Profilaxia antirrábica humana: proposta de uma nova metodologia de ação
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Data
2012-02-08
Autores
Frias, Danila Fernanda Rodrigues [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A avaliação dos casos de agressão por animais, sem critérios bem definidos, podem levar à indicação equivocada de tratamento antirrábico humano pós-exposição. O número desses tratamentos, em muitos municípios em todo o Brasil, tem preocupado as autoridades sanitárias. Assim, o presente trabalho objetivou avaliar os registros e a conduta da profilaxia antirrábica humana no Município de Jaboticabal, no período de 2007 a 2010, e propor uma nova metodologia de ação. Foi elaborada uma nova ficha de atendimento antirrábico humano, a ficha referência de atendimento a agressão animal e a ficha de visita zoossanitária, todas com seus respectivos manuais de instrução para preenchimento. Além disso, realizou-se a capacitação dos responsáveis pela aplicação das mesmas e as visitas zoossanitárias. Foram avaliadas as informações das fichas de atendimento e dos resultados de visitas domiciliares e observação dos animais agressores; os dados foram tabulados em Excel e analisados com softwares EpiInfo e Action. Também calculou-se o custo direto das vacinas antirrábicas humanas aplicadas. Em 1.366 fichas analisadas, computou-se um agravo para cada 212 habitantes; das pessoas agredidas, 74,3% receberam tratamento pós-exposição, num total de 1.251 doses de vacina. A análise detalhada dos dados, aliada ao fato de Jaboticabal ser considerada região controlada para a raiva, permite questionar que 894 pessoas podem ter recebido vacina sem necessidade, totalizando 1.094 doses a um custo aproximado de 20 mil reais. Nas visitas zoossanitárias constatou-se que, dentre os animais agressores, 78,1% eram domiciliados; 84,4% estavam sadios nos dias 0 e 10; 55% dos ataques foram provocados, e 73% das agressões ocorreram nas próprias residências. Assim, maior atenção deve ser dispensada ao atendimento a agravos por...
A poor assessment of cases of animal attacks towards humans may lead to inadequate human rabies prophylaxis. The high number of post exposure prophylaxis (PEP) treatments in many Brazilian cities has become a concern for Public Health authorities. The present study aimed to assess the records and the conduct of human PEP in the municipality of Jaboticabal, within 2007-2010, and to propose a new methodology. Versions for the following forms, together with instructions for filling them out, are proposed: human rabies medical attention form, animal attack notification form and a zoossanitary form. The personnel in charge of the health sector were trained for filling out these forms and conducting visits. It was evaluated the analysis of patient’s records and the results of home visitation and animal observation data. Data was organized in Excel spreadsheet and analyzed by EpiInfo and Action softwares. Direct cost of human vaccination was also calculated. In 1,366 analyzed records, there was one animal attack per 212 inhabitants. Among injured people, 74.3% received PEP, resulting in a total of 1,251 vaccines shots. The fact that Jaboticabal is located in a region that have controlled status for rabies, coupled with data analysis, allowed questioning that 894 persons may have received rabies shots unnecessarily, which resulted in a total of 1,094 shots at a cost of approximately 20 thousand reais. During zoossanitary visits, it was observed that among the aggressors, 78.1% were domiciled animals; 84.4% remained healthy between observation days 0 to 10; 55% of attacks were provoked and 73% of aggressions happened inside the domicile. It can be concluded that greater importance should be given to the attention of animal attacks cases. Adequacy should be made to the patient’s records, animal attack notification... (Complete abstract click electronic access below)
A poor assessment of cases of animal attacks towards humans may lead to inadequate human rabies prophylaxis. The high number of post exposure prophylaxis (PEP) treatments in many Brazilian cities has become a concern for Public Health authorities. The present study aimed to assess the records and the conduct of human PEP in the municipality of Jaboticabal, within 2007-2010, and to propose a new methodology. Versions for the following forms, together with instructions for filling them out, are proposed: human rabies medical attention form, animal attack notification form and a zoossanitary form. The personnel in charge of the health sector were trained for filling out these forms and conducting visits. It was evaluated the analysis of patient’s records and the results of home visitation and animal observation data. Data was organized in Excel spreadsheet and analyzed by EpiInfo and Action softwares. Direct cost of human vaccination was also calculated. In 1,366 analyzed records, there was one animal attack per 212 inhabitants. Among injured people, 74.3% received PEP, resulting in a total of 1,251 vaccines shots. The fact that Jaboticabal is located in a region that have controlled status for rabies, coupled with data analysis, allowed questioning that 894 persons may have received rabies shots unnecessarily, which resulted in a total of 1,094 shots at a cost of approximately 20 thousand reais. During zoossanitary visits, it was observed that among the aggressors, 78.1% were domiciled animals; 84.4% remained healthy between observation days 0 to 10; 55% of attacks were provoked and 73% of aggressions happened inside the domicile. It can be concluded that greater importance should be given to the attention of animal attacks cases. Adequacy should be made to the patient’s records, animal attack notification... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Profilaxia antirrábica humana, Human rabies prophylaxis
Como citar
FRIAS, Danila Fernanda Rodrigues. Profilaxia antirrábica humana: proposta de uma nova metodologia de ação. 2012. xi, 96 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Ciências Agrárias e Veterinárias, 2012.