Avaliação da profilaxia inicial pós-exposição da raiva humana, indicada em acidentes notificados com gatos, em Belo Horizonte/MG, no período de 2007 a 2016

• Ano de defesa: 2017
• Autor(a) principal: Isabela de Lourdes Araujo
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Raiva; profilaxia pós-exposição; quiróptero; gatos; Ciência animal
• Link de acesso: http://hdl.handle.net/1843/SMOC-ATHNM7

Rabies is an acute viral anthropozoonosis, progressive and with approximately 100% lethality. It is transmitted to humans by the inoculation of rabies virus present in the saliva of infected animals. Domestic cats are potential bat predators and the circulation of rabies virus is known in population of chiropterans in urban environments. Post-exposure prophylaxis of human rabies in Brazil should be instituted according to the Manual of Technical Norms of Human Rabies, available by the Ministry of Health. Individuals who require human rabies treatment must provide their complete medical history through anamnesis, according to the Anti-rabies Care Form. The study of human anti-rabies prophylaxis directly assists in the management of rabies control, since it allows a thorough understanding of the use of human anti-rabies immunobiologicals. The objective of this study was to evaluate the post-exposure care of the initial human rabies in Belo Horizonte, MG, from 2007 to 2016, in cases where the domestic cat was the aggressor species, and to identify possible recommendation divergences from the Ministry of Health. By conducting an exploratory analysis of the 2.589 SINAN (Notifications Information System) records of the human rabies service, it is possible to compare the treatment adopted by the health service with the recommendation of the Ministry of Health. In addition, it is also possible to understand the epidemiological profile of the patient attacked by cats, since little is known about the participation of felines in rabies cases in the country. It was observed that when the aggressor species is the cat, there is a predominance of adults of the female gender, aged between 20 and 59, in 969 (37.4%) notification forms, urban residents in 2.297 (88.7%), of white ethnicity in 676 (26.1%) and in 821 (31.7%) sought anti-rabies treatment up to 24 hours of rabies virus exposure. Regarding lesion characteristics, bites in 1.956 (75.6%) and scratches 600 (23.2%) were the most frequent type of exposure to rabies virus. The most affected anatomic regions were hands/feet in 1.610 (62.2%) notification forms, followed by superior members in 409 (15.8%). Wounds were mostly superficial in 1.542 (59.6%) notification forms and the distribution of injuries between single and multiple was homogeneous, with 50% in each category. When the procedures adopted by the health service were evaluated, in 2.269 (87.7%) of the notification forms, the procedures involved use of the vaccine. The most frequent type of procedure was observation of the animal associated with human rabies vaccination in 1.468 (56.7%) and the less frequent conduct was dismissal in 43 (1.7%). In the analysis of the first procedures adopted by the health service as recommended by the Ministry of Health, 71.1% of compatibility were observed. Among the incompatible procedures, 10.3% were excessive and 18.6% insufficient. Regarding the aggressor animals, in 1.760 (68%) notification forms, cats were considered healthy at the time of the aggression and in 1.773 (68.4%) were allowed to be under observation. It is understood that the correct prescription of human rabies treatment and correct completion of the medical records contribute significantly to improving public money management and to reducing the risk of rabies virus infection. It is recommended to improve the records of human rabies service, thus frequent recycling with health professionals who perform this care and a greater interaction between medical and veterinary medicine, since a large part of the analysis in case of rabies prophylactic treatment involves specific knowledge about animals. In addition, it is critical to make the population aware of risks and disease control measures, since without popular participation, the surveillance of rabies will not be fully performed. Key words: rabies, post-exposure prophylaxis, cats, chiropterans.