Rabies Exposures, Post-Exposure Prophylaxis and Deaths in a Region of Endemic Canine Rabies 英文参考文献.docVIP

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Rabies Exposures, Post-Exposure Prophylaxis and Deaths in a Region of Endemic Canine Rabies 英文参考文献.doc

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Rabies Exposures, Post-Exposure Prophylaxis and Deaths in a Region of Endemic Canine Rabies 英文参考文献

RabiesExposures,Post-ExposureProphylaxisandDeaths inaRegionofEndemicCanineRabies KatieHampson1,2*,AndyDobson2,MagaiKaare3{,JonathanDushoff4,MatthiasMagoto5 ,Emmanuel Sindoya5,SarahCleaveland6 1Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield, United Kingdom, 2Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America, 3Centre for Infectious Diseases, School of Biological Sciences, University of Edinburgh, King’s Buildings,AshworthLaboratories,Edinburgh,Midlothian,UnitedKingdom,4DepartmentofBiology,McMasterUniversity,Hamilton,Ontario,Canada,5MinstryofWater and Livestock Development, Serengeti District Livestock Office, Mugumu, Tanzania, 6Division of Infection and Immunity, The Roslin Institute/Royal (Dick) School of VeterinaryStudies,UniversityofEdinburgh,EasterBush,Roslin,Midlothian,UnitedKingdom Abstract Background:Thousandsofhumandeathsfromrabiesoccurannuallydespitetheavailabilityofeffectivevaccinesfollowing exposure,andfordiseasecontrolintheanimalreservoir.Ouraimwastoassessriskfactorsassociatedwithexposureandto determinewhyhumandeathsfromendemiccaninerabiesstilloccur. Methods and Findings: Contact tracing was used to gather data on rabies exposures, post-exposure prophylaxis (PEP) delivered and deaths in two rural districts in northwestern Tanzania from 2002 to 2006. Data on risk factors and the propensitytoseekandcompletecoursesofPEPwascollectedusingquestionnaires.Exposuresvariedfrom6–141/100,000 per year. Risk of exposure to rabies was greater in an area with agropastoralist communities (and larger domestic dog populations)thananareawithpastoralistcommunities.Childrenwereatgreaterriskthanadultsofbeingexposedtorabies and of developing clinical signs. PEP dramatically reduced the risk of developing rabies (odds ratio [OR] 17.33, 95% confidenceinterval[CI]6.39–60.83)andwhenPEPwasnotdeliveredtheriskswerehigherinthepastoralistthantheagro- pastoralistarea(OR6.12,95%C