PHARMACOVIGILANCE ON RABIES IMMUNOGLOBULINS ADMINISTRATION By Rajan H. Under the guidance of...

transcript

PHARMACOVIGILANCE ON RABIES

IMMUNOGLOBULINS

ADMINISTRATION By Rajan H.

Under the guidance ofSudharshan M.K., Mahendra B.J., Githa Kishore, Meera N.K.

Department of Pharmacy Practice Department of Pharmacy Practice

Visveswarapura Institute of Pharmaceutical SciencesVisveswarapura Institute of Pharmaceutical SciencesBangaloreBangalore

INTRODUCTION

DEPARTMENT OF PHARMACY PRACTICE – VIPS, BANGALORE

• Rabies is essentially a zoonotic disease with man being the dead-end host.

• Annual number of deaths caused by rabies worldwide as estimated by WHO accounts for 55,000 and mostly in the rural areas of Africa and Asia.

• Post-exposure prophylaxis adequately applied after exposure to a rabid animal is highly effective in prevention of human disease.

• Adverse reactions after vaccination are considered as an important practical problem.

• Identification of adverse reactions during post-exposure prophylaxis of rabies immunoglobulins would be helpful in improving the quality of life of the recipient and to prevent further hospitalization.

• This study is a small step in this direction.

OBJECTIVE

• To find out the various adverse reactions during post-exposure prophylaxis of rabies immunoglobulins.

• To find out the sociodemographic details of the host as well as the carriers.

METHODOLOGY

• A retrospective study was conducted in 1000-bed tertiary care teaching hospital, in Rabies Preventive Medicine Department, KIMS, Bangalore.

• The data was collected for a period of two and a half years from June 2003 to December 2005 based on the records and data stored in the department.

RESULTS

DISCUSSIONS

• Overall 1316 cases were analyzed.

Gender

889, 68%

427, 32%

female

RESULTS AND DISCUSSIONS

Female Patients

19, 4%

408, 96%

pregnant female

non pregnant

RESULTS AND DISCUSSIONS

Residence

341, 26%

975, 74%

Occupation

209, 12%

1107, 61%

499, 27%

un employed

employed

students

Educational Qualification

0100200300400500

illitera

diplom

Monthly Income

117 157

0100200300400500600700800900

Time of Bite

337, 26%

979, 74%

Place of Bite

375, 28%

941, 72%

on road

Nature of Bite

506, 38%

795, 61%

15, 1%

provoked

unprovoked

cant say

Biting Animal

3 1 27 4 2

3 19 4 220

Nature of Biting Animal

human pet stray wild

Pet:Stray Ratio is : 1:2.5

Vaccination Status Of Biting Animal

78, 6% 108, 8%

1130, 86%

fully vaccinated

partiallyvaccinated

unvaccinated

Place of Biting

774, 58%

520, 40%

22, 2%

over bareskinoverclothingboth

DEPARTMENT OF PHARMACY PRACTICE - VIPS, BANGALORE

Type of Wound

296, 22%

303, 23%242, 18%

393, 31%

82, 6%

abrations

lacerations

mixed(abrations+lacerations)punture wound

scratch

DEPARTMENT OF PHARMACY PRACTICE VIPS BANGALORE

Wound Washed

87, 7%

25, 2%

403, 31%

71, 5%616, 46%

114, 9%

antiseptic only

water andantiseptic

water andsoapwater only

water+soap+antiseptic

not done

Fate of Dog

100200300400500600

able sick

Conformation of Rabid Animal

0200400600800

confirmedrabid

not rabid probablyrabid

suspectrabid

Dressing of Wound

200400600800

100012001400

dressed notapplicable

nothingdone

sutured

Age of Subjects Bitten

343412

0100200300400500

Rig Administered

1237, 94%

79, 6%

Occurence of Reaction

126, 10%

1190, 90%

VaccineLocalPain Others No Reaction Total p-value

ERIG 147 7 1083 1237

0.015012HRIG 18 0 61 79

Total 165 7 1144 1316

Chi – Square Test For Immediate Reactions

Immediate reactions ERIG (n=1237) HRIG(n=79) p-value

Local Pain 147 18 0.0005

Others 7 0 0.503

No reaction 1083 61 0.008

Z Test For Proportions

Chi – Square Test For Delayed Reactions

Vaccine FeverLocal Pain

Urticaria Others No reaction Total p-value

ERIG 6 4 5 4 1218 1237

<0.001HRIG 3 3 0 2 71 79

Total 9 7 5 6 1289 1316

Late reaction ERIG (n=1237) HRIG(n=79) p-value

Fever 6 3 0.013

Local Pain 4 3 <0.001

Urticaria 5 0 0.571

Others 4 2 0.005

No reaction 1218 71 <0.001

Z Test For Proportions

CONCLUSION

• The study helps to identify the adverse reactions of rabies immunoglobulins so that further precautions can be taken by giving proper counseling and treatment to improve the quality of life of the recipient.

• Since P value is <0.05, we can conclude that there is a significant relationship between the type of vaccines and the immediate reaction.

CONCLUSION

• Since the pet:stray dog ratio is more ie 1:2.5, the stray dog population should be controlled.

THANK YOU

PHARMACOVIGILANCE ON RABIES IMMUNOGLOBULINS ADMINISTRATION By Rajan H. Under the guidance of...

Documents