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Workie Limenh L, Emagn Kasahun A, Ayalew Tessema T, Kerie Anagaw Y, Simegn W, Ayenew W. Assessment of traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia. PHARMACEUTICAL BIOLOGY 2024; 62:261-268. [PMID: 38389287 PMCID: PMC10896146 DOI: 10.1080/13880209.2024.2318795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
CONTEXT Although pharmaceutical equipment and medical supplies play a vital role in the quality of traditional medicines, they have not received much attention from stakeholders and researchers nationally and internationally. OBJECTIVE This study assesses traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia. MATERIALS AND METHODS A quantitative cross-sectional study was conducted on 70 traditional healers. The data were collected using an interview-based questionnaire. The collected data were checked and entered into Statistical Package for Social Sciences version 25.0 for analysis. The results were presented as percentages. The association between socio-demographic characteristics and traditional healers' knowledge of pharmaceutical equipment and medical supplies was examined using Pearson's Chi-squares test. RESULTS About 90% of traditional healers had information about pharmaceutical equipment and medical supplies, and currently 80% of them used different pharmaceutical equipment and medical supplies individually and in combination with traditional equipment. Although most traditional healers used different pharmaceutical equipment and medical supplies, only 13.3% of them used equipment and supplies a day. Only 15% of traditional healers continuously cleaned their equipment. None of the socio-demographic variables were significantly associated to the knowledge of pharmaceutical equipment and medical supplies. DISCUSSION AND CONCLUSIONS Pharmaceutical equipment and medical supplies used by traditional healers was inconsistent, mainly associated with their habit of using self-prepared and home-available equipment. Moreover, the checkup status of compounding equipment was poor. As Traditional healers provide high-patient care services, emphasis should be given to improving their preparation and treatment strategies.
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Affiliation(s)
- Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Emagn Kasahun
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Ayalew Tessema
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeniewa Kerie Anagaw
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondim Ayenew
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Davi SD, Lumeka A, Hildebrandt TR, Endamne LR, Otchague C, Okwu DG, Artus R, Hunstig F, Manego RZ, Blessmann J, Kremsner PG, Lell B, Mombo-Ngoma G, Agnandji ST, Ramharter M, Kreuels B. Assessing the Incidence of Snakebites in Rural Gabon-A Community-Based, Cross-Sectional Pilot Survey. Trop Med Infect Dis 2024; 9:68. [PMID: 38668529 PMCID: PMC11053831 DOI: 10.3390/tropicalmed9040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/09/2024] [Accepted: 03/20/2024] [Indexed: 04/29/2024] Open
Abstract
Snakebite envenoming (SBE) is a neglected tropical disease (NTD). Community-based studies from sub-Saharan Africa are urgently required as data on the incidence are scarce. This study aimed to determine the lifetime prevalence of snakebites in rural Gabon by preparing the conduct of a larger regional survey. A cross-sectional community-based epidemiological survey in Sindara, Ngounie province, was conducted. Households were interviewed about the history of snakebites of household members to calculate lifetime prevalence. In addition, the average annual incidence rate per 100,000 over the last 5 years was calculated. A total of 771 inhabitants were enrolled, of which 5 (0.65%; 95% confidence interval (95% CI: 0.2-1.5%)) were victims of snakebites. Over the past 5 years, annual incidence was 77 bites per 100,000 (95% CI: 0-620). This study provides a first rough estimate of the incidence of SBE from rural central Gabon, demonstrating the importance of this NTD. Key Contribution: The estimated annual incidence of snakebites found was 77 per 100,000. Snakebites occurred mainly during agricultural activities.
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Affiliation(s)
- Saskia Dede Davi
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany; (S.D.D.); (T.R.H.)
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Riems, 20359 Hamburg, Germany
| | - Anita Lumeka
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Teite Rebecca Hildebrandt
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany; (S.D.D.); (T.R.H.)
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Lilian Rene Endamne
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany; (S.D.D.); (T.R.H.)
| | - Cedric Otchague
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Dearie Glory Okwu
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Rica Artus
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- Research Group Snakebite Envenoming, Department of Implementation Research, Bernhard-Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany (J.B.)
| | - Friederike Hunstig
- Research Group Snakebite Envenoming, Department of Implementation Research, Bernhard-Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany (J.B.)
| | - Rella Zoleko Manego
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Jörg Blessmann
- Research Group Snakebite Envenoming, Department of Implementation Research, Bernhard-Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany (J.B.)
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, 72016 Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- Research Group Drug Implementation, Department of Implementation Research, Bernhard-Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
| | - Michael Ramharter
- Centre of Tropical Medicine, Bernhard-Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany; (S.D.D.); (T.R.H.)
- Centre de Recherches Médicales de Lambaréné, Lambarene BP 242, Gabon; (A.L.); (C.O.); (G.M.-N.); (S.T.A.)
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Riems, 20359 Hamburg, Germany
| | - Benno Kreuels
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Riems, 20359 Hamburg, Germany
- Research Group Snakebite Envenoming, Department of Implementation Research, Bernhard-Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany (J.B.)
