Epidemiology of snake bites in selected areas of Kenya

Abstract

IntroductionSnake bites are a silent public health problem in Kenya. Previous studies on snake bites in the country have mainly focused on identifying offending snake species, assessing the severity of envenomation and testing the efficacy of antivenom. Factors associated with snake bites in the country are yet to be fully understood. The aim of this work was to determine pharmaco-epidemiological factors associated with snake bites in areas of Kenya where incidence, severity and species responsible for snake bites have been reported.MethodsKakamega provincial hospital, Kabarnet, Kapenguria and, Makueni district hospitals were selected as study sites based on previous findings on incidence, severity and species responsible for snake bites in catchment areas of these hospitals. Persistent newspaper reports of snake bites in these areas and distribution of snakes in Kenya were also considered. Cases of snake bites reported between 2007-2009 were retrospectively reviewed and data on incidence, age, site of the bites, time of bite and antivenom use was collected.Results176 bites were captured, 91 of which occurred in 2009. Individual incidence was between 2.7/100,000/year and 6.7/100,000/year. Bites peaked in the 1-15 year age group while 132/176 bites were in the lower limb area and 49/176 victims received antivenom. Most bites occurred during the dry season, in the bush and in the evening. Overall mortality was 2.27%.ConclusionThere is a need to sensitize the Kenyan public and healthcare personnel on preventive measures, first aid and treatment of snake bites.

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].…”

“…Our data from all three respondent groups indicated that farmlands and bushes, and to a lesser extent, residential areas and roads are typical habitats for snakebite, as corroborated by several other studies in rural Africa [16, 31, 38, 50, 51]. Likewise, majority of bites occur during the peak farming periods (e.g.…”

“…We consistently found that young to middle-aged men (age group = 15-44 years) were most at risk of snakebites, corroborating similar findings from Ghana [22, 23, 24], other parts of West Africa [15, 25, 26, 27, 44, 46, 47] and Africa in general [30, 34, 48, 49, 50]. Adolescent and young men in their twenties are among the most active and adventurous, albeit least cautious, section of rural African people [24, 27, 44, 51].…”

“…Adolescent and young men in their twenties are among the most active and adventurous, albeit least cautious, section of rural African people [24, 27, 44, 51]. They expose themselves to snake encounters by risky behaviour during land clearing, harvesting, bush and charcoal burning, hunting and commuting on foot during dark or early morning hours with impaired visibility in dim light and dense vegetation [24, 47, 50]. Minors and the elderly who are traditionally home-bound, are less involved in farming activity, and are generally more cautious in their behaviour, which possibly explains their much lower snakebite vulnerability [31].…”

“…However, even though rainfall and snakebites are generally positively-correlated, our data also suggest that very intense rainfall reverses the trend, possibly caused by decreased activity of both snakes and humans as well as lower snakebite reporting rates due to the reduced mobility from flooding and erosion of basic road infrastructure. Although the dry season recorded lower snakebite rates, farmers are also at risk during this period, often being bitten during bush or charcoal burning, hunting, harvesting firewood, and at home during reduced farming activity in November-April [22, 47, 50].…”