Snakebite victim profiles and treatment-seeking behaviors in two regions of Kenya: results from a health demographic surveillance system

Abstract

Introduction Snakebites are a major cause of permanent injury and death among poor, rural populations in developing countries, including those in East Africa. This research characterizes snakebite incidence, risk factors, and subsequent health-seeking behaviors in two regions of Kenya using a mixed methods approach. Methods As a part of regular activities of a health demographic surveillance system, household-level survey on snakebite incidence was conducted in two areas of Kenya: Kwale along the Kenyan Coast and Mbita on Lake Victoria. If someone in the home was reported to have been bitten in the 5 years previous to the visit, a survey instrument was administered. The survey gathered contextual information on the bite, treatment-seeking behavior and clinical manifestations. To obtain deeper, contextual information, respondents were also asked to narrate the bite incident, subsequent behavior and outcomes. Results 8775 and 9206 households were surveyed in Kwale and Mbita, respectively. Out of these, 453 (5.17%) and 92 (1.00%) households reported that at least one person had been bitten by a snake in the past 5 years. Deaths from snakebites were rare (4.04%), but patterns of treatment seeking varied. Treatment at formal care facilities were sought for 50.8% and at traditional healers for 53.3%. 18.4% sought treatment from both sources. Victims who delayed receiving treatment from a formal facility were more likely to have consulted a traditional healer (OR 8.8995% CI [3.83, 20.64]). Delays in treatment seeking were associated with significantly increased odds of having a severe outcome, including death, paralysis or loss of consciousness (OR 3.47 95% CI [1.56; 7.70]). Conclusion Snakebite incidence and outcomes vary by region in Kenya, and treatment-seeking behaviors are complex. Work needs to be done to better characterize the spatial distribution of snakebite incidence in Kenya and efforts need to be made to ensure that victims have sufficient access to effective treatments to prevent death and serious injury.

Health care workers’ knowledge on identification, management and treatment of snakebite cases in rural Malawi: A descriptive study

“…Similar findings have been reported in Ghana, where HCWs overestimated their knowledge about snakebite management [ 24 ], and in Nigeria, where the knowledge about SAV among HCWs was grossly inadequate [ 28 ]. Patterns of lack of knowledge among HCWs on snakebite and SAV prescription and administration have also been reported in Brazil, Palestine, Kenya, Uganda, and Zambia [ 16 , 18 , 33 ]. While over two-thirds of the HCWs said that they had received training on snakebite management, this mainly was during their pre-service training at school, and it was unclear how the training was conducted.…”

“…In Malawi, a low-income country in southern Africa, there is a complete absence of literature on the estimated number of snakebites and treatment. A systematic review of 14 studies showed that most snakebite victims do not seek medical care at healthcare centers or hospitals due to distance to a health facility, financial constraints, and lack of availability of SAVs [ 16 – 18 ]. Studies done in rural Cameroon, Myanmar, Rwanda, and Ghana have also shown that traditional medicine is preferred and more trusted to cure snakebites than”western” bio-medicine [ 19 – 23 ].…”

Community and health system factors influencing snake envenomation management practices in three districts of Ghana: a qualitative inquiry from health stakeholders and snakebite victims

“…The health economic impact of snakebite treatment estimates the cost of managing snakebite envenoming at the local hospital level since victims are responsible for the cost [30, 28]. Antivenoms are frequently inaccessible to both patients and the suffering healthcare system due to their high cost [31].…”

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

“…In some cases, patients may spend hours or even days before reaching a medical facility equipped to treat SBE. Such delays, especially in those patients with severe SBE, have been shown to increase the risk of a poor outcome [ 12 , 14 , 15 , 29 , 30 , 31 , 32 ].…”