Exposure History, Post-Exposure Prophylaxis Use, and Clinical Characteristics of Human Rabies Cases: A Twelve-Year Retrospective Review at a Tertiary Facility in Ghana
P. Puplampu, A. A. Asare, N. A. H Seneadza V. J. Ganu
Abstract
BACKGROUND: Robust monitoring and reporting systems for
rabies are lacking thus increasing the risk of under reporting.
Highlighting the rabies cases brings to bear the needed urgent
attention for more efforts at preventing and controlling the disease.
OBJECTIVE: To describe the epidemiological characteristics of
patients managed for clinical rabies at the largest referral facility in
Ghana.
METHODS: A retrospective single-center hospital-based chart
review and data extraction were conducted for persons managed for
clinical rabies infection at the Korle-Bu Teaching Hospital from
January 2008 to December 2019. Data analysis was done using
STATA. Descriptive statistics were used to summarize the
epidemiological and clinical characteristics. Fisher's exact test, the
Kruskal-Wallis test, and Spearman's correlation coefficient were
used to explore significant associations.
RESULTS: A total of 28 cases were recorded over the period of
review. All of them died and most (68%) of them were males.
Twenty-one percent of them were less than 15 years old. Their
median age interquartile range (IQR) was 31 years (25.5 years) and
the median incubation period for rabies (IQR) was 60 days (60 days).
The source of rabies for cases was mainly dog bites. The vaccination
status of all the animals could not be ascertained. Majority (80%) of
the patients took neither anti-rabies vaccine nor immunoglobulin as
post-exposure prophylaxis after the dog bite. The median time of
admission before death (interquartile range) was 2 days (2 days).
Majority (82%) of the cases were furious rabies.
CONCLUSION: Attention should be directed at mass vaccination
of dogs as dog bites are common. Ensuring availability and access to
post-exposure prophylaxis (PEP) is also critical in averting rabiesrelated
deaths. WAJM 2024; 41 (1): 36 - 41.
KEYWORDS: Rabies, dog bite, post-exposure, prophylaxis, mass
vaccination.
