Current practice in management of animal bites in First Referral Unit of Ahmedabad, Gujarat

Background: Rabies is a zoonotic disease, which is caused by animal bites. Dog bites are responsible for 99% of rabies cases. Postexposure prophylaxis with anti-rabies vaccine is the only way to prevent rabies infection. Aims and Objectives: To analyze the magnitude of animal bite and actual practices following such bites, and to evaluate the quality of care delivered to the victim of animal bite in community health centers (CHCs). Materials and Methods: A hospital-based cross-sectional study was carried out in Rural Health Training Center of NHL Municipal Medical College (Singarva CHC), Ahmedabad, Gujarat, India. Total 580 animal bite cases were interviewed with pretested questionnaire during November 2012 to January 2013. Results: In our study, median age of the study population was 22 years; 4% of patients were below 5 years of age. Majority of bites were due to dogs (98%) followed by monkeys (1%) and cats (1%). Bites in male subjects were 76%. Class II bites constituted 91%. Most common site of bites was legs (61%) followed by hands (16%) and thighs (10%). Timing of the bites showed that 42% bites occurred in the evening, about 33% in the morning, and 23% in the afternoon. Majority of cases (60.3%) were reported within 24 h after bite and 2% cases after 5 days. Total 72% patients have missed one or more doses. Among them, default for second dose was 19% followed by 21% for third dose. Fourth and fifth doses were missed by 26% and 34% patients, respectively. 27%, 31%, 24%, and 17% delayed dose were found in second, third, fourth, and fifth doses, respectively. Conclusion: Majority of patients believed that anti-rabies vaccine is not given on Sunday, and it is the most common cause for