Factors associated with the abandonment of postexposure prophylaxis at the antirabies center in Abidjan, Côte d'Ivoire.

The main objective of this work is to analyze the factors associated with patients dropping out of postexposure prophylaxis (PEP) at the antirabies center of Abidjan (ARC). This descriptive, analytic cross-sectional study took place at the ARC of Abidjan from September 2014 through May 2015. Data were collected in two stages: first, all patients were interviewed at their first consultation. Exposed patients who failed to return were interviewed by telephone three days later. We recorded 441 subjects (59.3%) who had dropped out of their PEP. After multivariate analysis of social and demographic factors, the dropout rate was low in the groups aged 40-49 years (aOR = 0.40, 95% CI = 0.2, 0.8), 50-59 years (aOR = 0.40, 95% CI = 0.21; 0.82), and 60 years and older (aOR = 0.26, 95% CI = 0.09; 0.76), while it was elevated in retired persons (aOR = 10.07, 95% CI = [1.11, 91 , 7]). Moreover, the choice of protocol influenced PEP adherence, with subjects who chose the 5-dose protocol dropping out more frequently (P≤0.001). The main reason given by the subjects exposed to a suspect animal to explain dropping out of PEP was the lack of financial resources (41.5%). To alleviate this dropout problem, the ARC should strengthen public awareness of human rabies and the Ivorian government must implement universal health coverage to help the poor or make the vaccine available for free to all.