epidemiological study on animal bite cases
DESCRIPTION
This presentation has detailed analysis of animal bite cases regarding their knowledge,attitude and practices,and epidemiology of animal bite cases.TRANSCRIPT
An Epidemiological Study of Animal
Bite Cases Attending A Tertiary Care
Hospital In Western District Of
Rajasthan
Manish Mittal
Final Year Resident
Department of Community Medicine,
Dr .S.N. Medical College, Jodhpur,
Rajasthan
• Introduction
• Objectives
• Material and methods
• Results
• Conclusion
• Recommendations
• References
INTRODUCTION
Rabies has terrified man since antiquity
as it is invariably fatal and perhaps the
most painful and horrible of all
communicable diseases.
Rabies is known to be present in more
than 150 countries and territories.
About 26,400 - 61,000 deaths occur
annually from rabies with more human
deaths occur in Asia than anywhere else
in the world.(30,000 deaths per annum).
Some 84% of deaths from rabies occur
in rural areas, with 4 out of every 10
deaths being a child.
In India, dogs are responsible for about
97% of human rabies, followed by cats
(2%), jackals, mongoose and others (1%).
OBJECTIVESTo assess the knowledge and practices
of animal bite cases attending anti-rabies clinic.
To study the relationship of socio-demographic factors on knowledge and practices of these animal bite cases.
MATERIALS AND METHODS
STUDY DESIGN:
-Hospital based Cross Sectional Study
STUDY SETTING:
-Anti-rabies Clinic at M.G. Hospital,
Jodhpur
STUDY PERIOD:
-From July-2012 to September-2012
STUDY SUBJECTS:
-Total 1,213Animal bite cases.
TOOL:
-Self Designed and Pre-tested Questionnaire
TECHNIQUE:
-Prior consent was taken from cases attending
Anti-rabies clinic.
-Questionnaire developed for the purpose of the
study was filled out for each consecutive patient
through interview.
STASTISTICAL ANALYSIS;
-Data thus generated was
analyzed by using SPSS
version16th
-Appropriate figures and tables
were generated and χ2Test was
used for statistical inferences.
Results
Age wise distribution of Patients(in Years)
0 to 1037%
11 to 2024%
21 to 3013%
31 to 4010%
41 to 508%
51 to 605%
>604%
Distribution of patients according to Education status
Illiterate31%
Primary30%
Middle12%
Secondary13%
Graduate10%
Post-Graduate And Above
5%
Distribution of animal bite victims on the basis of their occupation
Laborers21%
Farming22%
Private service2%Govt. service
4%Business
2%
House wife7%
Unemployed5%
Student37%
Distribution of patients according to residence
Urban60%
Rural40%
Distribution of patients regarding awareness about rabies
Aware66%
Not aware34%
Source of information about rabies(n=802)
32
16
27
5
16
4
0
5
10
15
20
25
30
35
Family members
Other relatives
Neighbours Mass media Health personnel
Others
Pe
rce
nta
ge
Source of information
Knowledge about fatal nature of disease(n=802)
Yes31%
No69%
Knowledge about vaccine preventable nature of the disease(n=802)
Yes81%
No19%
Distribution of animal bite victims on the basis of species of biting animal
94.4
2.22 1.8 0.7 0.880
10
20
30
40
50
60
70
80
90
100
Dog Rat Cat Monkey Others
Pe
rce
nta
ge
Species of animal
Circumstances of Animal bite
Unprovoked74%
Provoked26%
Distribution of animal bite victims on the basis of
manner of cleaning the wound
Not cleaned 67%
Cleaned with water28%
Cleaned with Water and soap
5%
Distribution of animal bite victims on the basis of
type of substance applied on the wound
Dettol6%
Lime2%
Chili powder88%
None4%
Distribution of animal bite victims on the basis of their reporting time in Hospital
On Day of bite52%
After 1 Day37%
After 2 Days5%
After 3 Days3%
After 4 Days2%
After 1 Week or More1%
Distribution of patients according to cause of delay in reporting at hospital(n=583)
12.5
3.77
28.3
52
1.9 1.02 0.510
10
20
30
40
50
60
According to them animal
was normal at the time of bite
Victim/Family decided that there was no
need of treatment
Victim was too busy to come
Due to long distance from residence to
hospital
Lack of money Fear of treatment
Any other reason
Pe
rce
nta
ge
Distribution of animal bite victims on the basis of site of bite
Head and neck10% Upper limb
9%
Lower limb73%
Thorax and abdomen
8%
Distribution of animal bite victims on the
basis of category of bite
0.5%
26 %
73.5%
Category I Category II Category III
Distribution of patients regarding status of treatment completion
Completed94%
Not completed
6%
Relationship between awareness about rabies and literacy status(n=1213)
Awareness
Literacy
status
Yes No Total
Illiterate 129(32.36%) 251(67.64%) 380(100%)
Literate 673(80.79%) 160(19.21%) 833(100%)
Total 802(66.11%) 411(33.89%) 1213(100%)
χ2=255.6, df=1, p = 0.00
Relationship between awareness about rabies and Residence (n=1213)
Awareness
Residence Yes No Total
Urban 501(68.81%) 227(31.19%) 728(100%)
Rural 301(62.06%) 184(37.94%) 485(100%)
Total 802(66.11%) 411(33.89%) 1213(100%)
χ2=5.93, df=1, p = 0.01
Relationship between awareness about rabies and reporting time to the hospital(n=1213)
Awareness
Reported Yes No Total
On the
same day
427(67.77%) 203(32.23%) 630(100%)
Delayed 375(64.32%) 208(35.68%) 583(100%)
Total 802(66.11%) 411(33.89%) 1213(100%)
χ2=1.61, df=1, p = 0.20
Conclusion
• Majority(60%) of the patients belonged to 0-20 yr age group : Children and adolescent.
• Most of the patients were Students(37%) followed by outdoor workers i.e. Laborers (21%)and Farmers(22%) by occupation.
• Both of the above findings shows that outdoor exposure predispose one to be bitten by animal.
Even after easy and high reach property of Mass media ,it was found to play very little role as source of information.
Patient’s awareness regarding rabies is significantly related with literacy and their residence.
However such type of relationship is not seen with reporting time to the hospital.
Recommendations
In the light of findings mentioned in the conclusion we recommend that mass media must be utilized extensively to raise knowledgeabout rabies and intensify the positive attitude and practicesabout essential and complete antirabies vaccination to the animal bite cases.
• Maximum no. of cases belonged to Cat.3 bites. This indicates the importance of need of large amount of quality antirabies serum or HRIG.This can be ensured by promoting pharmaceutical production of these products.
For the same, there is urgent need to introduce training based school programme from the very childhood , addressing methods to prevent dog bite and management of animal bite cases.
There is need of same kind of national level programme for the general public.
References1. http://www.who.int/rabies/about/en/
2. Lozano R et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the GlobalBurden of Disease Study 2010. Lancet, 2012, 380(9859):2095–2128.
3. Murray CJL et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859):2197–2223.
4. Knobel DL et al. Re-evaluating the burden of rabies in Africa and Asia. Bulletin of the World Health Organization, 2005, 83(5):360–368
5. World health Organization.WHO expert consultation on rabies,WHOtechnical report series,Second edition.WHO press,Genewa:WHO;2013.p8
6. National Centre for Disease Control,Directorate General of Health Services Ministry of Health and Family Welfare ,Government of India. National Guidelines on Rabies Prophylaxis. New delhi,India:CDC;2013.p4.