Factors Limiting the Appropriate Use of Rabies Post-exposure Prophylaxis by Health Professionals in Brazil
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Fecha
2022-05
Profesor/a Guía
Facultad/escuela
Idioma
en
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Editor
Frontiers Media S.A.
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Licencia CC
Atribución 4.0 Internacional (CC BY 4.0)
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https://creativecommons.org/licenses/by/4.0/deed.es
Resumen
Post-exposure prophylaxis (PEP) is necessary to prevent the fatal onset of rabies but requires optimization to avoid overuse in populations at risk of rabies. In Brazil, the incidence of dog bites remains high, with almost half of dog-bite patients not receiving the PEP recommended by the Ministry of Health guidelines between 2008 and 2017. In this study, we aimed to identify the factors that limit the appropriate prescribing of PEP by interviewing health professionals responsible for PEP administration and completion of the ‘Information System on Diseases of Compulsory Declaration’ (SINAN) form reporting human anti-rabies care for patients seeking health care after a dog bite. We conducted 147 questionnaires (45 questions each) in three Brazilian states (i.e., Rio Grande do Sul, Santa Catarina, Rio Grande do Norte) including questions related to the criteria used by professionals to classify a dog as “suspect” or “rabid”, knowledge on PEP prescription guidelines, SINAN and communication with veterinarians. Our analyses showed that most health professionals delivering PEP in these three states struggle to identify a rabies “suspect” dog according to the Ministry of Health guidelines, and to indicate the adequate PEP regimen, with only 11% of professionals prescribing the appropriate PEP under various dog-bite patient scenarios. PEP knowledge score was higher among professionals trained on PEP guidelines and working in facilities with the highest incidence of dog bites. In contrast, PEP knowledge scores did not vary significantly between states, and were not correlated to the professional's level of experience, the number of colleagues available at the health unit or the professional's confidence on prescribing appropriate PEP. Our results suggest that knowledge gaps in PEP administration among health professionals of Brazil can be reduced by implementing training programs to differentiate among rabies risk scenarios, prescribe the corresponding appropriate PEP and improve communication between health and veterinary authorities. Copyright © 2022 da Silva, Megid, Hampson, Campos, Higashi, Medeiros, Pereira and Benavides.
Notas
Indexación: Scopus
Palabras clave
Bites, Dogs, Latin America, One Health, PEP, Questionnaires, Surveillance
Citación
Frontiers in Veterinary Science Open AccessVolume 96 May 2022 Article number 846994
DOI
10.3389/fvets.2022.846994