Characterization and management of animal bite injuries reported at Gatundu and Thika Referral Hospitals, Kiambu County, Kenya

Abstract

Background: Animal bite injuries are a major cause of public health problems worldwide; however severe losses occur in the middle and lower income countries. Animal bite injuries can lead to trauma, morbidities and mortalities when infectious organisms such as Rabies virus, Pasteurella spp and Tetanus are introduced through the bites. Objectives: To describe animal bites cases and factors influencing compliance with the recommended regime for the management of animal bites injuries, and determine the application of One Health approach in the management of the animal bites. Methodology: A cross-sectional study was conducted to eligible patients with complaints of animal bite injuries in Thika and Gatundu level five hospitals from January 2021 through to May 2021. Data were collected using semi-structured questionnaire, further Treatment information was obtained from patient records. Epi Info. 2.7.4 was used for statistical analysis. Frequencies and proportions were calculated for categorical variables, while measures of central tendency and dispersion were calculated for continuous variables. Chi-squared statistics was used to measure the statistical significance of the association between independent variables and the outcome of the animal bites at 95% Confidence Level at bivariate analysis. Unconditional logistic regression was done to identify independent factors associated with animal bites. Results: A total of 127 patients were interviewed; 69 (54.3%) from Thika Hospital and 58 (45.7%) from Gatundu Hospital. Their median age was 23 years, (Range 3–90 years, IQR 30). Respondents aged 10–14 years were 29 (22.8%) while 31 (24.4%) of the bites occurred in Thika West Sub-County. Bites on the legs were 105(82.7%). Dogs inflicted 120 (94.5%) of the bites. Biting animals with unknown ownership status were 56 (44.1%) while biting animals with antirabies vaccination status known were 20 (15.6%). Respondents who immediately washed the bite wound with soap at home were 55 (43.3%), those who received the first antirabies vaccine injection within 24 hours were 95 (77.8%). Only 3 (2.4%) respondents were referred by attending clinicians to the veterinary professional or local administration offices regarding biting animals’ interventions. Respondents who complied fully with WHO guidelines for animal bites management were 43 (35.2%). Factors associated with WHO compliance were those who were employed (aOR= 7.53, 95% CI: 2.45–23.09) and not knowing the biting animal ownership status (aOR= 3.3, 95% CI: 1.27-8.67) Conclusion: Compliance with WHO guidelines for animal bites management among respondents was low. Respondent’s employment status and biting animal of unknown ownership status were associated with compliance. Recommendations: The health authorities should increase the supply of human anti-rabies vaccines, raise community awareness on animal bites injuries, preclinical wound management, enforce responsible dog ownership and strengthen one health Approach in animal bites management.