Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana

Musah, Yahaya; Ameade, Evans Paul Kwame; Attuquayefio, Daniel K.; Holbech, Lars H.

doi:10.1101/543009

Cited by 6 publications

(8 citation statements)

References 47 publications

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“…27,34,36 Also, HCWs suggest farming to be the most common activity performed at the time of the bite, which supports other studies' findings that it is people in rural areas, dependent on agriculture for livelihood, who are most at risk. 13,34 At the same time, these people are most vulnerable to adverse health outcomes after snakebites because of poorer access to quality health care in rural areas. 14 This research underscores the paucity of HCW training on snakebite management: a mere 8-16% of HCWs had received any training.…”

Section: Discussionsupporting

confidence: 81%

“…27 Similar findings were also observed in Ghana and South Africa. 34,36 In our study, people aged 21-30 years were believed to be most prone to snakebites. This again resonates with previous research, which often finds highest incidence in relatively young age-groups.…”

Section: Discussionmentioning

confidence: 68%

“…32 Other studies (in Costa Rica and Ghana) found similar patterns of increased snakebite incidents during the rainy season. 33,34 In Kenya, the findings were not congruent with the rainy season. 35 Information about snakebite incidents over the months can help authorities to anticipate on fluctuations in demand for treatments and adjust stock accordingly.…”

Section: Discussionmentioning

confidence: 90%

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The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers’ Perspectives and Knowledge, and Health Facilities’ Treatment Capacity

Ooms

Oirschot

Waldmann

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Snakebites continue to be a public health concern in sub-Saharan Africa, where availability of appropriate medical treatment is rare, even though death and disability can be prevented with timely intervention. A challenge is the lack of sociopolitical studies to inform health policies. This study aimed to identify snakebite patient profiles, healthcare workers’ (HCWs) knowledge of snakebite, and facilities’ snakebite treatment capacity in Kenya, Uganda, and Zambia to inform interventions to improve access to appropriate treatment. The research comprised a cross-sectional key informant survey among HCWs from health facilities in Kenya (n = 145), Uganda (n = 144), and Zambia (n = 108). Data were collected between March 2018 and November 2019. Most of the HCWs suggested that the number of snakebite incidents was similar between the genders, that most patients were aged 21–30 years, and most people were bitten when farming or walking. Overall, only 12% of HCWs had received formal training in snakebite management. Only about 20% of HCWs in each country said their health facility had the medicines needed to treat snakebites, with antivenom available in 0–34% of facilities across the sectors and countries, and snakebites were not systematically recorded. This research shows that an integrative approach through policies to increase resource allocation for health system strengthening, including community education, HCW training, and improved access to snakebite treatment, is needed. Part of this approach should include regulations that ensure antivenoms available in health facilities meet quality control standards and that snakebites are accommodated into routine reporting systems to assess progress.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 90%

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The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers’ Perspectives and Knowledge, and Health Facilities’ Treatment Capacity

Ooms

Oirschot

Waldmann

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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“…Retrospective case audits in other sub-Saharan African countries such as Tanzania, Benin, Chad, and Ghana showed a different effect, with more men obtaining medical care for envenomation than women. [20][21][22][23] With respect to age, the highest number of cases occurred in children (< 18 years) and young adults (18-30 years), whereas the highest numbers per capita occurred in older adults (> 60 years). This difference between case counts and population proportions is explained by the large population of children relative to adults in Rwanda, resulting from past civil war, political unrest, and infectious disease epidemics.…”

Section: Discussionmentioning

confidence: 99%

“…13 The heightened risk among economically productive age-groups was also reported in Tanzania, Ghana, Benin, and Kenya and is one reason why SBE is linked to the poverty cycle. 2,9,[20][21][22]24 Low-income rural workers lacking personal protective equipment (e.g., shoes and torches) and safe sleeping areas are disproportionally exposed to high-risk rural environments through their work (e.g., farming, forestry, and mining) and also experience the greatest delays in accessing medical care. Rural children are similarly exposed but are more vulnerable because of their small body mass.…”

Section: Discussionmentioning

confidence: 99%

Snakebite Envenomation in Rwanda: Patient Demographics, Medical Care, and Antivenom Availability in the Formal Healthcare Sector

Nduwayezu

Kinney

Amuguni

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Snakebite envenomation (SBE) is a neglected One Health issue that overwhelmingly affects people living in rural and impoverished regions of Africa and Asia. Information on SBE is scarce in Rwanda; thus, our objectives were to 1) describe the demographics of SBE patients seeking hospital care, 2) evaluate physician adherence to national treatment guidelines, and 3) assess availability of snake antivenom at hospitals in Rwanda. To achieve these goals, we obtained national data on animal bites/stings and visited every district and provincial hospital in Rwanda to obtain physical records of SBE patients treated in 2017 and 2018. Hospital pharmacies were assessed for antivenom availability. We identified snakes as the second leading cause of animal bites, after dogs, among patients who sought hospital care in 2017 and 2018. Of 363 SBE patients, the highest number of cases occurred among children (< 18 years; 32%) and young adults (18–30 years; 33%), females (61%), farmers (82%), and those living in Eastern Province (37%). Overall, physician adherence to treatment guidelines was 63%. Prescriptions of vitamin K and antivenom were low (4% and 13%, respectively), and only 8% of hospital pharmacies had antivenom in stock throughout the study period. The antivenom stocked was an Indian generic suited for Asian snakes. This minimum estimate of hospitalization cases does not include individuals who died in communities or sought care outside the formal sector. Our study highlights the need to map incidence, risk factors, and patient experiences to mitigate human–snake conflicts and improve patient outcomes.

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Promoting co-existence between humans and venomous snakes through increasing the herpetological knowledge base

et al. 2021

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Snakebite incidence at least partly depends on the biology of the snakes involved. However, studies of snake biology have been largely neglected in favour of anthropic factors, with the exception of taxonomy, which has been recognised for some decades to affect the design of antivenoms. Despite this, within-species venom variation and the unpredictability of the correlation with antivenom cross-reactivity has continued to be problematic. Meanwhile, other aspects of snake biology, including behaviour, spatial ecology and activity patterns, distribution, and population demography, which can contribute to snakebite mitigation and prevention, remain underfunded and understudied. Here, we review the literature relevant to these aspects of snakebite and illustrate how demographic, spatial, and behavioural studies can improve our understanding of why snakebites occur and provide evidence for prevention strategies. We identify the large gaps that remain to be filled and urge that, in the future, data and relevant metadata be shared openly via public data repositories so that studies can be properly replicated and data used in future meta-analyses.

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Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana

Abstract: 344 15 ABSTRACT 21

Cited by 6 publications

References 47 publications

The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers’ Perspectives and Knowledge, and Health Facilities’ Treatment Capacity

The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers’ Perspectives and Knowledge, and Health Facilities’ Treatment Capacity

Snakebite Envenomation in Rwanda: Patient Demographics, Medical Care, and Antivenom Availability in the Formal Healthcare Sector

Promoting co-existence between humans and venomous snakes through increasing the herpetological knowledge base

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