RESUMO
All World Health Organization (WHO) pre-qualified rabies vaccines for humans are inactivated tissue culture rabies virus formulations produced for intramuscular (IM) administration. Due to costs and vaccine shortage, dose-saving intradermal (ID) administration of rabies post-exposure prophylaxis (PEP) is encouraged by WHO. This study compared the immunogenicity of the ID 2-site, 3-visit Institut Pasteur Cambodge (IPC) PEP regimen to the IM 1-site, 4-visit 4-dose Essen regimen using Verorab vaccine (Sanofi). The development of neutralizing antibodies (nAbs) and T cell response was assessed in 210 patients with a category II or III animal exposure in a rabies-endemic country. At day 28, all participants developed nAbs (≥0.5 IU/mL), irrespective of PEP scheme, age, or administration of rabies immunoglobulin. T cell response and nAb titers were similar for both PEP schemes. This study demonstrated that the 1-week ID IPC regimen is as effective as the 2-week IM 4-dose Essen regimen in inducing an anti-rabies immune response under real-life PEP.
Assuntos
Vacina Antirrábica , Vírus da Raiva , Raiva , Animais , Humanos , Profilaxia Pós-Exposição , Injeções Intramusculares , Raiva/prevenção & controle , Anticorpos Neutralizantes , Injeções Intradérmicas , Anticorpos AntiviraisRESUMO
BACKGROUND: There is little information concerning the preventive behaviors against cervical cancer among women in Cambodia, a country without organized cervical cancer screening programs and national human papillomavirus (HPV) vaccination policies. We aimed to examine the cervical cancer knowledge, attitudes, and practices as well as cervical cancer prevention methods among Cambodian women. METHODS: A community-based cross-sectional survey on cervical cancer prevention was conducted. We conducted a face-to-face interview survey for women aged 20-69 years who lived in Kampong Speu Province. The data collection was conducted by a nurse and a trained health worker using a structured questionnaire from January 8 to February 19, 2016. The questionnaire comprised 46 questions on demographic and reproductive characteristics, knowledge of cervical cancer, related risk factors and preventive methods, and attitudes toward and practices of Pap test and HPV vaccination. A logistic regression analysis was used to evaluate the relationship between preventive behaviors against cervical cancer and related factors such as age, education, income, and knowledge of cervical cancer. RESULTS: Among the 440 respondents, 74 and 34% of women had heard about cervical cancer and the Papanicolaou (Pap) Smear test, respectively, and 7% of women had ever been screened by a Pap test. The participants showed high willingness to undergo a Pap test (74%). Furthermore, 35% of women were aware that cervical cancer is preventable by vaccination and 62% of women were willing to get the HPV vaccine, but only 1% of women had been vaccinated against HPV. Women of a younger age (odds ratio: 76.7; 95% confidence interval: 19.2-306.5 among women aged 20-29 years compared to 60-69 years, P-for-trend< 0.0001) and those who were married (odds ratio: 2.8; 95% confidence interval: 1.3-6.3) were more likely to be willing to receive the vaccination. CONCLUSIONS: Women in the Kampong Speu province of Cambodia had a low awareness of cervical cancer screening and rarely practiced cervical cancer screening. However, the willingness to get Pap test and HPV vaccination is high.