Form Approved
OMB No. 0920-1011
Exp. Date 03/31/2017
Evaluation of Dog Bite Surveillance and Rabies Vaccine Systems in Haiti –
Medical Providers
Semi-Structured Key Stakeholder Interview Questions Medical Centers
(To be administered to: Physicians and nurses involved in dog bite management)
DEMOGRAPHICS
Education: □ Undergraduate Degree □ Master’s Degree □ Professional Degree
□ Other ____________________________________________________
Position / Title: ______________________________________
Years in Service at Center ______________________________
What are your job duties? (Use questions below to guide discussion. Note main content of discussion)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What disease conditions do you oversee? __________________________________
How many bite reports do you treat per month? _______________________
How many human encephalitis cases do you see per year? __________
How many suspect human rabies cases do you see per year? __________
Please describe what you know about the National Sentinel Surveillance System, operated by the Department of Epidemiology and Laboratory Resources
Please describe your roles and responsibilities regarding surveillance of animal bites
Please describe your roles and responsibilities regarding human rabies surveillance
DOG BITE SURVEILLANCE
What is the case definition for a reportable bite?
What is the case definition for a rabid animal?
What is the case definition for human encephalitis?
What is the case definition for human rabies?
Which of the following are reportable bites? (READ ALL)
Dog bites
Cat bites
Rat bites
Goat bites
Cow bites
Snake bites
Mongoose bites
Bat bites
When a dog bite victim is treated at your hospital, who do you notify? (DO NOT READ RESPONSES, mark all that apply)
Ministry of Health (MSPP)
DPSPE – Zoonotic Disease Unit
Department of Epidemiology, Laboratory and Research (DELR)
Departmental health office
Commune Health Department
Ministry of Agriculture
We do not report dog bites
Other: __________________
When do you need to report a dog bite? (DO NOT READ RESPONSES, choose the one best)
1. Always 3. Only if the bite is severe 5. Only when giving PEP
2. Never 4. Only if I know the animal has rabies 6. I don’t know
7. Other ________________
What information do you report, when reporting a dog bite? (DO NOT READ RESPONSES, Circle all that the interviewee states)
Anatomical site of the bite wound 4. Behavior of the biting animal
Location where the bite happened 5. Whether PEP was given
Type of animal 6. I don’t know
Other, please describe: ________________________________________________________
Is there a standardized form to report dog bites to MSPP/NSSS/DELR?
1. Yes 2. No 9. I don’t know
*if yes, please ask for a copy of a blank reporting form
If there is a form, is it in paper or electronic format?
1. Paper 2. Electronic 9. I don’t know
When a dog bite report is completed, which organizations should receive a copy of the form? (DO NOT READ, mark all that apply)
Commune health department
Departmental health office
Ministry of Health (MSPP)
DPSPE – Zoonotic Disease Unit
Department of Epidemiology, Laboratory and Research (DELR)
Ministry of Agriculture (MARNDR)
Hospitals
We do not report dog bites
Other: ____________________________________________________________
How soon after hearing about a bite victim do you need to submit a bite report? (DO NOT READ RESPONSES, choose the one best)
Immediately
Report by the end of my shift
Report by the end of the day
Report by the end of the week
Report by the end of the month
It doesn’t matter when I report
I do not report
I don’t know
What methods do you use to submit bite report forms? (DO NOT READ, mark all that apply)
Phone calls
Mailed reports
Hand delivered reports
Faxed reports
Emailed reports
Electronic surveillance platform
Other: ____________________________________________________________________
Are the forms used to track the bite victim’s treatment outcomes?
1. Yes 2. No 9. I don’t know
Are the forms analyzed to create epidemiologic summaries of bite events?
1. Yes 2. No 9. I don’t know
Does MSPP/DELR share summaries of bite reports with your health facility (feedback)?
1. Yes 2. No 9. I don’t know
Are there any other uses for bite reports? [OPEN ANSWER]
Are there any other tools or documents you use to record or track bite events?
BARRIERS TO REPORTING
Are there aspects of the bite form that are difficult to fill out? If yes, please explain.
Have you ever NOT reported a bite event to your commune, department, or MSPP/DELR?
1. Yes 2. No 9. I don’t know
What are some reasons that have caused you to NOT report a bite event to your commune, department, or MSPP/DELR? (READ ALL ANSWERS, circle if answer is affirmative)
I did not know I was required to report bite events
I did not have time to fill out the form
I did not have time to send in the report
This health facility does not report bite events
I did not have any bite surveillance forms
I do think reporting bites is important
Other reason, please describe: ________________________________________________________________________________________________________________________________________________
What are some reasons that have caused you to NOT report a bite event to the MARNDR Rabies Surveillance Officers (READ ALL ANSWERS, circle if answer is affirmative)
I did not know of this program
This program does not operate in my department
I did not have time to call the officer
I did not know how to contact the officer
This health facility does not report bite events
I am not pleased with the work the surveillance officers have done in the past
Other reason, please describe: ____________________________________________________________________________________________________________________________________________________
DOG BITE SURVEILLANCE: INVESTIGATIONS
Who are the people or organizations responsible for investigating dogs that have bitten people? (DO NOT READ, mark all that apply)
Commune sanitation officers (if yes: always, sometimes, or rarely responsible?)
