Michael Godpower C, Grema Bukar A, Aliyu Ibrahim, Alhaji Mohammed A, Lawal Teslim O, Ibrahim Haliru, Fikin Aminu G, Gyaran Fatima S, Kane Kennedy N, Thacher Thomas D, Badamasi Abba K, Ogwuche Emmanuel
Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria.
Trans R Soc Trop Med Hyg. 2018 Feb 1;112(2):47-56. doi: 10.1093/trstmh/try028.
Snakebite envenoming causes considerable morbidity and mortality in northern Nigeria. The clinician's knowledge of snakebite impacts outcome. We assessed clinicians' knowledge of snakebite envenoming to highlight knowledge and practice gaps for possible intervention to improve snakebite outcomes.
This was a cross-sectional multicentre study of 374 doctors selected from the accident and emergency, internal medicine, family medicine/general outpatient, paediatrics and surgery departments of nine tertiary hospitals in northern Nigeria using a multistage sampling technique. A self-administered questionnaire was used to assess their sociodemographics, knowledge of common venomous snakes, snakebite first aid, snake antivenom treatment and prevention.
The respondents' mean age was 35.6±5.8 y. They were predominantly males (70.6%) from urban hospitals (71.9%), from the northwest region (35.3%), in family medicine/general outpatient departments (33.4%), of <10 years working experience (66.3%) and had previous experience in snakebite management (78.3%). Although their mean overall knowledge score was 70.2±12.6%, only 52.9% had an adequate overall knowledge score. Most had adequate knowledge of snakebite clinical features (62.3%), first aid (75.7%) and preventive measures (97.1%), but only 50.8% and 25.1% had adequate knowledge of snake species that caused most injuries/deaths and anti-snake venom treatment, respectively. Overall knowledge predictors were ≥10 y working experience (odd ratio [OR] 1.72 [95% confidence interval {CI} 1.07 to 2.76]), urban hospital setting (OR 0.58 [95% CI 0.35 to 0.96]), surgery department (OR 0.44 [95% CI 0.24 to 0.81]), northwest/north-central region (OR 2.36 [95% CI 1.46 to 3.82]) and previous experience in snakebite management (OR 2.55 [95% CI 1.49 to 4.36]).
Overall knowledge was low. Improvements in overall knowledge may require clinicians' exposure to snakebite management and training of accident and emergency clinicians in the region.
在尼日利亚北部，蛇咬伤中毒导致相当高的发病率和死亡率。临床医生对蛇咬伤的了解会影响治疗结果。我们评估了临床医生对蛇咬伤中毒的了解情况，以突出知识和实践方面的差距，以便采取可能的干预措施来改善蛇咬伤的治疗结果。
这是一项横断面多中心研究，采用多阶段抽样技术，从尼日利亚北部九家三级医院的急诊科、内科、家庭医学/普通门诊、儿科和外科中选取了374名医生。使用一份自填式问卷来评估他们的社会人口统计学特征、对常见毒蛇的了解、蛇咬伤急救、蛇抗毒血清治疗和预防知识。
受访者的平均年龄为35.6±5.8岁。他们主要是男性（70.6%），来自城市医院（71.9%），来自西北地区（35.3%），在家庭医学/普通门诊科室工作（33.4%），工作经验<10年（66.3%），并且有过蛇咬伤治疗经验（78.3%）。尽管他们的平均总体知识得分是70.2±12.6%，但只有52.9%的人总体知识得分足够。大多数人对蛇咬伤的临床特征（62.3%）、急救（75.7%）和预防措施（97.1%）有足够的了解，但分别只有50.8%和25.1%的人对导致大多数伤害/死亡的蛇种和抗蛇毒血清治疗有足够的了解。总体知识的预测因素包括工作经验≥10年（比值比[OR]1.72[95%置信区间{CI}1.07至2.76]）、城市医院环境（OR 0.58[95%CI 0.35至0.96]）、外科科室（OR 0.44[95%CI 0.24至0.81]）、西北/中北部地区（OR 2.36[95%CI 1.46至3.82]）和有蛇咬伤治疗经验（OR 2.55[95%CI 1.49至4.36]）。
总体知识水平较低。提高总体知识水平可能需要临床医生接触蛇咬伤治疗，并对该地区的急诊科临床医生进行培训。
