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Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data

BACKGROUND: Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate...

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Autores principales: Bennasrallah, Cyrine, Ben Fredj, Manel, Mhamdi, Moncef, Kacem, Meriem, Dhouib, Wafa, Zemni, Imen, Abroug, Hela, Belguith Sriha, Asma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477457/
https://www.ncbi.nlm.nih.gov/pubmed/34579662
http://dx.doi.org/10.1186/s12879-021-06700-9
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author Bennasrallah, Cyrine
Ben Fredj, Manel
Mhamdi, Moncef
Kacem, Meriem
Dhouib, Wafa
Zemni, Imen
Abroug, Hela
Belguith Sriha, Asma
author_facet Bennasrallah, Cyrine
Ben Fredj, Manel
Mhamdi, Moncef
Kacem, Meriem
Dhouib, Wafa
Zemni, Imen
Abroug, Hela
Belguith Sriha, Asma
author_sort Bennasrallah, Cyrine
collection PubMed
description BACKGROUND: Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011). METHODS: We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included. RESULTS: A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = − 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared. CONCLUSION: Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease.
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spelling pubmed-84774572021-09-28 Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data Bennasrallah, Cyrine Ben Fredj, Manel Mhamdi, Moncef Kacem, Meriem Dhouib, Wafa Zemni, Imen Abroug, Hela Belguith Sriha, Asma BMC Infect Dis Research Article BACKGROUND: Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011). METHODS: We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included. RESULTS: A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = − 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared. CONCLUSION: Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease. BioMed Central 2021-09-27 /pmc/articles/PMC8477457/ /pubmed/34579662 http://dx.doi.org/10.1186/s12879-021-06700-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Bennasrallah, Cyrine
Ben Fredj, Manel
Mhamdi, Moncef
Kacem, Meriem
Dhouib, Wafa
Zemni, Imen
Abroug, Hela
Belguith Sriha, Asma
Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title_full Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title_fullStr Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title_full_unstemmed Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title_short Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data
title_sort animal bites and post-exposure prophylaxis in central-west tunisia: a 15-year surveillance data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477457/
https://www.ncbi.nlm.nih.gov/pubmed/34579662
http://dx.doi.org/10.1186/s12879-021-06700-9
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