Tendência e características do atendimento anti-rábico humano pós-exposição na Região Centro-Sul Fluminense, 2000-2005

Abstract

The objectives of this study were to understand the characteristics of human rabies postexposure prophylaxis (PEP) in Center-South Region of Rio de Janeiro State and analyze PEP trends against epidemiologic situation of canine rabies, indirectly analyzing integration between control actions developed in the area. Data from 4310 patients who visited health services because of animal aggressions between years 2000 and 2005 were obtained in Health State Department, as well as canine vaccination coverage information. In this paper, descriptive analysis was used to study variables like: method and source of exposure occurrence, patients age and sex, health conditions and species of the animal aggressor, PEP interruption, characteristics of the wounds and previously PEP prescription. Data related to animal exposure incidences, PEP prescription incidence, dogs density, dog/human rate and canine vaccination coverage were also studied. Simple linear regression was carried out to obtain human rabies prescription and canine vaccination trends. c² test was used to verify significant difference (r £ 0,05) among vaccinated patients proportion in the period. Incidence of animal agression ranged from 10,1/10.000 persons in 2000 to 29,2/10.000 persons in 2005, with an average of 23,7/10.000 persons. Bite exposures accounted for 79,3% of the wounds, dogs were responsible for 86,2% of the cases and most of them were healthy at the moment of the aggression (44,8%). Male patients accounted for 57,5% of the cases. Most of the patients between 1 and 15 years (35%) also were male (62,2%). Most of the wounds were unique (59,7%) superficial (60,8%) and not-provoked (60,1%). Incidence of rabies PEP ranged from 5,1/10.000 persons in 2000 to 23,6/10.000 persons in 2005, reaching an average of 15,2/10.000 persons. Rabies PEP prescription average and estimated canine vaccination coverage in the period was 64,1% and 92,8%, respectively. Estimated relation dog/human in 2005 was 1:5,8 and dog density in the same year was 16,7 dogs/km². There was significant difference between proportions of vaccinated and non-vaccinated patients in the period. The characteristics of human rabies post-exposure prophylaxis and animal aggressions hadn t changed and there was an ascended trend in human rabies post-exposure prophylaxis prescription, with high proportions and significant difference, despite the high levels of canine vaccination coverage and absence of human and canine rabies notification, indicating a lack of integration between prevention actions developed in the area.