Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series

Abstract

BackgroundSnakebites are a major cause of mortality and morbidity worldwide with the highest mortality burden in poor rural areas of sub-Saharan Africa. Inadequate surveillance systems result in loss of morbidity and mortality data in these settings. Although rarely reported in these resource-constraint environments, community-based audits are recognised pivotal tools which could help update existing data and indicate key public health interventions to curb snakebite-related mortality. Herein, we present two cases of snakebite-related deaths in a rural Cameroonian community.Case presentationsThe first case was a 3-year-old female who presented at a primary care health centre and was later referred due to absence of antivenom serum (AVS). However, she had an early fatal outcome before getting to the referral hospital. The second case was an 80-year-old traditional healer who got bitten while attempting to kill a snake. He died before hospital presentation.ConclusionCommunity-based audits help identify key intervention points to curb snakebite mortality in high-risk rural areas like ours. From our audits, we note a remarkable absence of affordable AVS in rural health facilities in Cameroon. We recommend frequent community health education sessions on preventing snakebites; continuous training modules for health personnel from high-risk areas; training traditional healers on the importance of AVS in managing cases of snakebite envenoming, and the need for timely hospital presentation; and setting up context-specific approaches to rapidly transport snakebite victims to hospitals.

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

“…Some girls and the elderly were however bitten at home or in school facilities, indicating that everyone is at risk of snakebites [7, 24, 31, 43, 51, 52]. Contrary to our findings, some studies in Africa actually report relatively higher snakebite prevalence in children, including girls, probably as a result of higher child-labour engagement or poorer parental care and supervision in such areas [23, 31, 50, 51, 53, 54, 55, 56].…”

Clinical assessment and pathophysiology of Bothrops venom-related acute kidney injury: a scoping review

“…Snakebites are an occupational hazard in rural tropical areas [26][27][28][29]. These accidents are more frequent during rainy seasons, the most affected group is young men and lower limbs are the most frequently injured body parts [3].…”

Identifying the snake: First scoping review on practices of communities and healthcare providers confronted with snakebite across the world

“…Although this is a dangerous practice (i.e. due to the risk of secondary bites [17,29,30,53,[128][129][130][131][132][133]), it occurs worldwide but particularly in Asia (e.g. Table 6.…”

“…In four publications, victims were bitten while attempting to kill a snake. This was the case for 53% and 100% of patients bitten on the fingers in two Australian studies [29,30] and caused the death of an 80-year-old traditional healer in Cameroon [53] and a worker in Hong Kong [17].…”

“…(4) Cerastes vipera (1) Boiga trigonata (4) Daboia russelii (985) Chrysopelea ornata (1) Daboia siamensis (383) Chrysopelea pelias (1) Echis carinatus (229) Coelognathus helena (5) Echis coloratus (5) Coelognathus radiatus (4) Hydrophis cyanocinctus (2) Cylindrophis maculatus (1) Hydrophis platurus (2) Cylindrophis ruffus (NR) Naja spp. (8) Lycodon striatus (15) Naja sumatrana (1) Malpolon moilensis (4) Ovophis monticola (1) « non-venomous snakes » (53) Rhabdophis subminiatus (5) Oligodon arnensis (7) Trimeresurus albolabris (344) Oligodon cyclurus (NR) Trimeresurus gramineus (20) Oligodon spp (7) Trimeresurus kanburiensis (1) Oligodon taeniatus (NR) Trimeresurus macrops (23) Oligodon taeniolatus (2) Trimeresurus malabaricus (26) Pareas carinatus (NR) Trimeresurus purpureomaculatus (3) Psammodynastes pulverulentus (2) Trimeresurus spp. (36) Ptyas mucosa (13) Trimeresurus trigonocephalus (19) Ptyas spp.…”