Commune surveillance officers (if yes: always, sometimes, or rarely responsible?)
Departmental health officers (if yes: always, sometimes, or rarely responsible?)
MARNDR rabies officers (if yes: always, sometimes, or rarely responsible?)
No one
Other (describe): _________________________________________________________
I do not know
What are some of the reasons to report dogs involved in a bite event? (DO NOT READ, mark all that apply)
To assess the dog for rabies virus infection
To remove the aggressive dog from the community
To identify other persons who may have been bitten by the same dog
To determine if the persons bitten need rabies vaccine
Because it is my job
Dogs are not routinely reported after a bite event
Other reasons: __________________________________________________________________
When you identify a person with rabies, who do you report it to? (DO NOT READ, mark all that apply)
commune health department
departmental health office
MSSP
DPSPE – Zoonotic Disease Unit
DELR
Departmental agriculture office
MARNDR
I don’t know
We do not report rabid animals to anyone
POST EXPOSURE PROPHYLAXIS
Where does your institution get rabies vaccine from? (READ ALL, mark all that apply)
MSPP
DPSPE – Zoonotic Disease Unit
DELR
PROMESS
Departmental Health Center
Commune Health Department
Non-Government Organizations (ie MSF)
Private Pharmacies
I do not know
We do not carry rabies vaccine
Other: ___________________________________________________________
How much does rabies vaccine cost your patients? (READ ALL, mark all that apply)
It is free to all dog bite victims
Sliding scale, based on how much the bite victim can afford
Specify cost for one dose of vaccine: $_______________
I do not know
Does your facility currently have rabies vaccine available for bite victims?
1. Yes 2. No 9. I don’t know
Other ________________________________________________________
In the last six months, has your facility experienced a shortage of rabies vaccine?
Yes (describe circumstance): _________________________________________
No
Don’t know
Is there a rabies vaccine reporting form that your health center uses to report vaccine use to MSPP/DELR, departmental health, or commune health offices?
1. Yes 2. No 3. I don’t know
*if yes, please request a blank copy of the form
If there is a rabies vaccine form, is it available in paper or electronic format? (circle all that apply)
1. Paper 2. Electronic 9. I don’t know
When do you need to fill out a rabies vaccine form? (DO NOT READ, choose the one best)
1. After every dose administered 2. After the course is completed 3. Never
Other _______________________________________________________________
How soon after giving a rabies vaccine do you need to submit a rabies vaccine form? (DO NOT READ, choose the one best)
Immediately
Report by the end of my shift
Report by the end of the day
Report by the end of the week
Report by the end of the month
It doesn’t matter when I report
Report after the person completes the course of vaccination
I do not report
I don’t know
To whom do you submit rabies vaccine forms? (DO NOT READ, mark all that apply)
Commune health department
Departmental health office
Ministry of Health (MSPP)
DPSPE – Zoonotic Disease Unit
DELR
Hospitals
We do not report dog bites
Other: ____________________________________________________________
By which methods do you submit rabies vaccine forms to the department or DELR? (DO NOT READ, mark all that apply)
Hand deliver
Phone Calls
Email/Faxes
A Web-based system
I don’t know
Other, please describe: _________________________________________________
Are the forms used to track the bite victim’s vaccination schedule?
1. Yes 2. No 9. I don’t know
Are the forms required to be submitted to DELR to receive more vaccine?
1. Yes 2. No 9. I don’t know
Does MSPP/DELR share summaries of rabies vaccine forms with your health department?
1. Yes 2. No 9. I don’t know
Are there any other uses for rabies vaccine forms? [OPEN ANSWER]
Are there any other tools or documents you use to record or track rabies vaccine usage?
Where does your institution get rabies immune globulin from? (READ ALL, mark all that apply)
MSPP
DPSPE – Zoonotic Disease Unit
DELR
PROMESS
Departmental health office
Commune Health Department
Non-Government Organizations (ie MSF)
Private Pharmacies
I do not know
We do not carry rabies immune globulin
Other: ___________________________________________________________
What type of rabies immune globulin do you use?
Human RIG
Equine RIG
Other: ___________________________________
How much does rabies immune globulin cost bite victims? (READ ALL, mark all that apply)
It is free to all dog bite victims
Sliding scale, based on how much the bite victim can afford
Specify Cost per Vial: $_______________
I do not know
Does your institution currently have rabies immune globulin available for bite victims?
