The Burden of Snakebite in Rural Communities in Kenya: A Household Survey

Abstract

Annually, about 2.7 million snakebite envenomings occur worldwide, primarily affecting those living in rural regions. Effective treatment exists but is scarce, and traditional treatments are commonly used. To inform context-specific policies in Kenya, this study aimed to determine the health-seeking behavior and the health, social, and economic burden of snakebites in rural communities. Nonprobability sampling was used to survey 382 respondents from four snakebite-endemic counties, from February to August 2020, using a structured questionnaire. Descriptive statistics, Fisher’s exact tests, binary logistic regressions, and Mantel-Haenszel tests were used for analysis. Life-time experience with snakebites included 13.1% of respondents who reported being personally bitten and 37.4% who reported knowing of a community member being bitten. Respondents reported death after a snakebite in 9.1% of bitten community members and in 14.6% of bitten family members. Risk of snakebite was not significantly associated with sex, educational level, or occupation. Snakebite victims were most often walking (38%) or farming (24%) when bitten. Of those bitten, 58% went to a health facility, 30% sought traditional treatment, and 12% first went to a traditional healer before visiting a facility. Significant differences existed in perceptions on the financial consequences of snakebites among those who had been personally bitten and those who had observed a snakebite. Most commonly mentioned preventive measures were wearing shoes and carrying a light in the dark. Community engagement, including engagement with traditional healers, is needed to reduce snakebites. This should be done through education and sensitization to improve used preventive measures and effective health-seeking behavior.

Snakebite case management: a cohort study in Northwest Ethiopia, 2012-2020

“…In areas where MSF is operating, the routinely collected data show that annual snakebite cases in Ethiopia and South Sudan has increased from a few hundreds to more than a thousand [26]. Similarly, in Kenya snakebite was reported in 13.1% of the respondents in a community while in Sudan 12623 snakebite cases were seen annually [27]. Interrupted supply of antivenoms, unaffordability of the antivenom, going to traditional healers, humanitarian crisis and the study being a hospital-based may contribute as factors for the underestimation of snakebite burden.…”

Pattern and Trends in Adult Hospitalization/Admission and Mortality Among Medical Ward Inpatients at Gadarif Hospital in Eastern Sudan: A Four-Year Retrospective Study

“… 30 Interestingly, in Kenya, 382 community respondents reported that 9.1% of bitten community members and 14.6% of bitten family members died from snakebites. 31 Thus, it seems that snakebite is a neglected health problem in Sudan and more effort is required to address this problem.…”

Dermonecrosis caused by spitting cobra snakebite results from toxin potentiation and is prevented by the repurposed drug varespladib

“…These spitting cobra venoms also cause ophthalmia following defensive venom-spitting events (5)(6)(7). Spitting cobra bites are perhaps the most frequent in sub-Sahel regions of Africa and include bites by N. pallida in eastern Africa (8), N. mossambica in southern Africa (9) and N. nigricollis which has a wide distribution throughout northern parts of sub-Saharan Africa (10). Collectively, envenomings by spitting cobras substantially contribute to the numerous cases of severe local envenoming that result in permanent, lifeafflicting morbidity across the African continent (11).…”