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Tianyi FL, Oluoch GO, Otundo D, Ofwete R, Ngari C, Trelfa A, Ahmed S, Wang D, Smith M, Meta V, Casewell NR, Lalloo DG, Harrison RA, Stienstra Y. Snakebite prevalence and risk factors in a nomadic population in Samburu County, Kenya: A community-based survey. PLoS Negl Trop Dis 2024; 18:e0011678. [PMID: 38165835 PMCID: PMC10760648 DOI: 10.1371/journal.pntd.0011678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/21/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Snakebite is an important public health concern, especially in tropical areas, but the true burden remains unclear due to sub-optimal reporting and over-reliance on health facility-based data. METHODS A community-based cross-sectional survey was conducted in Samburu County, Kenya from December 2019 to March 2020. Geospatial techniques were used to create a sampling frame of all households in Samburu County and a multistage cluster sampling strategy to select households and recruit study participants. Five year prevalence and mortality rates were estimated, the characteristics and circumstances of snakebite were described, and multilevel logistic regression models were built to identify independent risk factors for snakebite. RESULTS We recruited 3,610 individuals living in 875 households from 30 clusters. The 5-year prevalence of snakebite was 2.2% (95% CI 1.4%-3.4%), and the 5-year mortality rate was 138 (95% CI 44-322) deaths per 100,000 inhabitants, resulting in an estimated 1,406 snakebites and 88 deaths from snakebites per year in Samburu County. Snakebite incidents often occurred at night between 9pm and 6 am (44%, n = 36), and the participants were mostly walking/playing outdoors (51%, n = 41) or sleeping (32%, n = 27) when they were bitten. Lower household socioeconomic status and smaller numbers of people per house were significant independent risk factors. CONCLUSION Samburu County has a high snakebite burden and the most victims are bitten while sleeping or walking outdoors at night. Snakebite prevention and health promotion programs in Samburu County, and other endemic regions, need to be contextualised and consider the geographic, seasonal, and temporal specificities found in our study. Our findings also have implications for health care delivery, especially identification of the need for night-time staffing with expertise in snakebite management and antivenom availability to better manage patients and thereby improve outcomes.
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Affiliation(s)
- Frank-Leonel Tianyi
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - George O. Oluoch
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | - Denis Otundo
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | - Robert Ofwete
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | - Cecilia Ngari
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | - Anna Trelfa
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Sayem Ahmed
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Monica Smith
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | | | - Nicholas R. Casewell
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - David G. Lalloo
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Robert A. Harrison
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Kenya Snakebite Research and Intervention Centre, Kenya Institute of Primate Research, Ministry of Health, Karen, Nairobi, Kenya
| | - Ymkje Stienstra
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- University of Groningen, Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
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Iliyasu G, Dajel TB, Abubakar SB, Azi NA, Danamarya NM, Obateru OA, Dayyab AM, Hamza M, Alabi OA, Habib AG. Comparison of snakebite in children and adults in Nigeria. Toxicon 2023; 228:107128. [PMID: 37062344 DOI: 10.1016/j.toxicon.2023.107128] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
Snakebite envenoming is a major global public health problem and disproportionately affects children. To study the differences in clinical presentation and outcomes between children and adults, 2922 snakebite patients of whom 30.3% were children were analysed. Most bites (>75%) were in the lower. Features of local envenoming were commoner among children compared to adults (p < 0.05), while systemic envenoming features, mortality and complications were similar, p = 0.356, p = 0.12, and p = 0.16 respectively.
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Affiliation(s)
| | - Titus B Dajel
- Comprehensive Health Center Zamko, Langtang, Plateau state, Nigeria
| | - Saidu B Abubakar
- Snakebite Hospital & Research Center, Kaltungo, Gombe state, Nigeria
| | - Nyam Agwom Azi
- Comprehensive Health Center Zamko, Langtang, Plateau state, Nigeria
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Mana K, Ghosh R, Gantait K, Saha K, Parua P, Chatterjee U, Sarkhel S. Incidence and treatment of snakebites in West Bengal, India. Toxicol Rep 2019; 6:239-243. [PMID: 30899676 PMCID: PMC6409390 DOI: 10.1016/j.toxrep.2019.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/20/2019] [Accepted: 02/24/2019] [Indexed: 11/27/2022] Open
Abstract
Objective Snake envenomation is a major cause of death and disability in the developing countries. In India and neighboring countries, the four venomous snakes of concern include – Indian cobra(Naja naja), Common Krait (Bungarus caeruleus); Russell's Viper (Daboia russelli); Saw Scaled Viper (Echis carinatus). We describe the management protocol for snakebite treatment in a tertiary care hospital of Paschim Medinipur district, West Bengal based on case reports of subjects admitted and treated in Ghatal Subdivisional Hospital(GSH) during 2013–2016. Methods &materials We developed a structured data collection form to record demographic and clinical details of patients hospitalized at GSH between 1 January 2013 through 31 December 2016. Results Snake bite cases in Ghatal Subdivisional hospital(GSH) were assessed during the period 2013–2016. A total 18 deaths due to snakebite has been reported from this tertiary care hospital during the period. Total patients admitted in this hospital with snakebite is 1160 during the period 2013–2016. In 80% of the cases the lower extremities were affected. Preliminary first aid was provided in 45% cases. About 65% of the affected victims suffered snakebite in the morning hours. Some of the recommended drugs that were prescribed by the physicians of GSH were neostigmine, atropine, adrenaline, hydrocortisone, Amoxicillin. WBCT20 and Urea, Creatinine level were routinely performed. Conclusion Hospital studies are a key source of information about snake bites. The ready availability and appropriate use of AVS, close monitoring of patients, the institution of ventilator support and if required, early referral to a larger hospital all help to reduce the mortality. Thus knowledge of the varied clinical manifestations of snake bite is important for effective management in hospitals by a complete health care team.
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Affiliation(s)
- Kaushik Mana
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
| | - Rituparna Ghosh
- Department of Medicine, Midnapur Medical College, Paschim Medinipur, 721102, West Bengal, India
| | - Kripasindhu Gantait
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
| | - Kanchan Saha
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
| | - Poulami Parua
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
| | - Upasana Chatterjee
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
| | - Sumana Sarkhel
- Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India
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