Rabies Situation in Cambodia 英文参考文献.docVIP

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Rabies Situation in Cambodia 英文参考文献.doc

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Rabies Situation in Cambodia 英文参考文献

RabiesSituationinCambodia SowathLy1,PhilippeBuchy2,NayYimHeng1,SivuthOng2,NarethChhor3,Herve′ Bourhy4 ,Sirenda Vong1* 1EpidemiologyandPublicHealthUnit,InstitutPasteurinCambodia,PhnomPenh,Cambodia, 2VirologyUnit,InstitutPasteurinCambodia,PhnomPenh,Cambodia, 3CalmetteHospital,PhnomPenh,Cambodia,4LyssavirusUnit,UPRELyssavirusDynamicsandHostAdaptation,WHOCollaboratingCenterforReferenceandResearchon Rabies,InstitutPasteur,Paris,France Abstract Background: Rabies, a fatal but preventable zoonosis, is a major public health problem in developing countries. In Cambodiathediseaseburdenislargelyunderestimatedbecausepatientswithencephalitisfollowingdogbitesarerarely hospitalizedanddieathome.Since1998InstitutPasteurinCambodia(IPC),PhnomPenhhasbeentheonlysourceoffree post-exposureprophylaxis(PEP)andpost-mortemdiagnosis. Methods: The 1998–2007 data compiled by IPC was analyzed to describe all treated patients for PEP, results of human testingandconfirmedrabiescases,andresultsofanimaltesting.Fromdogbites’characteristics,wedefinedasuspected rabiddogbiteinjury(SRDBI)inhumansasabitethatwasunprovoked,fromadogthatdiedspontaneously,orfromadog thatwasreportedsick.Weappliedadeterministicprobabilitymodeltoestimate2007rabieshumanmortalitynationwide fromtheestimatedincidenceofrabiddogbites,thebodydistributionofbitewounds,andtheprobabilityofPEPaccess. Results:During1998–2007,124,749patientsreceivedPEPatIPC(average12,470;range8,907–14,475),and63fatalhuman casespresentingwithencephalitisfollowingadogbitewerereported,inwhich73%wereconfirmedpositiveforrabiesby directimmunofluorescenceassayorbyreverse-transcriptasepolymerasechainreaction.During1998–2007,IPCtested1,255 animalbrainsamples;1,214(97%)werefromdogsincluding610(49%)positivesamples.In2007,14,475patientsreceived PEP (100 PEP/100,000 people in Cambodia) including 95% who resided in Phnom Penh (615 PEP/100,000) or five neighboring provinces. The predictive model estimated 810 human rabies deaths would occur in 2007 (95%confidenc