Consumption of human rabies immunoglobulin (HRIG) for major animal bites in government hospitals of Sri Lanka.

Abstract
Introduction:Rabies still remains as a significant public health problem in Sri Lanka. Published data related to the usage of human rabies immunoglobulins (HRIG) which is an expensive biological used for post exposure prophylaxis and the types of animal bites are limited. This study was designed to analyze the consumption of HRIG for major animal bites in government hospitals of Sri Lanka.

Methods: A audit was carried out at the rabies unit in the Medical Research Institute (MRI) on the use of HRIG from 1st of January to 31st of December 2012 . Data was extracted from scrutinizing the forms sent to the Rabies Unit following the administration of HRIG by the government hospitals which administer HRIG. 

Results:1896, 2160, 2186 patients have received HRIG during 2010, 2011and 2012 respectively. The number of patients treated without adhering to the rabies treatment protocol issued by the ministry of health also has inreased over the same period of time. Each year around 60% of total HRIG has been used for stray dog and cat bites, 24% for domestic animal and 17% for wild animal bites.  

Conclusions and recommendations:Annual consumption as well as the misuse of HRIG has increased from 2010 to 2012. Effective methods to control stray dogs and cats and the concept of responsible pet ownership should be encouraged. Medical officers in rabies treatment units should be trained on adherence to government protocol for anti rabies post exposure therapy.