Document Type: Original Article

Authors

1 1Health Services Management Road Traffic Injury Research Center, Iranian International Safe Community Support Center, Tabriz University of Medical Science, Tabriz, Iran ; 2Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 PhD student in Applied ELT at Ilam University, Faculty of humanities and foreign languages Ilam, Iran

3 School of Nursing of Miyandoab, Urmia University of Medical Sciences, Urmia, Iran

4 Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran

5 Tabriz Health Center, Tabriz rabies prevention and treatment center, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran

6 Department of Health Services Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

7 MSc of Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Objectives: The aim of the present study was identifying factors associated with h delayed initiation of post-exposure prophylaxis (PEP) among animal bite victims.
Methods:This cross-sectional study assessed biting patterns among 3032 cases that were referred to Tabriz Rabies Center. The delay was described as the initiation of PEP more than 48 hours (h) after possible exposure to the rabies virus. Determinants of delay in initiating PEP were recognizing by a decision tree model.
Results: Totally, 8.5% of the victims who were bitten by an animal had a delay of more than 48 h in the initiation of PEP. The relative frequency of delay more than 48 h in females was higher than the males (12.9% compared to 8.5%) (p-value= 0.004). Relative frequency of delay more of 48 h from carnivorous (dog, jackal, fox) was significantly less than others (p -value< 0.001). Of the decision tree, the overall classification accuracy was 89.5%, with 44.1% sensitivity and 92.3% specificity. The identified variables included gender,biting place (rural, urban), and type of animal.
Conclusion: Based on the study findings on various variables that affect the delayed initiation of PEP, particularly being female, and rural residents were the major factors associated with a delay in the initiation of PEP for rabies prevention. We found relatively low rates of vaccine completion. Our findings indicate that provider training and patient education are required to ensure the completion of appropriate treatment.

Keywords