Coverage of post-exposure rabies vaccine at community hospitals In Phra Nakhon Sri Ayutthaya Province, 2019

Abstract

The objectives of this study were to determine coverage of post-exposure rabies vaccine in hospitals in
Phra Nakhon Sri Ayutthaya Province, 2019 and provide suggestions for improvement. A cross-sectional study was conducted by reviewing medical records of rabies cases, patients bitten by mammals and those receiving post-exposure rabies vaccine (A82, W53 – W55 and Z242 by ICD-10-TM coding) in 2 community hospitals of the districts with reported animal rabies during the previous 3 years (2017-2019). A total of 2,813 cases with post-exposure rabies vaccine were found and 398 cases were randomly selected for the study. The coverage of post-exposure rabies vaccine was 100.00% among those with exposure to laboratory-confirmed animal rabies and 95.23% among those exposed to no laboratory-confirmed animal rabies. The accuracy of service quality was 93.72%. The inaccurate service provision included no rabies immunoglobulin (RIG) according to the national guidelines (5.78%, 23 times) and incorrect vaccine administration from intradermal (ID) to intramuscular (IM) injection (0.50%, 1 case with 2 times). The completeness of data quality was 82.91%. The incomplete data were incorrect vaccination records of ID/IM injections (10.30%, 41 times), no records of drug use (3.52%, 14 times) and incorrect ICD-10-TM coding (3.27%, 13 times). In conclusion, the coverage of post-exposure rabies vaccine in the study areas was very high among those with exposure to either laboratory-confirmed or no laboratory-confirmed animal rabies. It is recommended to encourage use of the national guidelines for post-exposure rabies vaccination and orientate or train the new officers for ICD-10-TM records. Package of separated ID and IM rabies vaccination records may be useful to reduce incorrect recording.