Identification of risk factors is crucial to find ways to reduce rabies deaths. We investigated the hospital records of rabies deceased through contact tracing of the relatives of the victims using enhanced verbal autopsies (VA) to identify why the people had to die from rabies in recent years in Bangladesh. Patients whose deaths were confirmed by physicians based on the history of animal exposure and clinical signs were taken into account for VA. Socio-demographic profile of the deceased, animal exposure, nature of the wound, and history of postexposure prophylaxis (PEP) data were obtained and analysed. The study found 256 cases in which the cause of death was attributed to rabies, most of the victims were male (71.88%), resided in the rural community (80.47%), dependent (49.22%), and children below the age of 15 years (47.27%). Dogs were the single most responsible (81.64%); however, cats (12.11%), jackals (3.91%) and mongoose (2.34%) were also found accountable for rabies incidence (P< 0.05). Significantly, limbs were the most common (67.97%) site of exposure, and the shortest incubation period was identified in the case of bites to head and face (P < 0.05). The majority (86.72%) of the deceased did not receive any PEP; whereas, 66.80% sought treatment from traditional healers. Among the deceased (13.28%, n¼ 34) who had received PEP, only 8.82% of them completed the full course of the vaccination regimen (P< 0.01); however, none of them had history of taking rabies immunoglobulin (RIG). The study recommends extensive public health awareness programs in the rural community and establishing methods to improve healthcare-seeking behaviours, including receiving PEP instead of visiting traditional healers. Moreover, the availability and accessibility of PEP in the government hospital facilities are desirable, and laboratory-based surveillance with compatible rapid data reporting may be incorporated in the existing policy.
Abstract
Identification of risk factors is crucial to find ways to reduce rabies deaths. We investigated the hospital records of rabies deceased through contact tracing of the relatives of the victims using enhanced verbal autopsies (VA) to identify why the people had to die from rabies [...]
Developing and successfully implementing effective vaccination programs requires understanding the peculiarities of the people’s attitude towards vaccination. The prevalence of indecision regarding vaccination (understood as refusing or postponing vaccination despite the availability of vaccines) among the population can undermine the formation of collective immunity and compromise the effectiveness of vaccination programs. The goal of this work is to analyze the key factors influencing the people’s behavior and attitude towards vaccination. For this purpose, the authors review domestic and foreign studies devoted of the public behavior and attitude towards vaccination. As a result, three large groups of factors of population behavior in relation to vaccination are described: individual, organizational, and contextual. The most important socio-demographic predictors of readiness to be vaccinated are age and level of education. Such psychological features as the presence of cognitive distortions, intuitive thinking style, highly reactive temperament type contribute to indecision regarding vaccination. Other significant determinants of the readiness for vaccination are a high level of trust in the government, political actors, science and health authorities, social and interpersonal trust. In the context of the pandemic, concerns about the safety and effectiveness of vaccines and unknown long-term side effects have become the main reasons for hesitation regarding vaccination. At the same time, awareness about the vaccines and the diseases they prevent, the availability of reliable and transparent information is positively associated with the willingness to get vaccinated. The intention to get vaccinated will be higher if the perceived probability of COVID-19 infection is high and the expected consequences for one's own and others’ health and well-being are assessed as serious. Previous vaccination experience, the presence of those vaccinated against COVID-19 and/or those who have contracted the disease in one’s social environment can act as the incentives for vaccination. The most important organizational factors contributing to a positive attitude and desire to get vaccinated are the availability of vaccination services, high awareness of the vaccines and a positive attitude towards them on the part of medical professionals. At the same time, the short development time of the new vaccines, the novelty of some platforms carrying the COVID-19 vaccine antigen, contribute to indecision regarding vaccination. Contextual factors include historical, political, and socio-cultural factors, as well as the state of the communication and information environment.
Abstract
Developing and successfully implementing effective vaccination programs requires understanding the peculiarities of the people’s attitude towards vaccination. The prevalence of indecision [...]
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