Assessment of behavior and barriers of post-exposure prophylaxis for prevention of rabies in patients attending a tertiary care center in eastern India – a mixed method approach

Ipsita Debata
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Rosy Nayak
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Basanta Kumar Behera
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Prem Sagar Panda
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Smrutiranjan Nayak
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Dibyajyoti Mandal
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Department of Community Medicine, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Received: 3 May 2024 / Revised: 10 June 2024 / Accepted: 9 July 2024 / Published: 30 December 2024

Abstract

Introduction and aim. Rabies from animal bites, although preventable, is almost 100% fatal, with the dog being the most common infected animal. Several factors influence the timely initiation of post-exposure prophylaxis (PEP) which needs to be explored. This study aimed to determine the facilitating and inhibiting factors in initiating PEP among animal bite victims attending a tertiary care center in Eastern India.

Material and methods. A cross-sectional study was conducted among 150 consenting animal bite victims attending casualty and medicine as out-patients in a tertiary care hospital. A mixed-method study approach was undertaken to explore the facilitating and inhibiting factors for the timely initiation of PEP using a pre-tested and semi-structured questionnaire and in-depth interviews. Data were analyzed using SPSS software version 20.

Results. The most common biting animal were dogs (96.2%). Around 102 patients (68%) were males and 48 (32%) were females. Timely initiation of PEP was seen in 112 (74.7%) of the study sample while delay was seen in 38 (25.3%). The inhibiting factors were the absence of an accompanying person (54.67%), the absence of vaccines and immunoglobulins in the nearest health facility (50.67%), referral from other health facilities (44%) and preferred other modalities of treatment (24.67%). Delays in initiation of PEP was significantly associated with gender (p=0.018), place of residence (p<0.001), those living more than 20 km from a health facility (p=0.014), educational status (p<0.001), and those with monthly income <10000 INR (p<0.01).

Conclusion. Lower economic status, education, and accessibility to health facilities were major inhibiting factors causing a delay in the initiation of PEP. Further, community-based studies are warranted.

 

Cite

Debata I, Nayak R, Behera BK, Panda PS, Nayak S, Mandal D. Assessment of behavior and barriers of post-exposure prophylaxis for prevention of rabies in patients attending a tertiary care center in eastern India – a mixed method approach. Eur J Clin Exp Med. 2024;22(4):839–844. doi: 10.15584/ejcem.2024.4.24.

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