An exploratory focus group study on experiences with snakebites: health-seeking behaviour and challenges in rural communities of Kenya

Abstract

Background Snakebite envenoming is a long-hidden public health threat in the rural communities of Kenya. This study aimed to shed light on the health-seeking behaviour of people bitten by snakes, views on prevention measures and community needs and the consequences for snakebite patients in these areas. Methods Six focus group interviews were conducted in communities in the Kajiado (n=3) and Kilifi (n=3) counties. Results Traditional first-aid practices such as the use of a tourniquet and/or cutting the wound, use of a black stone and a variety of other traditional remedies were common. Challenges with transportation to health facilities and inadequately resourced facilities complicated accessing medical care. Community members voiced a need to improve access to trained healthcare workers and snakebite treatments at health facilities. Conclusion While communities had high trust in evidence-based medical care, traditional treatment was often sought, causing delays in timely medical attention. Traditional practices were often used in the home environment and these were not usually administered by a traditional healer. The findings illustrate the need to combine improving the availability of effective snakebite treatment and healthcare worker training on snakebite with community education to reduce the impact of snakebite.

“At the hospital they do not treat venom from snakebites”: A qualitative assessment of health seeking perspectives and experiences among snakebite victims in Rwanda

“…Snakebite victims in this study encountered snakes while working in agricultural areas, walking on roads, and while in their homes/yards, highlighting the importance of managing shared human-snake environments. This finding aligns with other studies in Sub-Saharan Africa where farming and domestic activities (including sleeping) have been highlighted as key activities preceding SBE ( van Oirschot et al, 2021 ; Owuor et al, 2005 ; Sloan et al, 2007 ). Poor visibility and lack of closed-toed shoes were common among those bitten in Rwanda.…”

“…Social pressure, misperceptions surrounding physicians’ ability to provide care, distance to hospitals and uncertainty of treatment costs were major reasons our respondents delayed or avoided hospitals. This aligns with other studies spanning Sub-Saharan Africa demonstrating a high usage of traditional medicine ( Alcoba et al, 2020 ; van Oirschot et al, 2021 ; Sloan et al, 2007 ; Steinhorst et al, 2021 ). Moreover, for those bitten in rural and remote locations, traditional medicine is often perceived to be more accessible and affordable ( Bénard-Valle et al, 2015 ; Owuor et al, 2005 ).…”

“…Most snakebite victims in this study reported receiving First Aid prior to seeking formal or informal care and killing the snake. The field practices reported in Rwanda (tourniquets, cutting or burning skin, urinating on the wound, and ingesting herbal concoctions) appear to be common regionally and have been reported in several other African countries (e.g., Nigeria, South Africa, Cameroon, Kenya; Alcoba et al, 2020 ; Michael et al, 2011 ; van Oirschot et al, 2021 ; Owuor et al, 2005 ; Sloan et al, 2007 ; Steinhorst et al, 2021 ). Such practices differ from global recommendations from the medical community, which advocate taking distance from the snake to avoid further injury, laying down with the wound below the heart, removing tight jewelry/clothing, and covering the wound with a dry, clean dressing ( WHO, 2010b ).…”

Identifying key factors contributing to treatment costs for snakebite envenoming in private tertiary healthcare settings in Tamil Nadu, India

“…In some places, snakebite has been considered a fate, and therefore, they should not seek any treatment. For several individuals, the traditional treatment is the only solution for SBE although this significantly delays the hospital treatment [ 16 , 39 , 40 ]. Similarly, there are several other misconceptions about snakes and SBE treatments [ 41 ].…”

Barriers and enablers of community engagement practices for the prevention of snakebite envenoming in South Asia: A qualitative exploratory study

“…Snakebite envenoming (SBE) is a preventable, grossly neglected tropical disease (NTD) caused by venomous snakes that inject toxic secretions through bites or spraying venom in victims' eyes ( Gutiérrez et al, 2017 ). SBE is known to disproportionately affect low-and-middle income countries, and in particular rural communities, those with a lower socio-economic status, those with a lower-level of education and those working in agriculture ( Gutiérrez et al, 2017 ; Ooms et al, 2021 ; Van Oirschot et al, 2021 ). South Asia, according to current estimates, is one of the most affected regions of the world, as it accounts for 70% of all SBE mortality ( Ralph et al, 2019 ).…”