Assessing factors associated with observed levels of adherence to Antirabies pep vaccine among animal bite victims in Machakos level five hospital
Rabies is a viral disease that affects the central nervous system. It affects both animals animal rabies and man human rabiesCohenPowderly 2004. Rabies virus has its reservoir in dogs cats and bats with dogs being the major reservoir and hence source of the vast majority human rabies deaths Willoughbyet al. 2005. According to MOPHS 2011thirty percent of rabies cases are paralytic.The MOPHS 2011report also state that human rabies is present in all continents except Antarctica but 95 of human deaths occur in Asia and Africa. It occurs in more than 150 countries and more than 55000 people die of human rabies each year in Africa and Asia. Africa accounts for 24000 deaths annually.Rabies control in Kenya has been hampered by the high cost and scarce supplies of high quality vaccines. In Machakos County despite the domestication of dogs human rabies has been endemic for over 40 years with stray dogs increasing in number and isa health hazard to the human population. This is worsened by the ignorance portrayed by the dog owners regarding the need and value to vaccinate dogs and other pets. There is also a great drop out of the bitten victims from the post exposure prophylaxis and a poor follow up of such victims by the relevant departments hence increasing the risk of acquiring the disease. According to MOPHS 2012 the total number of human rabies deaths in Kenya confirmed by laboratory tests was 2 in 2010 1 in 2011 and 1 in 2012. The total number of human rabies deaths diagnosed on clinical grounds only in 2010 2011 and 2012 were not recorded. The total number of people bitten by dogs recorded as animal bites was 38944 in 2010: 133150 in 2011 and 146362 in 2012. Animal rabies has been widespread in the country over the last ten years. To date all the eight provinces have at least had rabies. Generally the number of districts with positive cases has ranged from seventeen to twenty nine. Eastern Rift Valley Central and Nairobi Provinces contributed slightly over ninety five percent of total rabies cases over 1983 -1992 periods. The highest Incidence was in Machakos in Eastern followed by Nairobi then Nakuru in Rift Valley Nyeri and Kiambu in Central and Kericho in Rift Valley in that order contributing nearly seventy two percent of the outbreaks. There hasbeen no laboratory confirmed rabies recorded in Garissa and Mandera in North Eastern and Lamu and Tana River in Coast Provinces Dept. of Veterinary Services Kabete. 1994. Surveillance studies on the disease according toKitala et al. 1994during the period 1981-1990 in Machakos County indicates that the study had 8027 people bitten by dogs and 4947 of them received PEP and 22 died of rabies. 505 confirmed cases of animal rabies were also reported by the Machakos district veterinary department during the same period. This is an indication of the situation in the district and not a precision since most of the cases are unreported. It also demonstrated the central role played by dogs in maintenance and transmission of the disease in the county.92 ofrabid suspect animals and 81 confirmed animals were dogs. Also 97 of the human animal bite cases were due to dogs. Therefore the high incidence of rabies in the county is due to a high dog density and minimal dog control which have a low vaccination rate Kitala et al. 1994
The purpose of this study was to determine factors associated with observed levels of adherence to ant rabies PEP vaccine among animal bite victims in Machakos level five hospital.
The study used Cross sectional study design. It utilized both qualitative and quantitative methods. Data was collected by use of semi-structured questionnaires physical examination sheet and key informant interview. The study population was victims of animal bites who revisited the health facility for the scheduled PEP vaccine. Random Sampling was used to select the revisiting animal bite victims until a sample size of 68 was achieved. Purposive sampling was used to select health care workers directly involved in management of animal bite victims until a sample size of three was achieved. Quantitative data was analyzed using SPSS version 20 and excel computer programs. Qualitative data was analyzed by content analysis. Binary logistic regression and multivariate regression was done.
The study findings established that knowledge of rabies significantly affects the level of adherence to antirabies PEP vaccine. At least 48.50 of the respondents admitted that they have no knowledge of rabies and 75 had no knowledge of prevention of rabies. The study also found out that affordability of the cost of PEP vaccine is statistically associated with adherence to anti-rabies PEP vaccination.
The study concluded that: the level of adherence and the overall awareness not only of anti-rabies PEP vaccine the follow-up of victims to check on the completion of the anti-rabies PEP vaccine schedule but also the management of wounds before visiting health facilities among animal bite victims in MKS L5 Hospital is low thus a major public health concern both to the community and the county government.
Publication Information
Focus County(s):
Machakos County
Programme Area(s):
Research Priority Area(s):
Disease Domain(s):
Document History:
Publication Date: 01.Jan.1970
Conference Title: