Effect of phone text message reminders on compliance with rabies post-exposure prophylaxis following dog-bites in rural Kenya

Chuchu, V. M. et al. (2023) Effect of phone text message reminders on compliance with rabies post-exposure prophylaxis following dog-bites in rural Kenya. Vaccines, 11(6), 1112. (doi: 10.3390/vaccines11061112) (PMID:37376501) (PMCID:PMC10303647)

Abstract

The prompt administration of post-exposure prophylaxis (PEP) is one of the key strategies for ending human deaths from rabies. A delay in seeking the first dose of rabies PEP, or failure to complete the recommended dosage, may result in clinical rabies and death. We assessed the efficacy of short message system (SMS) phone texts in improving the adherence to scheduled PEP doses among bite patients in rural eastern Kenya. We conducted a single-arm, before-after field trial that compared adherence among bite patients presenting at Makueni Referral Hospital between October and December 2018 (control) and between January and March 2019 (intervention). Data on their demographics, socio-economic status, circumstances surrounding the bite, and expenditures related to the bite were collected. A total of 186 bite patients were enrolled, with 82 (44%) in the intervention group, and 104 (56%) in the control group. The odds of PEP completion were three times (OR 3.37, 95% CI 1.28, 10.20) more likely among patients who received the SMS reminder, compared to the control. The intervention group had better compliance on the scheduled doses 2 to 5, with a mean deviation of 0.18 days compared to 0.79 days for the control group (p = 0.004). The main reasons for non-compliance included lack of funds (30%), and forgetfulness (23%) on days for follow-up treatment, among others. Nearly all (96%, n = 179) the bite patients incurred indirect transport costs, at an average of USD 4 (USD 0–45) per visit. This study suggests that the integration of SMS reminders into healthcare service delivery increases compliance with PEP, and may strengthen rabies control and elimination strategies.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hampson, Professor Katie
• Authors: Chuchu, V. M., Mutono, N., Bichanga, P., Kitala, P. M., Ksee, D., Muturi, M., Mwatondo, A., Nasimiyu, C., Akunga, L., Amiche, A., Hampson, K., and Thumbi, S. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Vaccines
• Publisher: MDPI
• ISSN: 2076-393X
• ISSN (Online): 2076-393X
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Vaccines 11(6):1112
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
301620		The Science of Rabies Elimination	Katie Hampson	Wellcome Trust (WELLCOTR)	207569/Z/17/Z	Institute of Biodiversity, Animal Health and Comparative Medicine