Assessment of compliance to anti-rabies vaccine post-exposure prophylaxis in a tertiary care centre in Jammu
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254027Keywords:
Animal bite, Anti rabies, Compliance, Health issueAbstract
Background: Rabies remains a fatal global health threat, with India bearing a significant burden. Anti-rabies vaccine’s (ARV) post-exposure prophylaxis is crucial, yet poor adherence hinders eradication efforts and for improving outcomes of post-exposure prophylaxis we need to know about reasons behind non-compliance and delayed compliance. This study investigated ARV PEP adherence and its contributing factors at GMC, Jammu.
Methods: This Study was conducted among 594 animal bite victims (Category 2 and 3) at GMC Jammu's Anti-Rabies Clinic and study subjects were selected via convenience sampling method from September 2022 to July 2023. Data on demographics, bite characteristics, and wound care were collected, and ARV adherence was monitored. Reasons for non-compliance or delayed compliance were ascertained via telephone.
Results: Of participants, 74.2% completed the ARV course. However, about 22.1% had delayed adherence, while 3.7% had non-compliant. Delayed compliance’s most common reasons were residence far away from clinic, work location outside Jammu, forgotten dates, negligence and loss of wages. Non-compliance was primarily due to negligence and health issues. There was no statistically significant association found between full compliance and combined (delayed and non-compliance) with factors such as age, residence, education, gender, category of bite, number of wounds, type of animal bite, wound washing practices, method of wound washing, or duration of wound washing (p>0.05). Chi-square test was applied for testing significance.
Conclusions: The study highlights considerable delayed and non-compliance with ARV, largely driven by patient negligence and health problems. This necessitates enhanced awareness, comprehensive patient education, and practical solutions to improve ARV PEP adherence and reduce rabies mortality in India.
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References
World Health Organization. Animal bites. Key facts, 2023. Available at: https://www.who.int/newsroom/fact-sheets/detail/rabies. Accessed 15 June 2025.
World Health Organization. WHO expert consultation on Rabies: Third report, 2018. Available at: https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf?ua=1. Accessed 15 June 2025.
National Centre for Disease Control. National Guidelines for Rabies Prophylaxis, 2019-National Rabies Control Programme. Available at: https://ncdc.gov.in. Accessed 15 June 2025.
Centers for Disease Control and Prevention (CDC). Human rabies prevention United States, 1999: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1999;48(RR-1):1-21.
World Health Organization. WHO guide for rabies pre and post exposure prophylaxis in humans, 2018. Available at: https://cdn.who.int/media/docs/default-source/searo/india/health-topic-pdf/pep-prophylaxis-guideline-15-12-2014.pdf?sfvrsn=8619bec3_2. Accessed 15 June 2025.
Panda M, Kapoor R. Compliance to post-exposure prophylaxis among animal bite patients-A hospital-based epidemiological study. J Family Med Prim Care. 2022;11(10):6215. DOI: https://doi.org/10.4103/jfmpc.jfmpc_497_22
World Organisation for Animal Health (WOAH) - Asia. National Action Plan for Dog Mediated Rabies Elimination from India by 2030. Available at: https://rr-asia.woah.org. Accessed 15 June 2025.
Sastry N, Deshmukh J, Jadhao A, Kalaivani M, Solanki M, Nitnaware V. Compliance to post-exposure prophylaxis among patients attending anti-rabies vaccination clinic in a tertiary health care centre in central India: a cross-sectional study. Int J Community Med Public Health. 2023;10:2890-6. DOI: https://doi.org/10.18203/2394-6040.ijcmph20232384
Venkatesan M, Dongre A, Ganapathy K. A community-based cross-sectional study of dog bites in children in a rural district of Tamil Nadu. Int J Med Sci Public Health. 2017;6(1):109-12. DOI: https://doi.org/10.5455/ijmsph.2017.28062016568
Lilare RR, Rathod N, Narlawar UW. Compliance of post-exposure rabies vaccination among patients attending anti rabies OPD in the Government Medical College, Nagpur. Int J Community Med Public Health. 2018;5:3045-8. DOI: https://doi.org/10.18203/2394-6040.ijcmph20182646
Domple VK, Doibale MK, Sonkar VK, Aswar NR, Khadilkar HA, Jain SR. Treatment compliance of self-reported dog bite cases attending outpatient department of tertiary care hospital, Maharashtra. Int J Med Public Health. 2015;5(4):297-300. DOI: https://doi.org/10.4103/2230-8598.165954
Shankaraiah RH, Rajashekar RA, Veena V, Hanumanthaiah AD. Compliance to anti rabies vaccination in post exposure prophylaxis. Indian J Public Health. 2015;59(1):58-60. DOI: https://doi.org/10.4103/0019-557X.152867
Sahu KK, Ranjan A, Singh NK, Dixit S, Giri S, Gupta N. Epidemiological characteristics of patients attending for rabies post-exposure prophylaxis at a tertiary care hospital in Northern India. J Family Med Prim Care. 2015;4(2):210-13.
Dhaduk KM, Unadkat SV, Katharotiya PR, Mer AR, Chaudhary MC, Prajapati MM. Case profile, volume analysis, and dropout rate of anti rabies vaccination regimens among animal bite victims in Gujarat. Indian J Public Health. 2016;60(4):268-72. DOI: https://doi.org/10.4103/0019-557X.195855
Anandaraj R, Balu PS. Compliance to anti rabies vaccine and animal bite management practices in a rural area of Davangere, Karnataka, India. Int J Community Med Public Health. 2016;3(1):170-3. DOI: https://doi.org/10.18203/2394-6040.ijcmph20151556
Praveen G, Subhashini K, Metri S, Sundar M. Assessment of compliance to anti-rabies vaccination of post exposure prophylaxis among animal bite cases reporting to dedicated anti rabies clinic of a tertiary care hospital, Hassan, Karnataka. MedPulse Int J Commu Med. 2019;11:48-53. DOI: https://doi.org/10.26611/10111132
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