Cuc H Tran1, Doris O Afriyie2, Thach N Pham3, Satoko Otsu4, Maho Urabe4, Anh D Dang3, Huong G T Tran5, Hoang V Nguyen3, Ha T Le6, Huong T T Nguyen3. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, United States; Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, United States. Electronic address: ywj0@cdc.gov. 2. U.S. Centers for Disease Control and Prevention Country Office in Vietnam, 2 Ngo Quyen, Hanoi, Viet Nam. 3. National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin Street, Hanoi, Viet Nam. 4. World Health Organization, Representative Office for Vietnam, 304 Kim Ma Street, Hanoi, Viet Nam. 5. International Cooperation Department, Ministry of Health, 138A Giang Vo, Hanoi, Viet Nam. 6. Hanoi Medical University, No 1 Ton That Tung, Hanoi, Viet Nam.
Abstract
BACKGROUND: Adhering to post-exposure prophylaxis (PEP): wound treatment, vaccine, and rabies immunoglobulin (RIG) is a crucial step in preventing rabies mortality. When PEP is widely available, a lack of adherence to the recommended treatment guidelines can also lead to death. Our objective was to understand characteristics associated with adherence to the vaccine regimen and RIG in Vietnam. METHODS: We obtained individual-level data on PEP adherence from registries at 10 sites located in five provinces. From these registries, we extracted epidemiologic characteristics of patients including the timing of PEP initiation and completion. We used descriptive analyses and logistic regression to examine patient characteristics associated with initiation and completion of RIG and vaccine. Based on reported rabies mortality, the government defined provincial rabies burden as medium-burden (<5 and >2 deaths) and high-burden (≥5 deaths). RESULTS: During 2014-2016, 15,646 patients received PEP in our study. Among 14,296 vaccinated patients, only 41.4% (5847) completed their five-dose intramuscular (IM) injections and 81.6% (133) of patients completed their eight-dose intradermal (ID) injections. Approximately 26% of patients received RIG. Patient characteristics associated with vaccine completion were females (44%), <15 years of age (44%), category 1 exposure (68%, bite location on leg (46%), bite from bat (56%), bite from a healthy animal (45%), high-burden province (86%), and district preventive center (49%). Disparities were revealed among provinces, with high-burden provinces having highest (86%) and lowest (7%) vaccine completion rates. CONCLUSIONS AND RELEVANCE: Vietnam has made tremendous progress towards reducing the burden of rabies. However, despite the wide availability of PEP, we found relatively low rates of vaccine completion. Our findings suggest provider training and patient education is needed to ensure appropriate treatment is completed. Moreover, our data suggest changes to information reported through the national surveillance system for monitoring good clinical practice for rabies prevention and control. Published by Elsevier Ltd.
BACKGROUND: Adhering to post-exposure prophylaxis (PEP): wound treatment, vaccine, and rabies immunoglobulin (RIG) is a crucial step in preventing rabies mortality. When PEP is widely available, a lack of adherence to the recommended treatment guidelines can also lead to death. Our objective was to understand characteristics associated with adherence to the vaccine regimen and RIG in Vietnam. METHODS: We obtained individual-level data on PEP adherence from registries at 10 sites located in five provinces. From these registries, we extracted epidemiologic characteristics of patients including the timing of PEP initiation and completion. We used descriptive analyses and logistic regression to examine patient characteristics associated with initiation and completion of RIG and vaccine. Based on reported rabies mortality, the government defined provincial rabies burden as medium-burden (<5 and >2 deaths) and high-burden (≥5 deaths). RESULTS: During 2014-2016, 15,646 patients received PEP in our study. Among 14,296 vaccinated patients, only 41.4% (5847) completed their five-dose intramuscular (IM) injections and 81.6% (133) of patients completed their eight-dose intradermal (ID) injections. Approximately 26% of patients received RIG. Patient characteristics associated with vaccine completion were females (44%), <15 years of age (44%), category 1 exposure (68%, bite location on leg (46%), bite from bat (56%), bite from a healthy animal (45%), high-burden province (86%), and district preventive center (49%). Disparities were revealed among provinces, with high-burden provinces having highest (86%) and lowest (7%) vaccine completion rates. CONCLUSIONS AND RELEVANCE: Vietnam has made tremendous progress towards reducing the burden of rabies. However, despite the wide availability of PEP, we found relatively low rates of vaccine completion. Our findings suggest provider training and patient education is needed to ensure appropriate treatment is completed. Moreover, our data suggest changes to information reported through the national surveillance system for monitoring good clinical practice for rabies prevention and control. Published by Elsevier Ltd.
Authors: Quang Duy Pham; Lan Trong Phan; Thuy Phuong Thi Nguyen; Quan Minh Ngoc Doan; Hai Duc Nguyen; Quang Chan Luong; Thuong Vu Nguyen Journal: Front Public Health Date: 2021-04-29
Authors: Huong Tt Nguyen; Nhan Dt Le; Thach N Pham; Maho I Urabe; Doris O Afriyie; Satoko Otsu; Duong N Tran; Huong Gt Tran; Hoang V Nguyen; Ha T Le; Cuc H Tran Journal: Vaccine Date: 2019-06-22 Impact factor: 3.641
Authors: Trisha A Whitbread; Kathleen J Kabuya; Nimesh Naran; Amilcar M Juggernath; Moushumi A Mathews; Lucille H Blumberg; Jacqueline Weyer; Vivien Essel Journal: S Afr J Infect Dis Date: 2022-09-13