Abstract:

Background and Objectives: Human bite is the bite or scratch from vector species or the introduction of saliva or central nervous system tissue from vectors species into an open fresh wound or mucous membrane of the human being. It is the serious public health problem due to its risk for rabies virus exposure, and predominantly caused by dogs. Despite the fact that rabies can be prevented by vaccination, completion of the recommended doses remains a challenge in low and middle income countries. This study aimed at finding out the factors associated with completion of anti-rabies vaccination among animal bite victims in Sengerema and Ukerewe district hospitals.

Methodology: The retrospective study of rabid animal bites at Sengerema and Ukerewe District Hospital was conducted between May 2016 to May 2019. Data were collected from the registers of animal bite presenting to the hospitals to receive PEP. Data were analysed by STATA version 13 as per study objectives.

Result: Of 515 patients enrolled, 294 (57.1%) were males and the median age (1QR) was 12 (8-32) years, ranging from 0.33 to 89 years. Majority of patients were from Sengerema designated hospital 356 (69.3%). Children below 15 years had increased chances (60.6%) of being bitten by dogs than other age groups. A total of 434 (84.7%) of the animals-bite victims accessed a health facility within 24 hours after the bite. Approximately 87.9% 54.6% and 34.6% received 1st, 2nd and 3rd doses of PEP, respectively. Individuals whose payment modality was unknown were more likely to complete PEP (61.4%) compared to those under health insurance (31.3) and out-of-packet payment (22.1%); p-value <0.001. Also, those who attended hospitals within 24 hours were more likely to complete compared to those who attended >24 hours (70.5% versus 38.1%; p-value <0.001).

Conclusion: The animal’s bites are prevented at Sengerema and Ukerewe districts, and mostly affect children <15 years of age. The majority of bite victims received the 1st dose, while only half and only one-third received the 2nd and 3rd doses, respectively. A need to document-fully modality of payment for PEP is recommended to ensure health system accountability and planning for resources allocation. Prospective studies on the reasons of not completing PEP should be explored among 2/3rd of the bite victims, and alternative reminding systems such a telephone calls or SMS could be assessed in future studies.