Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic

A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. Th...

Descripción completa

Detalles Bibliográficos
Autores principales: Castillo-Neyra, Ricardo, Buttenheim, Alison M., Brown, Joanna, Ferrara, James F., Arevalo-Nieto, Claudia, Borrini-Mayorí, Katty, Levy, Michael Z., Becerra, Victor, Paz-Soldan, Valerie A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394441/
https://www.ncbi.nlm.nih.gov/pubmed/32692739
http://dx.doi.org/10.1371/journal.pntd.0008478
_version_ 1783565231792848896
author Castillo-Neyra, Ricardo
Buttenheim, Alison M.
Brown, Joanna
Ferrara, James F.
Arevalo-Nieto, Claudia
Borrini-Mayorí, Katty
Levy, Michael Z.
Becerra, Victor
Paz-Soldan, Valerie A.
author_facet Castillo-Neyra, Ricardo
Buttenheim, Alison M.
Brown, Joanna
Ferrara, James F.
Arevalo-Nieto, Claudia
Borrini-Mayorí, Katty
Levy, Michael Z.
Becerra, Victor
Paz-Soldan, Valerie A.
author_sort Castillo-Neyra, Ricardo
collection PubMed
description A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting.
format Online
Article
Text
id pubmed-7394441
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-73944412020-08-13 Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic Castillo-Neyra, Ricardo Buttenheim, Alison M. Brown, Joanna Ferrara, James F. Arevalo-Nieto, Claudia Borrini-Mayorí, Katty Levy, Michael Z. Becerra, Victor Paz-Soldan, Valerie A. PLoS Negl Trop Dis Research Article A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting. Public Library of Science 2020-07-21 /pmc/articles/PMC7394441/ /pubmed/32692739 http://dx.doi.org/10.1371/journal.pntd.0008478 Text en © 2020 Castillo-Neyra et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Castillo-Neyra, Ricardo
Buttenheim, Alison M.
Brown, Joanna
Ferrara, James F.
Arevalo-Nieto, Claudia
Borrini-Mayorí, Katty
Levy, Michael Z.
Becerra, Victor
Paz-Soldan, Valerie A.
Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title_full Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title_fullStr Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title_full_unstemmed Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title_short Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic
title_sort behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in arequipa, peru, during a canine rabies epidemic
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394441/
https://www.ncbi.nlm.nih.gov/pubmed/32692739
http://dx.doi.org/10.1371/journal.pntd.0008478
work_keys_str_mv AT castilloneyraricardo behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT buttenheimalisonm behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT brownjoanna behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT ferrarajamesf behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT arevalonietoclaudia behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT borrinimayorikatty behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT levymichaelz behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT becerravictor behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic
AT pazsoldanvaleriea behavioralandstructuralbarrierstoaccessinghumanpostexposureprophylaxisandotherpreventivepracticesinarequipaperuduringacaninerabiesepidemic