Tianyi Frank-Leonel, Agbor Valirie Ndip, Tochie Joel Noutakdie, Kadia Benjamin Momo, Nkwescheu Armand Seraphin
Mayo Darle Sub-divisional Hospital, Banyo, Adamawa Region, Cameroon.
Ibal Sub-divisional Hospital, Oku, North West Region, Cameroon.
BMC Res Notes. 2018 May 18;11(1):317. doi: 10.1186/s13104-018-3409-3.
Snakebites are a major cause of mortality and morbidity worldwide with the highest mortality burden in poor rural areas of sub-Saharan Africa. Inadequate surveillance systems result in loss of morbidity and mortality data in these settings. Although rarely reported in these resource-constraint environments, community-based audits are recognised pivotal tools which could help update existing data and indicate key public health interventions to curb snakebite-related mortality. Herein, we present two cases of snakebite-related deaths in a rural Cameroonian community.
The first case was a 3-year-old female who presented at a primary care health centre and was later referred due to absence of antivenom serum (AVS). However, she had an early fatal outcome before getting to the referral hospital. The second case was an 80-year-old traditional healer who got bitten while attempting to kill a snake. He died before hospital presentation.
Community-based audits help identify key intervention points to curb snakebite mortality in high-risk rural areas like ours. From our audits, we note a remarkable absence of affordable AVS in rural health facilities in Cameroon. We recommend frequent community health education sessions on preventing snakebites; continuous training modules for health personnel from high-risk areas; training traditional healers on the importance of AVS in managing cases of snakebite envenoming, and the need for timely hospital presentation; and setting up context-specific approaches to rapidly transport snakebite victims to hospitals.
蛇咬伤是全球死亡和发病的主要原因，在撒哈拉以南非洲的贫困农村地区死亡率负担最高。监测系统不完善导致这些地区发病和死亡数据缺失。尽管在这些资源有限的环境中很少有报道，但基于社区的审计被认为是关键工具，有助于更新现有数据并指明遏制蛇咬伤相关死亡的关键公共卫生干预措施。在此，我们介绍喀麦隆一个农村社区两例与蛇咬伤相关的死亡病例。
第一例是一名3岁女性，她在一家初级保健健康中心就诊，后因没有抗蛇毒血清而被转诊。然而，她在到达转诊医院之前就早早死亡。第二例是一名80岁的传统治疗师，他在试图杀死一条蛇时被咬伤。他在送往医院之前就去世了。
基于社区的审计有助于确定关键干预点，以遏制像我们这样的高风险农村地区的蛇咬伤死亡率。通过我们的审计，我们注意到喀麦隆农村卫生设施中明显缺乏负担得起的抗蛇毒血清。我们建议经常开展关于预防蛇咬伤的社区健康教育；为来自高风险地区的卫生人员提供持续培训模块；培训传统治疗师认识到抗蛇毒血清在治疗蛇咬伤中毒病例中的重要性以及及时送往医院的必要性；并制定因地制宜的方法，迅速将蛇咬伤受害者送往医院。
