Volume 7, Issue 2 (December 2021)                   Elderly Health Journal 2021, 7(2): 58-64 | Back to browse issues page

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Soleimanpour H, Abbasian M, Sarbazi E, Paknezhad S P, Jalilvand H, Masoudi N, et al . Predictors of Delay in Seeking Post-Exposure Prophylaxis in Older Adults with Animal Bite Injuries: A Population-Based Study. Elderly Health Journal. 2021; 7 (2) :58-64
URL: http://ehj.ssu.ac.ir/article-1-242-en.html
Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran , ehsansarbazi20@gmail.com
Abstract:   (298 Views)
Introduction: Animal bites are of the major health threats. Delayed post-exposure prophylaxis (PEP), especially in frail older people, may lead to mortal risks in this age group. The aim of this study was to investigate the pattern of delayed PEP in animal-bites injuries and to identify its contributing factors in older people of Tabriz city, Iran.

Methods: In this cross-sectional study, the census method was used to obtain data from health records of older adults who were referred to Tabriz's Rabies Treatment Center between March 2013 and March 2018. The delay was defined as starting PEP longer than 24 hours after a suspected rabies virus exposure. The relations between delayed PEP and each of the predictors were investigated using the chi-square test in univariate analysis. The decision tree model was applied to predict the delay time of PEP.

Results: A total of 322 older people with a mean age of 67.62 ± 7.18 were studied. In all, 31.7 % of the older persons victims who were bitten by an animal had a delayed PEP. Urban victims (34.1%) compared to rural (16.3 %), stray animal victims (42.0 %) compared to an owned animal-bite victim 24.6 %, all other animal bite-related victims (39.9 %) compared to dog-bite injuries (23.8%) experienced a higher frequency of delayed PEP. The decision tree revealed that animal ownership status, animal status, and animal species were the most important factors for predicting delayed PEP (p < 0.001).

Conclusion: The possibility of delayed PEP in older adults bites victims, increased if the animal was ownerless and escaped. A reasonable approach to tackle this issue might be to conduct larger population studies in the future.
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Type of Study: Research | Subject: Special
Received: 2021/09/5 | Accepted: 2021/10/31 | Published: 2021/12/19

