How familiar are our doctors towards Rabies prophylaxis- A study from coastal south India

Background: Rabies, a 100% fatal disease claims more than 59,000 human lives every year globally. One human life is lost every 15 minutes due to this deadly preventable disease. Timely initiation of post exposure prophylaxis following an animal exposure can result in 100% preventability of this fatal disease. Methodology: This facility based study was conducted among clinical fraternities of teaching hospitals. A semi structured questionnaire was used for collection of data. Institutional Ethics Committee approval was sought. The study investigators visited the workplace of the participants and distributed the questionnaire. SPSS Ver 16 (Chicago, IL, USA) was used to analyse the data. Findings: Most of the participants knew that veterinary groups and zoo-keepers should be given pre-exposure prophylaxis. Many participants knew about the Intra Muscular schedule of anti-rabies vaccine and its site of administration for pre exposure prophylaxis. It was observed that most participants had knowledge regarding correct intramuscular regimen of anti-rabies vaccine for post-exposure prophylaxis but less than half were able to differentiate between the intramuscular and intradermal regimens. Less than half of participants were aware of the fact that local administration of anti-rabies serum is useful. Conclusion: The knowledge regarding WHO categorisation of animal exposure and recommended post exposure prophylaxis according to type of exposure observed to be minimal among clinical fraternity. Author summary: Rabies is a zoonotic disease. More than 95% of human rabies deaths is dog mediated. Rabies a 100% fatal yet preventable disease; a major public health problem in most of the Asian countries including India. The reduction in human rabies deaths is possible only when our clinical fraternity are aware of WHO recommended rabies post exposure prophylaxis to be offered to animal bite victims. With this in mind, a study was done among clinical fraternities and post graduates of Medicine, Surgery and Paediatrics departments of three tertiary care teaching hospitals affiliated to a medical college. It was observed that, the knowledge regarding reservoir of rabies infection and modes of transmission of rabies infection was satisfactory but the knowledge regarding WHO categorisation of animal exposure and recommended rabies post exposure prophylaxis was inadequate. Bridging this knowledge gap through periodically conducted Continuous Medical Education, Workshops and hands on training is essential for reducing human rabies deaths.