Abstract
Background: The increasing trend in animal bites and rabies in recent years make the disease a public health concern in Iran. The objectives of the current study were to investigate the epidemiologic aspects of the animal bite as well as to determine associated risk factors of the delay in initiation of prophylaxis post-exposure (PEP) against rabies in Iran.
Study design: registery-based cross-sectional study
Methods: This national study included all registered cases of animal bites between March 2021 and March 2022 at the Center for Communicable Diseases Management, Ministry of Health and Medical Education, Iran. We retrieved epidemiologic data on person, time, place, as well as data on the PEP outcome.
Results: A total of 260,470 animal bite cases (approximately 3 per 1000 population, 15 deaths) registered in during the study period. About 77% were in male, 4% in fewer than 5 years, 56% occurred in urban area, 98% from domestic animal, 38% in 12:00 to 18:00 and mostly in north and northeast area of Iran. Approximately 3% of cases had delay more than 48 hours for initiation of rabies PEP. The provinces of Yazd (10%), Qom (6%) and Hormozgan (6%) had the highest delay, respectively. Significant determinants of delay were female (OR=1.4), foreign nationality (1.2), rural residents (1.1), fall and winter (1.2), wild animal (1.2) (p-value<0.05).
Conclusion: The observed burden of animal bites in a year alerts a serious public health concern and the need of targeted interventions especially in at risk areas and vulnerable population