Clinical and demographic profile of patients with snakebite in a tertiary hospital in Ghana

Yakubu, Abdul-Subulr; Abdul‐Mumin, Alhassan; Adam, Atiku

doi:10.4103/smj.smj_68_18

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…At the health facility level, an 11% case fatality rate was reported in a pre-intervention study at a rural health facility in the central part of the country [ 17 ]. Complications such as haematoma, impairment and even loss of vision, intracerebral haemorrhage, compartment syndrome and amputation have been reported as some of the acute consequences of snakebite envenoming in Ghana [ 18 – 20 ]. Appropriate healthcare seeking behaviour and adequate health staff competence in diagnosis and management protocol compliance have however proven to significantly reduce the mortality rate snakebite [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

What the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities

et al. 2022

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Background The estimated five million snakebites per year are an important health problem that mainly affect rural poor populations. The global goal is to halve both mortality and morbidity from this neglected tropical disease by 2030. Data on snakebite morbidity are sparse and mainly obtained from hospital records. Methods This community-based study was conducted among 379 rural residents with or without a history of snakebite in the Ashanti and Upper West regions of Ghana. All participants in the snakebite group were bitten at least six months before the day of survey. The World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Buruli Ulcer Functional Limitation Score were used to obtain patient-reported measure of functioning and disability. Long-term consequences were evaluated based on the severity of the symptoms at the time of the snakebite. Findings The median (IQR) time since the snakebite was 8.0 (3.5–16.5) years. The relative risk of disability was 1.54 (95% CI, 1.17–2.03) in the snakebite group compared to the community controls. Among patients with clinical symptoms suggesting envenoming at the time of bite, 35% had mild/moderate disabilities compared to 20% in the control group. The disability domains mainly affected by snakebite envenoming were cognition level, mobility, life activities and participation in society. A combination of the severity of symptoms at the time of the bite, age, gender and region of residence most accurately predicted the odds of having functional limitations and disabilities. Conclusion The burden of snakebite in the community includes long-term disabilities of mild to moderate severity, which need to be considered when designing appropriate public health interventions. Estimating the total burden of snakebite is complicated by geographic differences in types of snakes and their clinical manifestations.

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Section: Introductionmentioning

confidence: 99%

What the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities

et al. 2022

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“…Only included patients requiring surgical debridement [16] Ghana Echis ocellatus 35.3 using backwards stepwise logistic regression. Only variables that were signifcant in univariate analysis were included in the multivariable model.…”

Section: 6mentioning

confidence: 99%

The Incidence of Infection Complicating Snakebites in Tropical Australia: Implications for Clinical Management and Antimicrobial Prophylaxis

Smith,

Vardanega,

Smith

et al. 2023

Journal of Tropical Medicine

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Objective. To define the incidence of infection following snakebite in tropical Australia and the resulting implications for the routine prescription of prophylactic antibiotics. Methods. A retrospective study of all individuals presenting to Cairns Hospital, a tertiary referral hospital in tropical Australia, after a snakebite between December 2013 and October 2020. Results. There were 732 hospitalisations, 720 (98.4%) patients presented within 8 hours of the snakebite, and 29/732 (4.0%) were envenomated. Envenomated patients were more likely to receive empirical antibiotics than nonenvenomated patients (8/29 (27.6%) versus 14/703 (2.0%), p < 0.001 ), although this was frequently as a bundle of care for critically ill individuals. Superficial skin infection was diagnosed by clinicians in 6/732 (0.8%) patients during their hospitalisation; infection was diagnosed more commonly in envenomated than in nonenvenomated patients (3/29 (10.3%) versus 3/703 (0.4%), p = 0.001 ). All 3 envenomated individuals diagnosed with infection were believed to have taipan (genus Oxyuranus) bites. Five (83%) of the six patients diagnosed with infection had received empirical antibiotics at presentation; only 1/710 (0.1%) patients who received no antibiotics developed a (superficial) infection. Conclusion. Infection is a very uncommon complication of snakebite in tropical Australia. Individuals bitten by snakes in tropical Australia should not routinely receive antibiotic prophylaxis.

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“…Snake envenoming affects women, children and farmers in poor rural communities in low- and middle-income countries but the highest burden occurs in countries where health systems are weakest and medical resources rudimentary [ 1 ]. Hospital-based data from only sub-Saharan Africa puts incidence at 56.4/100,000 and mortality at 1.35/100,000 inhabitants in rural areas [ 5 , 6 ]. In most instances, this data is only a microcosm of actual snake bite data as the reported data is largely from a few parts in Africa noted for notoriously high rates of snake bites [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Northern Ghana, there were an estimated 86 envenomings and 24 deaths/100,000/year caused mainly by Echis ocellatus [ 5 ] while other studies in the Brong-Ahafo Region of Ghana found snakebite incidence of 92/100,000 [ 11 ]. Emerging from these studies is that, complete epidemiological data on snakebites are inadequate suggesting that most cases are never reported.…”

Section: Introductionmentioning

confidence: 99%

Compendium of medically important snakes, venom activity and clinical presentations in Ghana

et al. 2023

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Background Snake bite envenoming (SBE) is one neglected tropical disease that has not received the needed attention. The sequelae of burdensome disability and mortality impact the socioeconomic life of communities adversely with little documentation of SBE in health facility records in Ghana. This study details SBE and snake distribution, habits/habitats, type of venom expressed and clinical manifestations. Methodology We conducted a structured thematic desk review of peer reviewed papers, books and reports from repositories including PubMed, WHO and WCH using bibliographic software EndNote and search engine Google Scholar with the following key words; snakes, medical importance, snake bites, venom and venom type, envenomation, symptoms and signs, vaccines, venom expenditure, strike behaviour and venom-metering + Ghana, West Africa, Africa, World. We also reviewed data from the District Health Information Management System (DHIMS) of the Ghana Health Service (GHS). Outcome variables were organized as follows: common name (s), species, habitat/habit, species-specific toxin, clinical manifestation, antivenom availability, WHO category. Findings Snake bites and SBE were grouped by the activity of the expressed venom into neurotoxic, cardiotoxic, haemorrhagic, cytotoxic, myotoxic, nephrotoxic and procoagulants. Neurotoxic snake bites were largely due to elapids. Expressed venoms with cardiotoxic, haemorrhagic, nephrotoxic and procoagulant activities principally belonged to the family Viperidae. Snakes with venoms showing myotoxic activity were largely alien to Ghana and the West African sub-region. Venoms showing cytotoxic activity are expressed by a wide range of snakes though more prevalent among the Viperidae family. Snakes with neurotoxic and haemorrhagic venom activities are prevalent across all the agro-ecological zones in Ghana. Conclusion/Significance Understanding the characteristics of snakes and their venoms is useful in the management of SBE. The distribution of snakes by their expressed venoms across the agro-ecological zones is also instructive to species identification and diagnosis of SBE.

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Clinical and demographic profile of patients with snakebite in a tertiary hospital in Ghana

Cited by 5 publications

References 16 publications

What the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities

What the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities

The Incidence of Infection Complicating Snakebites in Tropical Australia: Implications for Clinical Management and Antimicrobial Prophylaxis

Compendium of medically important snakes, venom activity and clinical presentations in Ghana

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