Abstract:
Introduction. Each year, an estimated 25000 rabies death occurs in Africa. Post-exposure prophylaxis (PEP) remains the only
proven approach in preventing rabies deaths. Most of rabies deaths occur among those who delayed, did not receive, or complete
rabies PEP. )e aim of this study was to determine the pattern of animal bite, factors associated with delays in initiating, and
nonadherence to rabies PEP regimen. Method. Data on clients reporting for rabies PEP in a tertiary hospital setting in Ghana were
collected from 2013 to 2016. Demographics, place, and source of exposure were collected. Other information obtained included
adherence to the PEP protocol and GPS coordinates of the town of animal bites. )e shortest distance between the GPS coordinates
of town of animal bite and the site of administration of the rabies PEP was calculated. A total of 1030 individuals received
rabies PEP over the period. Results. Overall, 52.9% (545) were males while 47.1% (485) were females. Majority of the cases were
between the age group 1–10 years accounting for 29.2%. Dog bites accounted for 96.5% (n = 994). Cats, nonhuman primates,
human bites, respectively, accounted for 1.8% (n = 18), 1.2% (n = 12), and 0.6% (n = 6) of all bites. Majority of bites occurred at
home (66.2% (n = 646)). Also, 31.6% (n =308) and 2.3% (n =22) of bites occurred on the streets and neighbors/friends’ homes,
respectively. Only, 18.7% initiated PEP within 24 hours of bite. Rabies PEP regimen completion rate was 95.2% (n = 976). )e
median distance travelled to access rabies PEP was 7.87 km (IQR, 3.58–16.27) km. Overall, 34.7% (n = 344) had the animal bite
within 4.99 km radius of the treatment room of KBTH. Clients who delayed in initiating rabies PEP were 2.6 (95% CI, 1.3–5.1)
times more likely to be males and 2.0 (1.1–3.9) times more likely to receive bites in a location more than 5 km radius from the
KBTH treatment room. Gender, age, and distance of bite from the treatment room were not associated with the likelihood of not
completing rabies PEP schedule. Discussion. Bites from suspected rabies infected animals remain a problem in southern Ghana.
)ere are significant delays in initiating PEP for rabies prevention. Most animal bite victims are children ten years and below. Male
gender and bites more than 5 km radius from the site of rabies PEP administration were most significant factors associated with
delays in initiating rabies PEP. )ere is the need for adopting strategies to encourage prompt initiation and adherence to PEP.
