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      Conocimiento de la población peruana acerca de las acciones que componen la triada preventiva de la rabia transmitida por mordedura de canes domésticos Translated title: Knowledge of the Peruvian population about the actions that make up the preventive triad of rabies transmitted by bite of domestic dogs

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          Abstract

          RESUMEN El objetivo del estudio fue determinar el conocimiento de la población peruana acerca de las acciones que componen la triada preventiva de la rabia que fueron reportadas en la Encuesta Nacional de Programas Presupuestales 2020. Las variables independientes fueron los departamentos del país (incluye Callao), área (urbana y rural), región geográfica (costa, sierra y selva) y estratos sociodemográficos urbanos (A, B, C, D y E). El estudio recuperó información de 52 791 encuestas, encontrándose que el componente de la triada preventiva reconocido con mayor frecuencia fue el acudir al establecimiento de salud (85.4%), seguido por lavarse la herida con abundante agua y jabón (43.1%) y, por último, identificar al animal agresor (15.5%). Estos componentes fueron reconocidos con mayor frecuencia en área urbana y en la costa del país. Se encontró una correlación positiva y directa entre el conocimiento de los componentes de la triada preventiva y el nivel socioeconómico. Entre los departamentos endémicos a rabia, Arequipa presentó una mejor proporción de respuestas favorables en comparación a Puno. Se concluye que es necesario difundir el conocimiento de los componentes de la triada preventiva, especialmente en zonas endémicas a rabia canina, a fin de incrementar las actitudes y prácticas que impacten en la reducción del riesgo de la transmisión del virus y el desarrollo de la enfermedad en humanos.

          Translated abstract

          ABSTRACT The aim of this study was to determine the knowledge of the Peruvian population about the actions that make up the preventive triad of rabies that were reported in the National Survey of Budgetary Programs 2020. The independent variables were the departments of the country (includes Callao), area (urban and rural), geographic region (coast, highlands and jungle) and urban sociodemographic strata (A, B, C, D and E). The study retrieved information from 52 791 surveys, finding that the most frequently recognized component of the preventive triad was going to the health facility (85.4%), followed by washing the wound with plenty of soap and water (43.1%) and, by last, identify the aggressor animal (15.5%). These components were recognized more frequently in urban areas and on the coast of the country. A positive and direct correlation was found between knowledge of the components of the preventive triad and socioeconomic level. Among endemic departments to rabies, Arequipa presented a better proportion of favourable responses compared to Puno. It is concluded that it is necessary to disseminate knowledge of the components of the preventive triad, especially in areas endemic to canine rabies to increase attitudes and practices that impact on the reduction of the risk of virus transmission and the development of the disease in humans.

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          Estimating the Global Burden of Endemic Canine Rabies

          Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts.
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            Human rabies: neuropathogenesis, diagnosis, and management.

            Rabies is an almost invariably fatal disease that can present as classic furious rabies or paralytic rabies. Recovery has been reported in only a few patients, most of whom were infected with bat rabies virus variants, and has been associated with promptness of host immune response and spontaneous (immune) virus clearance. Viral mechanisms that have evolved to minimise damage to the CNS but enable the virus to spread might explain why survivors have overall good functional recovery. The shorter survival of patients with furious rabies compared with those with paralytic rabies closely corresponds to the greater amount of virus and lower immune response in the CNS of patients with the furious form. Rabies virus is present in the CNS long before symptom onset: subclinical anterior horn cell dysfunction and abnormal brain MRI in patients with furious rabies are evident days before brain symptoms develop. How the virus produces its devastating effects and how it selectively impairs behaviour in patients with furious rabies and the peripheral nerves of patients with paralytic rabies is beginning to be understood. However, to develop a pragmatic treatment strategy, a thorough understanding of the neuropathogenetic mechanisms is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Accidentes por mordedura canina, casos registrados en un hospital de niños de Lima, Perú 1995 - 2009

              Entre 1995 a 2009 se registraron 206 hospitalizaciones en el Instituto Nacional de Salud del Niño debido a accidentes por mordedura canina. La mediana de edad de los pacientes fue cuatro años y para los días de hospitalización tres. El 61,7 % fueron varones. Los accidentes ocurrieron en el domicilio de una tercera persona (39,3 %), en vía pública (33,5 %) y en el domicilio del agredido (27,2 %). El 66,5 % de los episodios fueron precedidos por un estímulo del niño y el 88,8 % causado por animales reconocidos por los lesionados. El 34,0 % reconoció la raza del animal (52,9 % animales cruzados). El 79,1 % fueron lesiones múltiples y la región anatómica más afectada fueron la cabeza y cuello (79,1 %). Se registraron complicaciones en un 20,4 % y secuelas estéticas en el 94,7 %. Las mordeduras caninas afectan la salud física de los niños
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                Author and article information

                Journal
                rivep
                Revista de Investigaciones Veterinarias del Perú
                Rev. investig. vet. Perú
                Universidad Nacional Mayor de San Marcos. Facultad de Medicina Veterinaria (Lima, , Peru )
                1609-9117
                May 2022
                : 33
                : 3
                : e22903
                Affiliations
                [1] Lima Lima orgnameUniversidad Peruana Cayetano Heredia orgdiv1Facultad de Medicina Veterinaria y Zootecnia Peru
                Article
                S1609-91172022000300021 S1609-9117(22)03300300021
                10.15381/rivep.v33i3.22903
                aa8ee0ed-818e-488a-ab2e-ae89d10b8564

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                SciELO Peru

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                rabia,zoonosis,triada preventiva,mordeduras,Una Salud,rabies,preventive triad,bites,One Health

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