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Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants.

Abstract Rabies is invariably a fatal disease. Appropriate wound treatment and prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China.
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Authors

Mayor MeshTerms

Health Knowledge, Attitudes, Practice

Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28692657
OWN - NLM
STAT- MEDLINE
DA  - 20170710
DCOM- 20170801
LR  - 20170801
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul
TI  - Improper wound treatment and delay of rabies post-exposure prophylaxis of animal 
      bite victims in China: Prevalence and determinants.
PG  - e0005663
LID - 10.1371/journal.pntd.0005663 [doi]
AB  - BACKGROUND: Rabies is invariably a fatal disease. Appropriate wound treatment and
      prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies
      prevention. The objective of this study was to investigate the prevalence and
      influencing factors of improper wound treatment and delay of rabies PEP after an 
      animal bite in Wuhan, China. METHODOLOGY: This cross-sectional study was
      conducted among animal bite victims visiting rabies prevention clinics (RPCs). We
      selected respondents by a multistage sampling technique. A face-to-face interview
      was conducted to investigate whether the wound was treated properly and the time 
      disparity between injury and attendance to the RPCs. Determinants of improper
      wound treatment and delay of rabies PEP were identified by a stepwise
      multivariate logistic regression analysis. PRINCIPAL FINDINGS: In total, 1,015
      animal bite victims (564 women and 451 men) responded to the questionnaire, and
      the response rate was 93.98%. Overall, 81.2% of animal bite victims treated their
      wounds improperly after suspected rabies exposure, and 35.3% of animal bite
      victims delayed the initiation of PEP. Males (OR = 1.871, 95% CI: 1.318-2.656),
      residents without college education (OR = 1.698, 95% CI: 1.203-2.396),
      participants liking to play with animals (OR = 1.554, 95% CI: 1.089-2.216), and
      people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096-2.270), were
      more likely to treat wounds improperly after an animal bite. Patients aged 15-44 
      years (OR = 2.324, 95% CI: 1.457-3.707), who were bitten or scratched by a
      domestic animal (OR = 1.696, 95% CI: 1.103-2.608) and people who knew the
      incubation period of rabies (OR = 1.844, 95% CI: 1.279-2.659) were inclined to
      delay the initiation of PEP. CONCLUSIONS: Our investigation shows that improper
      wound treatment and delayed PEP is common among animal bite victims, although
      RPCs is in close proximity and PEP is affordable. The lack of knowledge and poor 
      awareness might be the main reason for improper PEP. Educational programs and
      awareness raising campaigns should be a priority to prevent rabies, especially
      targeting males, the less educated and those aged 15-44 years.
FAU - Liu, Qiaoyan
AU  - Liu Q
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Wang, Xiaojun
AU  - Wang X
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Liu, Bing
AU  - Liu B
AD  - Center of Health Administration and Development Studies, Hubei University of
      Medicine, Shiyan, Hubei, China.
FAU - Gong, Yanhong
AU  - Gong Y
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Mkandawire, Naomie
AU  - Mkandawire N
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Li, Wenzhen
AU  - Li W
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Fu, Wenning
AU  - Fu W
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Li, Liqing
AU  - Li L
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
AD  - School of Economics and Management, Jiangxi Science and Technology Normal
      University, Nanchang, Jiangxi, China.
FAU - Gan, Yong
AU  - Gan Y
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Shi, Jun
AU  - Shi J
AD  - Department of Orthopedics, Shiyan Traditional Chinese Medicine Hospital, Shiyan, 
      Hubei, China.
FAU - Shi, Bin
AU  - Shi B
AD  - Xinhua Street Community health center of Jianghan District, Wuhan, Hubei, China.
FAU - Liu, Junan
AU  - Liu J
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Cao, Shiyi
AU  - Cao S
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
FAU - Lu, Zuxun
AU  - Lu Z
AUID- ORCID: http://orcid.org/0000-0001-8432-5109
AD  - School of Public Health, Tongji Medical College, Huazhong University of Science
      and Technology, Wuhan, Hubei, China.
LA  - eng
PT  - Journal Article
DEP - 20170710
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Rabies Vaccines)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Animals
MH  - Animals, Domestic/virology
MH  - Bites and Stings/*epidemiology
MH  - Child
MH  - Child, Preschool
MH  - China/epidemiology
MH  - Cross-Sectional Studies
MH  - Debridement
MH  - Female
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Infant
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Post-Exposure Prophylaxis/*statistics & numerical data
MH  - Rabies/*epidemiology/*prevention & control
MH  - Rabies Vaccines/*therapeutic use
MH  - Surveys and Questionnaires
MH  - Time-to-Treatment
MH  - Young Adult
EDAT- 2017/07/12 06:00
MHDA- 2017/08/02 06:00
CRDT- 2017/07/11 06:00
PHST- 2016/12/28 [received]
PHST- 2017/05/24 [accepted]
PHST- 2017/07/20 [revised]
AID - 10.1371/journal.pntd.0005663 [doi]
AID - PNTD-D-16-02232 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jul 10;11(7):e0005663. doi:
      10.1371/journal.pntd.0005663. eCollection 2017 Jul.