Profile of children with rabies dog bites: Manado experience, Indonesia

Abstract

Background: Rabies is an infectious viral disease that is almost always fatal following the onset of clinical signs. Forty percent of all human rabies occur in children <14yearold. In up to 99% of rabies virus is transmitted by dogs.

Objective: To determine the mortality risk factor of children with rabies dog bites in Prof. Dr. RD Kandou Hospital, Manado, from 20122016.

Methods: We performed a retrospective cohort study of all pediatric patients with rabies dog bites. Rabies was diagnosed via detection of nucleoprotein from dogs brain using fluorescent antibody test (FAT). We used chi-square test and calculated odd ratio using software SPSS 23.0 to determine the mortality risk factor of patients with rabies dog bites, considering p value <0.05 as significant.

Results: During the study period, 38 children came with rabies dog bites (71.1% were boys). Incubation period range from 1 week to 4 years. Most common bites location was hand. Symptoms associated with rabies mortality were hydrophobia (OR 143, 95% CI 11.78-1735.96, p=0.0001), photophobia (OR 19.6, 95% CI 2.04-181.93, p=0.002), and hypersalivation (100% mortality, p=0.0001). Postexposure vaccination associated with mortality of patients (OR 0.003, 95% CI 0.000-0.056, p=0.0001).

Conclusion: Hypersalivation, hydrophobia, and photophobia are major risk factors of rabies dog bites mortality. Postexposure vaccination is important to prevent rabies infection after a high-risk bite.

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