Characteristics of Animal Bite Victims Presenting for Antirabies Post-Exposure Prophylaxis Vaccine in Machakos Level Five Hospital, Kenya

Abstract

Rabies is a viral disease that affects the central nervous system. It affects both animals (animal rabies) and man (human rabies). Human rabies is present in all continents except Antarctica. It is a zoonotic disease transmitted through rabid bites, scratches, infectious saliva getting into contact with an open mucous membrane or break into the skin. Rabies control in Kenya has been hampered by the high cost and scarce supplies of potent vaccines. In Machakos County, human rabies has been endemic for over 40 years with stray dogs increasing in number day in day out and consequently leading to an increase in animal bite victims. The main objective of the study was to determine the characteristics of animal bite victims presenting for antirabies post-exposure prophylaxis vaccine in Machakos Level Five Hospital, Kenya The study employed both qualitative and quantitative methods of data collection. A Cross sectional design was used for the quantitative study while in depth interviews were used for the qualitative aspect. Data was collected by use of questionnaires, physical examination sheet and key informant interview. The study population was victims of animal bites who revisited the health facility for the scheduled post exposure prophylaxis vaccine. Random Sampling was used to select the revisiting animal bite victims until a sample size of 243 was achieved. Purposive sampling was used to select health care workers directly involved in management of animal bite victims. A physical examination of the bite was also done to determine the nature and extent of the wound. Quantitative data was analyzed using SPSS Version 20 and excel computer programs. Qualitative data was analyzed by content analysis. Ethical clearance was granted by the Kenyatta National Hospital/ University of Nairobi Ethics Research Committee and permission to conduct the study in Machakos Level 5 Hospital was received from the Medical Superintendent. Permission to use an audio recorder during in depth interviews was sought from the respondents. Data was coded and had no names for confidentiality purposes. According to this study, knowledge of rabies significantly affects the presentation for antirabies post exposure prophylaxis vaccine. At least 48.50% of the respondents admitted that they had no knowledge of rabies and 75% had no knowledge of prevention of rabies. The results also indicate that only 4.4% of the respondents said that the health workers get in contact with them to check on completion of the antirabies post-exposure prophylaxis vaccine schedule. This shows lojw follow up measures are in place. In conclusion, the overall knowledege of anti-rabies post exposure prophylaxis vaccine and the follow-up of victims to check on the completion of the anti-rabies post exposure prophylaxis vaccine schedule among animal bite victims in Machakos Level Five Hospital is low, thus a major public health concern both to the community and the county government. The study recommends that Machakos county government put more resources into raising the awareness and knowledge on rabies and its prevention in the County.