Predictors of Delay in Seeking Post-Exposure Prophylaxis in Older Adults with Animal Bite Injuries: A Population-Based Study

Hassan  Soleimanpour; Mehdi  Abbasian; Ehsan  Sarbazi; Seyed Pouya  Paknezhad; Hadi  Jalilvand; Nazanin  Masoudi; Hosein  Azizi; Zahra Khalili

doi:10.18502/ehj.v7i2.8118

Hassan Soleimanpour Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
Mehdi Abbasian Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Ehsan Sarbazi Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Seyed Pouya Paknezhad Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
Hadi Jalilvand Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Nazanin Masoudi Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Hosein Azizi Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Zahra Khalili Department of Nursing and Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran

DOI: https://doi.org/10.18502/ehj.v7i2.8118

Keywords: Post-Exposure Prophylaxis, Decision Tree, Bite Injury, Delay of Vaccine

Abstract

Introduction: Animal bites are of the major health threats. Delayed post-exposure prophylaxis (PEP), especially in frail older people, may lead to mortal risks in this age group. The aim of this study was to investigate the pattern of delayed PEP in animal-bites injuries and to identify its contributing factors in older people of Tabriz city, Iran.

Methods: In this cross-sectional study, the census method was used to obtain data from health records of older adults who were referred to Tabriz's Rabies Treatment Center between March 2013 and March 2018. The delay was defined as starting PEP longer than 24 hours after a suspected rabies virus exposure. The relations between delayed PEP and each of the predictors were investigated using the chi-square test in univariate analysis. The decision tree model was applied to predict the delay time of PEP.

Results: A total of 322 older people with a mean age of 67.62 ± 7.18 were studied. In all, 31.7 % of the older persons victims who were bitten by an animal had a delayed PEP. Urban victims (34.1%) compared to rural (16.3 %), stray animal victims (42.0 %) compared to an owned animal-bite victim 24.6 %, all other animal bite-related victims (39.9 %) compared to dog-bite injuries (23.8%) experienced a higher frequency of delayed PEP. The decision tree revealed that animal ownership status, animal status, and animal species were the most important factors for predicting delayed PEP (p < 0.001).

Conclusion: The possibility of delayed PEP in older adults bites victims, increased if the animal was ownerless and escaped. A reasonable approach to tackle this issue might be to conduct larger population studies in the future.