RABIES IMMUNOGLOBULIN: Brief history and recent experiences in Côte d'Ivoire.

摘要: Abstract Background Rabies is a fatal viral zoonosis mainly transmitted via dog bites. The estimated 59′000 annual deaths caused by the disease are preventable through correct and timely administration of post-exposure prophylaxis (PEP). PEP should be initiated as soon possible after an exposure to rabies suspected animal consists course active vaccinations immunoglobulin (RIG) in case severe exposure. However, RIG not accessible most endemic countries its impact on survival combination with modern vaccines cost-effectiveness unclear. We examined effect equine (eRIG) field-trial Cote d'Ivoire, developing country low but chronic burden persistent lack RIG, similar majority attempting elimination disease. Methods Data from 3367 patients attending anti-rabies centers (Centres Anti-Rabiques, CARs) National Institute for Public Hygiene (Institut d'Hygiene Publique, INHP) departments Bouake San Pedro d'Ivoire was prospectively collected between April 2016 March 2018. identified 1594 at risk infection eligible administration. Depending local availability eRIG vaccination protocol applied, consisted immunization only (non-eRIG group, n = 1145) or passive (eRIG n = 449). Patients were followed-up phone interviews least 15 months their assess deaths. Results Follow-up data available 641 non-eRIG group (56%) 242 (54%). Three occurred each two groups, corresponding mortality 1.2% (95% CI 0.3–3.6%) 0.5% 0.1–1.4%) group. difference proportions small statistically significant (0.7%, p = 0.21). Deaths both groups associated treatment delay non-compliance protocol. No death independent Conclusion provision did lead measurable reduction our study population. This underlines that improved access will effective reducing even if remains difficult countries. A benefit severely exposed cannot excluded based these results.