Causes of delay in offering rabies post-exposure prophylaxis services in Abadeh district of Iran

• Main Authors: Ahmad Karimi, Behnam Karimi, Ahmad Karimifard, Nabiollah Taherimotlagh, Amin Kasraei, Fatemeh Safikhani, Fatemeh Majidpour, Mohammad Yandarani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Acute Disease
• Subjects: rabies; zoonosis; post-exposure prophylaxis; rabies vaccines; abadeh
• Online Access: http://www.jadweb.org/article.asp?issn=2221-6189;year=2020;volume=9;issue=1;spage=20;epage=26;aulast=Karimi

Objectives: To identify the reasons for delayed reception of postexposure prophylaxis (PEP). Methods: In this cross-sectional study, a total of 1 407 individuals with animal bites who were referred to the Abadeh Rabies Treatment Center were investigated using the census method from January 2012 to December 2018. The patients were divided into two groups based on their delay times to referral and receive PEP: timely referral (less than 48 h after the bite) and delayed referral (equal to or longer than 48 h after the bite). Frequency, Chi-square, and logistic regression tests were used. Results:. The average delay time was (16.33±11.37) h. Low level of education (OR: 3.87; 95% CI: 1.19-12.54; P=0.02), active economic age (21-35 and 36-50 years-old, OR: 12.81; 95% CI: 3.16-51.97; P<0.001 and OR: 3.83, 95% CI: 3.83-58.61; P<0.001 respectively), occupation (OR: 9.16; 95% CI: 1.89-44.29; P=0.006), long distance from the rabies treatment center (OR: 3.41; 95% CI: 2.03-5.72; P<0.001), bites by household and domestic animals (OR: 12.22; 95% CI: 2.29-65.18, P=0.003), superficial injuries (OR: 4.51; 95% CI: 1.38-14.73; P=0.01), and residence in rural area (OR: 12.74; 95% CI: 6.58-24.66; P<0.001) had significant correlations with delayed referral of victims. Conclusions: To reduce the delay time, the high-risk groups should be informed about the importance of timely referral via educational measures. Furthermore, rabies treatment services should be rendered at the nearest possible center.