1. World Health Organization. WHO expert consultation on rabies: third report [Internet]. World Health Organization; 2018 [cited 2021 May 12]. Available from: https://apps.who.int/iris/handle/10665/272364
2. Ripani A, Mérot J, Bouguedour R, Zrelli M. Review of rabies situation and control in the North African region with a focus on Tunisia. Revue Scientifique et Technique (International Office of Epizootics). 2017; 36(3): 1-16.
3. Singh R, Singh KP, Cherian S, Saminathan M, Kapoor S, Manjunatha Reddy G, et al. Rabies–epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: a comprehensive review. The Veterinary Quarterly. 2017; 37(1): 212-51.
4. World Health Organization. Rabies vaccines: WHO position paper, April 2018–Recommendations. Vaccine. 2018; 36(37): 5500-3.
5. Abedi M, Doosti-Irani A, Jahanbakhsh F, Sahebkar A. Epidemiology of animal bite in Iran during a 20-year period (1993–2013): a meta-analysis. Tropical Medicine and Health. 2019; 47(1): 1-13.
6. Kisaka S, Makumbi FE, Majalija S, Bangirana A, Thumbi S. Epidemiology and preclinical management of dog bites among humans in Wakiso and Kampala districts, Uganda: implications for prevention of dog bites and rabies. PloS One. 2020; 15(9): 1-21.
7. Khazaei S, Rezaeian S, Soheylizad M, Gholamaliee B. Factors associated with delay in post-exposure prophylaxis in bitten people. Medical Journal of the Islamic Republic of Iran. 2014; 28(158): 1-7.
8. Sarbazi E, Sarbazi M, Ghaffari-Fam S, Babazadeh T, Heidari S, Aghakarimi K, et al. Factors related to delay in initiating post-exposure prophylaxis for rabies prevention among animal bite victims: a cross-sectional study in Northwest of Iran. Bulletin of Emergency & Trauma. 2020; 8(4): 236-42.
9. Addai JA, Nuertey BD. Pattern of animal bites and delays in initiating rabies postexposure prophylaxis among clients receiving care in korle-bu teaching hospital. Journal of Tropical Medicine. 2020; 2020(4): 1-6.
10. Mirzaie M, Darabi S. Population aging in Iran and rising health care costs. Salmand: Iranian Journal of Ageing. 2017; 12 (2): 156-69.
11. Fillit HM, Rockwood K, Young JB. Brocklehurst's textbook of geriatric medicine and gerontology. 8th Edition. Elsevier Health Sciences; 2016.
12. Loder RT. The demographics of dog bites in the United States. Heliyon. 2019; 5(3): e01360.
13. Suraweera W, Morris SK, Kumar R, Warrell DA, Warrell MJ, Jha P, et al. Deaths from symptomatically identifiable furious rabies in India: a nationally representative mortality survey. PLoS Neglected Tropical Diseases. 2012; 6(10): 1-9.
14. Wani RT, Chowdri IN, Dar H. Factors influencing delay in initiating post-exposure prophylaxis for rabies prevention among animal bite victims: a cross sectional study. Journal of Family Medicine and Primary Care. 2020; 9(9): 4751-5.
15. Joseph J, Sangeetha N, Khan AM, Rajoura O. Determinants of delay in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: hospital based study. Vaccine. 2013; 32(1): 74-7.
16. Esmaeilzadeh F, Rajabi A, Vahedi S, Shamsadiny M, Ghojogh MG, Hatam N. Epidemiology of animal bites and factors associated with delays in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: A population-based study. Journal of Preventive Medicine and Public Health. 2017; 50(3): 210-6.
17. Azarafza M, Ghazifard A. Urban geology of Tabriz city: environmental and geological constraints. Advances in Environmental Research. 2016; 5(2): 95-108.
18. Han J, Pei J, Kamber M. Data mining: concepts and techniques. Third Edition. Elsevier; 2011.
19. Kassiri H, Lotfi M, Ebrahimi A. Epidemiological and demographic study of acute animal biting in Abdanan County, Ilam Province, Western Iran. Journal of Acute Disease. 2017; 6(6): 272-7.
20. Romero-Sengson RF. Factors affecting compliance to rabies post-exposure prophylaxis among pediatric patients seen at the research institute for tropical medicine. Pediatric Infectious Disease Society of the Philippines Journal. 2013; 14(2): 56-62.
21. Riahi S, Latifi A, Bakhtiyari M, Yavari P, Khezeli M, Hatami H. Epidemiologic survey of animal bites and causes of delay in getting preventive treatment in Tabbas during 2005-2010. Tolooebehdasht. 2012; 11(1): 20-31.[Persian]
22. Brandão MdPM, Martins L, Szewczyczak M, Talarska D, Philp I, Cardoso MF. Threats to health and well-being perceived by older people in Poland and Portugal. Acta Medica Portuguesa. 2018; 31(7-8): 409-15.
23. Thumé E, Facchini LA, Wyshak G, Campbell P. The utilization of home care by the elderly in Brazil's primary health care system. American Journal of Public Health. 2011; 101(5): 868-74.
24. Martínez-Baz I, Aguilar I, Morán J, Albéniz E, Aldaz P, Castilla J. Factors associated with continued adherence to influenza vaccination in the elderly. Preventive Medicine. 2012; 55(3): 246-50.
25. Siren A, Kjær MR. How is the older road users’ perception of risk constructed?. Transportation Research Part F: Traffic Psychology and Behaviour. 2011; 14(3): 222-8.
26. Samiee-Roudi K, Soltani M. Pattern of animal bites and factors associated with delay in post-exposure prophylaxis in bitten people. Chronic Diseases Journal. 2018; 6(4): 171-8.
27. Hamta A, Saghafipour A, Hosseinalipour SA, Rezaei F. Forecasting delay times in post-exposure prophylaxis to human animal bite injuries in Central Iran: A decision tree analysis. Veterinary World. 2019; 12(7): 965-71.
28. Gaffari-fam S, Sarbazi E, Moradpour H, Soleimanpour H, Azizi H, Heidari S. Epidemiological patterns, trends of animal bites and factors associated with delays in initiating post-exposure prophylaxis for rabies prevention in hurand, iran: a cross-sectional study. Journal of Clinical and Basic Research. 2021; 5(3): 1-8.
29. Mohammadzadeh A, Mahmoodi P, Sharifi A, Moafi M, Erfani H, Siavashi M. A three-year epidemiological study of animal bites and rabies in Hamedan Province of Iran. Avicenna Journal Clinical Microbiology Infection. 2017; 4(2): 1-5.
30. Bannazadeh Baghi H, Alinezhad F, Kuzmin I, Rupprecht CE. A perspective on rabies in the Middle East—Beyond Neglect. Veterinary Sciences. 2018; 5(3): 67.
31. Tenzin T, Dhand NK, Ward MP. Human rabies post exposure prophylaxis in Bhutan, 2005–2008: trends and risk factors. Vaccine. 2011; 29(24): 4094-101.
32. Sheikholeslami NZ, Rezaeian M, Salem Z. Epidemiology of animal bites in Rafsanjan, southeast of Islamic Republic of Iran, 2003-05. EMHJ-Eastern Mediterranean Health Journal. 2009; 15 (2): 455-7.
33. Fang LX, Ping F, Hui BG, Yan YX. Socioeconomic status is a critical risk factor for human rabies post-exposure prophylaxis. Vaccine. 2010; 28(42): 6847-51.
34. Rafiei N, Heshmati H, Taneh A. Animal bite and its contributors in aq-qala district, golestan province, Iran. Journal of Basic Research in Medical Sciences. 2014; 1(2): 36-42.
35. Sambo M, Cleaveland S, Ferguson H, Lembo T, Simon C, Urassa H, et al. The burden of rabies in Tanzania and its impact on local communities. PLoS Neglected Tropical Diseases. 2013; 7(11): 1-9.
36. Issah B, Ansah T, Alagma H. Awareness of zoonotic diseases among pet owners in wa municipality of ghana. UDS International Journal of Development. 2020; 7(2): 387-97.
37. Hundal JS, Sodhi SS, Gupta A, Singh J, Chahal US. Awareness, knowledge, and risks of zoonotic diseases among livestock farmers in Punjab. Veterinary World. 2016; 9(2): 186-91.
38. Özlü H, Atasever M, Atasever MA. Knowledge, attitude, and practices of cattle farmers regarding zoonotic diseases in Erzurum, Turkey. Austral Journal of Veterinary Sciences. 2020; 52(3): 79-85.

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