Discontinuation of postexposure prophylaxis at the anti-rabies Center of Abidjan, Côte d'Ivoire

Despite the availability of effective anti-rabies vaccine, rabies keeps affecting people in developing countries such as Côte d'Ivoire. The low compliance with Post Exposure Prophylaxis (PEP) partially explains this situation. This study was aiming at studying the reasons to abandon PEP. This descriptive and cross-sectional study has taken place at the anti-rabies Center of Abidjan from October 1st to December 2009. Data were collected in two steps: we first interviewed all the patients at the anti-rabies center during their first consultation, and then phone interviews were conducted one month later, only with exposed patients who abandoned their PEP. These phone calls allowed us to complete the questionnaire (the status of the animal and PEP discontinuation). Patients' verbal informed consent was obtained prior to data collection. Besides, patients were explained the risks they were exposed to and were advised to complete immunization. The results obtained revealed that, out of 220 people included in the study, 116 (52.7%) abandoned the PEP. The compliance was lower with the protocol of five injections compared to that of four injections. More than half of the patients abandoned PEP after the first injection. In 32.8% of patients who abandoned PEP, the animal was dead, disappeared, was destroyed or there were no information about it one month after bite or scratch. Animal owners' refusal of taking in charge the victims (20%) and the lack of financial resources for purchasing the vaccine (13.6%) were the most frequent reasons to abandon PEP. To increase the protection of the human population against rabies and to increase the compliance with PEP protocols, the improvement of financial accessibility to the vaccine for population and the elaboration of compulsory regulations for animal owners to take in charge the PEP are necessary. © 2013 Springer-Verlag France.