Caring for patients with rabies in developing countries – the neglected importance of palliative care |
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Authors: | Arnaud Tarantola Yoann Crabol Bangalore Jayakrishnappa Mahendra Sotheary In Hubert Barennes Hervé Bourhy Yiksing Peng Sowath Ly Philippe Buchy |
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Affiliation: | 1. Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia;2. Rabies Prevention Center, Institut Pasteur du Cambodge, Cambodia;3. Kodagu Institute of Medical Sciences, Madikeri, India;4. WHO Collaborating Centre for Reference and Research on Rabies, Institut Pasteur, Paris, France;5. Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia;6. GlaxoSmithKline, Vaccines Value & Health Sciences, Singapore |
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Abstract: | Although limited publications address clinical management of symptomatic patients with rabies in intensive care units, the overwhelming majority of human rabies cases occur in the rural setting of developing countries where healthcare workers are few, lack training and drugs. Based on our experience, we suggest how clinicians in resource‐limited settings can make best use of essential drugs to provide assistance to patients with rabies and their families, at no risk to themselves. Comprehensive and compassionate patient management of furious rabies should aim to alleviate thirst, anxiety and epileptic fits using infusions, diazepam or midazolam and antipyretic drugs via intravenous or intrarectal routes. Although the patient is dying, respiratory failure must be avoided especially if the family, after being informed, wish to take the patient home alive for funereal rites to be observed. Healthcare staff should be trained and clinical guidelines should be updated to include palliative care for rabies in endemic countries. |
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Keywords: | rabies treatment palliative care diazepam midazolam hydrophobia developing countries rage traitement soins palliatifs diazé pam midazolam hydrophobie pays en voie de dé veloppement Rabia tratamiento cuidados paliativos diazepam midazolam hidrofobia paí ses en ví as de desarrollo |
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