Yes
No
I don’t know
Other _______________
In the last six months, has your institution experienced a shortage of rabies immune globulin?
Yes (describe circumstance): _________________________________________
No
Don’t know
When you give a rabies immune globulin do you need to report this to anyone?
1. Yes 2. No 3. Don’t know
If Yes, who do you report rabies immune globulin usage to? ________________________________________________________________________
PEP PROTOCOLS
When should the bite wound be washed with disinfectants (ie soap) and water?
Always
Sometimes
Never
Don’t know
Other: ____________________________________________________
When should Rabies Immune Globulin be administered to bite victims? (DO NOT READ, circle ONE best answer)
Always
Sometimes (describe) ________________________________________
Never
Don’t know
Other: ____________________________________________________
When should Rabies Vaccine be administered to bite victims? (DO NOT READ, circle ONE best answer)
Always
Sometimes (describe) ________________________________________
Never
Don’t know
Other: ____________________________________________________
Which rabies vaccine schedules are used (list days administered)? (DO NOT READ, circle all that apply)
0, 3, 7, 14, 28
0, 3, 7, 14
2-1-1 (2x0, 7, 21)
Don’t know
Other _____________________________________________________
Which routes of rabies vaccine administration are used? (DO NOT READ, circle all that apply)
Intramuscular
Intradermal
Subcutaneous
Don’t know
Other ___________________________________________________
Who is responsible to ensure that the bite victim completes the full course of rabies vaccination? (DO NOT READ, mark all that apply)
The bite victim or the victim’s family
The Hospital
The commune health department
The departmental health office
MSPP
DPSPE – Zoonotic Disease Unit
DELR
No one is responsible
I don’t know
Other:____________________________________________________
Rabies Knowledge and Surveillance Attitudes
Which of the following animals can get rabies? (READ ALL, mark all that apply)
Cows Yes [1] No [2]
Goats Yes [1] No [2]
Pigs Yes [1] No [2]
Snakes Yes [1] No [2]
Dogs Yes [1] No [2]
Cats Yes [1] No [2]
Birds Yes [1] No [2]
Fish Yes [1] No [2]
What are the signs that a dog might have rabies? (Circle all that the interviewee states)
Lethargy [1] Lack of muscle control [5] Difficulty Breathing [9]
Fever [2] Weakness [6] Excessive Salivation [10]
Vomiting [3] Paralysis [7] Abnormal Behavior [11]
Anorexia [4] Seizures [8] Aggression [12]
Have you ever seen a rabid dog?
Yes [1] No [2] Unknown [3]
Have you ever seen a person with encephalitis?
Yes [1] No [2] Unknown [3]
How many cases of encephalitis were diagnosed in your hospital in 2014?
Number: _________________
Have you ever seen a person with rabies?
Yes [1] No [2] Unknown [3]
How many rabies victims were diagnosed in your hospital in 2014?
Number: _________________
Do you agree or disagree with these statements:
Rabies is a significant problem in dogs in Haiti
Agree [1] Disagree [2]
Rabies is a significant problem in people in Haiti
Agree [1] Disagree [2]
Rabies is easily diagnosed in a person based on clinical signs
Agree [1] Disagree [2]
All dog bite victims should receive rabies vaccination
Agree [1] Disagree [2]
Only persons bitten by sick dogs should receive rabies vaccination
Agree [1] Disagree [2]
Washing the wound, in the absence of vaccination, will prevent a person from getting rabies
Agree [1] Disagree [2]
Rabies vaccination consists of only one shot
Agree [1] Disagree [2]
When I report a bite event, the results of the investigation are reported back to me in a timely manner:
MSPP: Yes [1] No [2] NA [3]
Department health officer Yes [1] No [2] NA [3]
Commune Health Officer: Yes [1] No [2] NA [3]
Sanitation Officer: Yes [1] No [2] NA [3]
MARNDR: Yes [1] No [2] NA [3]
Other:________________ Yes [1] No [2] NA [3]
It is important to report dog bites to MSPP/DELR because it can save lives
Yes [1] No [2]
I have contacted the Ministry of Agriculture to evaluate a rabies suspect dog
Yes [1] No [2]
Were you happy working with them (if yes or no, why)
Yes (describe): _______________________________________________________
No (describe): ________________________________________________________
Please provide us with any other suggestions you have for improving bite surveillance in Haiti:
Please provide us with any other suggestions you have for improving PEP surveillance in Haiti:
Please provide us with any other suggestions you have for improving human rabies surveillance in Haiti
Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74 Atlanta, Georgia 30333; ATTN: PRA (0920-1011)
File Type | application/msword |
File Title | Emergency Epidemic Investigations |
Author | lmp2 |
Last Modified By | Tran, Cuc Hong (CDC/OPHSS/CSELS) |
File Modified | 2015-10-31 |
File Created | 2015-10-31 |