference needs to be balanced with the small margin of safety of low potency doses. In local health centres where the staffs are not specially trained in rabies vaccination, the Zagreb intra-muscular regimen is an economical option.
