Adequabilidade da conduta profilática no primeiro atendimento antirrábico nas regionais de saúde do Estado do Paraná no ano de 2010

Abstract

Rabies is a disease with high lethality and the post-exposure prophylaxis is of utmost importance. The post-exposure prophylaxis of rabies aims to reduce adverse events, and prophylactic treatment presents itself as an important strategy. The decision for the type of treatment depends on the characteristics of the lesion, species and condition of the animal aggressor, who will determine whether or not there is need of the vaccination and use of serum antirabies. This study aimed to analyze the profile of the antirabies treatment and evaluate the appropriateness of the prophylactic treatment post-exposure, occurred in 2010 in the state of Paraná. Data were obtained from records of Information System for Notification Diseases. To analyze the profile of the treatment was accomplished simple frequency of categorical variables and calculation of incidence of treatment. To prophylactic conduct were performed univariate analysis using the chi-square and regression, with a confidence interval of 95% and a significance level of <0.05 for outcome variable. There were 39,087 cases, with the largest number of cases for males with 55.14% for adults aged 20 to 59 years old with 45.00% and 58.04% for individuals with incomplete elementary schooling. The dog was the main aggressor in 92.69% and the bite was the kind of exposure most frequently (82.11%). It was found that 40.82% were the inadequate treatment. In bivariate analysis the population with the highest risk of receiving inadequate treatment were the men, individuals 13-19 years and individuals residing in the urban periphery. It was also observed that the Regional Health centers were considered protective factors for inadequacy treatment, as well as deep wounds and lacerating. Individuals who were dispensed from treatment presenting 207.88 times more likely to have inadequacy treatment when compared to individuals who received vaccine and observation of the animal. The coaching of health professionals in order to improve the investigation of cases to correct indication of prophylactic treatment is of utmost importance, as well as prevention campaigns of animals potentially transmitting rabies to the general population.