Rabies-Related Knowledge and Practices Among Persons At Risk of Bat Exposures in Thailand

Rabies is a fatal encephalitis caused by lyssaviruses. Evidence of lyssavirus circulation has recently emerged in Southeast Asian bats. We surveyed persons regularly exposed to bats and bat habitats in Thailand to assess rabies‐related knowledge and practices. Targeted groups included guano miners, bat hunters, game wardens, and residents/personnel at Buddhist temples where mass bat roosting occurs. Of the 106 people interviewed, 11 (10%) identified bats as a source of rabies. History of a bat bite/scratch was reported by 29 (27%), and 38 (36%) expressed either that they would do nothing or that they did not know what they would do in response to a bat bite. Guano miners were less likely than other groups to indicate animal bites as a mechanism of transmission (68% vs. 90%, p=0.03) and were less likely to say they would respond appropriately to a bat bite or scratch (61% vs. 27%, p=0.003). These findings indicate a need for educational outreach in Thailand to raise awareness of bat rabies, promote exposure prevention, and ensure health‐seeking behaviors for bat‐inflicted wounds, particularly among at‐risk groups

Atypical Presentation of Lymphoma in an HIV-Seropositive Child

A case of lymphoma in an HIV sero-positive child whose parents also tested positive for the HIV infection is presented. He was initially being managed for meningitis in a private clinic. The rapid progression and dissemination of the disease to other parts of the body was no doubt, due to the HIV infection. It is important that health workers become more aware of the protean clinical manifestations of HIV infection in this environment where other childhood diseases share some of the clinical features and it should be considered in patients with lymphoma and rapid progression of the disease. Nigerian Journal of Paediatrics 2001;28:43. pp 43-4

Post-neonatal Tetanus in Nigeria: The need for Booster doses of Tetanus Toxoid

Eighty-two (87 per cent) of the 94 cases of post-neonatal tetanus patients seen in the department of paediatrics, University College Hospital, Ibadan, over an 11-year period were aged five years and above. Persistent occurrence of this preventable condition for which an effective vaccine is available indicates deficiencies in the health system of the country. Although, a case fatality rate of 12 per cent compared favourably with those of centres employing more sophisticated treatment modalities, morbidity was high with patients spending an average of 23 days (range 3 to 76 days) in hospital. Although no reliable record of tetanus immunization was obtained in 37 of the patients, 34, 8 and 15 patients received doses of DPT immunization of 0, 1 - 2 and 3, respectively, during infancy. No patient had tetanus toxoid (TT) administered after infancy. The findings indicate that the current Expanded Programme on Immunisation (EPI) recommended by the WHO for developing countries of which three doses of DPT are given during infancy with no provision for booster doses, is inadequate for tetanus prevention during childhood. It is suggested that a clause be added to the EPI schedule, advising two extra doses of TT between ages four to six years and 11 to 12 years (entry into primary school and secondary school, respectively) for all children. In order to ensure compliance, these booster doses of TT could be made prerequisites for entry into these schools. Nigerian Journal of Paediatrics 2001; 28:35. pp. 35-3