评估两家医院回顾性登记的狂犬病疑似病例,以及埃塞俄比亚南部牧民社区和传统治疗师的知识、态度和做法

Balako Gum, Sisay Girma, Hussein Mohamed, O. Kerro, H. Chaka
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摘要

尽管人类和动物都有狂犬病保护性疫苗,但在非洲和亚洲,动物狂犬病向人的传播仍在继续。据估计,全球每年有59,000多人死于该疾病。欧洲和北美的大多数工业化国家已经从家养狗群中消灭了狂犬病。然而,在大多数发展中国家,狂犬病仍然在家养狗中流行,而且控制不力。为了解埃塞俄比亚南部牧民和农牧民地区的狂犬病情况,收集并审查了在蓝霍拉和亚贝洛医院登记的431例狂犬病疑似动物咬伤病例的回顾性数据。此外,对107名选定的社区成员和55名传统治疗师的知识、态度和行为进行了评估。431例患者中,15岁以下占55.7%,16 ~ 25岁年龄组占24.4%。男性55.5%多于女性44.5%。在亚贝洛医院登记的病例中,只有32%接受了接触后预防,其余的则转到其他卫生设施。造成咬伤的动物98%为狗,其余为猫、狐狸和驴。主要发生在3 - 6月(36.2%)和11 - 2月(35.5%)。在受访的参与者中,87.8%的人知道狂犬病,83.2%的人能够提到狂犬病动物的症状。78.5%的参与者提到了狂犬病是如何传播给狗的,其中88.1%的人认为狗是主要的传染源。91.6%的参与者告诉我们狂犬病是通过患狂犬病的动物咬伤传染给人类的,94.3%的参与者认为狂犬病是可治疗的疾病,预防的主要手段是传统治疗。几乎所有的传统治疗师都提到狂犬病在人和动物中的症状及其传播途径;然而,90.9%的人认为传统治疗是控制狂犬病的有效手段。对社区居民和传统治疗师的访谈结果表明,大部分狂犬病病例由传统治疗师治疗。卫生服务提供者必须为咬伤受害者提供PEP疫苗,并需要通过健康教育提高当地社区对狂犬病和动物咬伤管理的认识。关键词:回顾性研究;狂犬病;南埃塞俄比亚;牧民
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Assessment of retrospective rabies suspected cases registered at two hospitals, community and traditional healers’ knowledge, attitude and practices in south Ethiopian pastoralist
Despite of available protective rabies vaccines for both human and animal, transmission of rabies from animals to people continues in Africa and Asia. Every year, over 59,000 people are estimated to die from the disease globally. Most of industrialized countries in Europe and North America have eliminated rabies from domestic dog populations. However, in the majority of developing countries, rabies remains endemic in domestic dog and poorly controlled. To understand rabies situation in pastoralist and agro-pastoralists area of southern Ethiopian, retrospective data on 431 rabies suspected animal bite cases registered at Bule Hora and Yabello Hospitals were collected and reviewed. Moreover, the knowledge, attitude and practice of 107 selected community members and 55 traditional healers were assessed. Out of 431 cases, 55.7% and 24.4% were < 15 and between 16-25 years age group, respectively. There were more male 55.5% cases than female 44.5%. Only 32% of cases registered at Yabello Hospital received post exposure prophylaxis (PEP), whereas the remaining referred to other health facilities. Ninety eight percent (98 %) of animal responsible for the bite was dog and the remaining were cat, fox and donkey. Most of bites were occurred in March-June (36.2%) and November-February (35.5%). Out of interviewed participants 87.8% of them know rabies and 83.2% were able to mention rabid animals’ symptoms. The 78.5% of participants did mention how rabies transmitted to dog and 88.1 % of them described dog as main source of infection. The 91.6% of participants told us that rabies is transmitted to human by rabid animals’ bite and 94.3% of them believe that rabies is treatable disease and the major means of prevention is traditional treatment. Almost all traditional healers mention that the symptom of rabies in human and animals, and its way of transmission; however 90.9% of them believe that traditional treatment as effective means of rabies control. Interview result of both community members and traditional healers indicated that most of the rabies cases treated by the traditional healers. Health service providers have to make PEP vaccines available for bite victims and need to raise awareness of the local communities through health education about rabies and animal bite management. Keyword : Retrospective Study; Rabies; South Ethiopia; pastoralists
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