EPIDEMIOLOGIC PROFILE AND THE QUALITY OF CARE MANAGEMENT OF PEOPLE EXPOSED TO RABIES; BOUSALEM DISTRICT, JENDOUBA, TUNISIA; 2020

Abstract

Intro: Tunisian Ministry of Health has reported 05 human rabies deaths during 2022. Our study aims to describe the epidemiologic profile and to assess the quality of care management of people exposed to rabies in BouSalem District during 2020. Methods: This is a descriptive study of potential rabies exposure and of the quality of post exposure management. We collected data from rabies registry. Data analysis was performed using MS Excel and EpiInfo 7.Comparisons were made using the KHI2 test Findings: The number of exposed people to animal aggressions has exceeded 2000 in the last four years. During 2020, 452 cases of exposed people was registered. More than half, were from rural areas (56%). As for, the age distribution, people with 60 years old and over seemed to be more exposed with male predominance (62%). Otherwise, aggressor animals samples for laboratory analysis were taken from 86 attacking animals; the overall positivity rate was 31.4%. The type of lesions caused were essentially superficial (84.5%). The site concerned the extremities in half of the cases (49.7%). As for the time frame for taking charge, it varied between 0 and 34 days with an average of 0.9 days .People who consulted at the second day or more represented (9.9%). In which concerns Post Exposure Prophylaxis scheme, the A02 was the most prescribed (66.4%).In fact, 84% of people received a complete treatment according to the recommended number of doses. Schemes A and B, based on the condition of the animal after exposure, were met in 37.4 and 84.6%, respectively. Thus, we tried to assess the risk of exposure to RABV, the probability of having rabies after a rabid animal bite is 55% for a head bite,22% for an upper limb wound 9% and 12% for a lower limb. Conclusion: Rabies is a major public health problem. The ''One Health'' approach must be implemented through operational measures.