- Division for Tropical Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
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Pandey DP, Thapa NB. Analysis of News Media-Reported Snakebite Envenoming in Nepal during 2010-2022. PLoS Negl Trop Dis 2023; 17:e0011572. [PMID: 37639403 PMCID: PMC10491300 DOI: 10.1371/journal.pntd.0011572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/08/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Snakebite envenoming is a well-known medical emergency in the Terai of Nepal in particular. However, there is an epidemiological knowledge gap. The news media data available online provide substantial information on envenomings. Assessing this information can be a pristine approach for understanding snakebite epidemiology and conducting knowledge-based interventions. We firstly analyzed news media-reported quantitative information on conditions under which bites occur, treatment-seeking behavior of victims, and outcomes of snakebite envenomings in Nepal. METHODOLOGY/PRINCIPAL FINDINGS We analyzed 308 Nepalese snakebite envenomed cases reported in 199 news media articles published between 2010 and 2022 using descriptive statistics, Wilcoxon, and Chi-square tests to know why and how victims were bitten, their treatment-seeking behavior, and the outcomes. These envenomated cases known with substantial information represented 48 districts (mostly located in the Terai region) of Nepal. These envenomings mostly occurred in residential areas affecting children. Generally, envenomings among males and females were not significantly different. But, in residential areas, females were more envenomed than males. Further, victims' extremities were often exposed to venomous snakebites while their active status and these episodes often occurred at night while victims were passive during snakebites indoors and immediate surroundings of houses. Snakebite deaths were less among referred than non-referred cases, males than females, and while active than passive conditions of victims. CONCLUSION/SIGNIFICANCE The most of reported envenomed patients were children, and most envenomings were due to cobra bites. Consultation with traditional healers complicated snakebite management. In most cases, deaths that occur without medical interventions are a severe snakebite consequence in Nepal. Further, several deaths in urban areas and mountains and higher hills of Nepal suggest immediate need of snakebite management interventions in the most affected districts. Therefore, there is an urgent need to immediately admit Nepalese snakebite victims to nearby snakebite treatment centers without adopting non-recommended prehospital interventions. The strategies for preventing snakebite and controlling venom effects should also include hilly and mountain districts where snakebite-associated deaths are reported.
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Affiliation(s)
- Deb P. Pandey
- Department of Veterinary Microbiology and Parasitology, Agriculture and Forestry University, Rampur, Chitwan, Bagmati Province, Nepal
| | - Narayan B. Thapa
- Department of Pediatrics, Bharatpur Hospital, Bharatpur, Chitwan, Bagmati Province, Nepal
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Pandey DP, Shrestha BR, Acharya KP, Shah KJ, Thapa-Magar C, Dhakal IP, Mohamed F, Isbister GK. A prospective study of snakebite in a tertiary care hospital in south-western Nepal. Trans R Soc Trop Med Hyg 2023:6972592. [PMID: 36611273 DOI: 10.1093/trstmh/trac127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Snakebite is a neglected public health issue in Nepal. We aimed to characterize patients with snake envenoming admitted to hospital in south-western Nepal. METHODS This was a prospective cohort study of 476 snakebite patients admitted to Bheri Hospital from May to December 2017. Data were collected on patient demographics, bite circumstances, snake type, treatment-seeking behavior, clinical effects, complications and treatment. RESULTS There were 139/476 (29%) patients with clinical features of envenomation and 10 deaths (8%), of which six were prehospital deaths; 325/476 (68%) patients used non-recommended prehospital first aid, including 278 (58%) who applied a tourniquet and 43 (9%) consulting traditional healers. Median time to hospital arrival was 1.5 (IQR: 0.8-4) h. Also, 127 envenomated patients (91%) developed neurotoxicity and 12 (9%) hemotoxicity, while 124 patients (89%) received antivenom, with a median dose of 10 (4-30) vials. Three patients developed anaphylaxis following antivenom administration; 111 of 139 (80%) cases were admitted to the ICU and 48 (35%) were intubated. Median length of hospital stay for all cases was 0.5 (IQR: 0.5-1.2) d, but it was 2.2 (IQR: 1.5-3.8) d for envenomated cases. CONCLUSIONS The majority of snakebite patients used non-recommended first aid or attended traditional healers. Almost one-third of patients developed systemic envenomation and required antivenom. The case fatality rate was high, but many died prior to arriving in hospital.
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Affiliation(s)
- Deb Prasad Pandey
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka.,Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales, 2308, Australia.,Department of Veterinary Microbiology and Parasitology, Agriculture and Forestry University, Rampur, Chitwan, Bagmati, 44200, Nepal
| | | | | | | | | | - Ishwari Prasad Dhakal
- Department of Veterinary Microbiology and Parasitology, Agriculture and Forestry University, Rampur, Chitwan, Bagmati, 44200, Nepal
| | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka
| | - Geoffrey K Isbister
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka.,Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales, 2308, Australia
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