Steinhorst Jonathan, Aglanu Leslie Mawuli, Ravensbergen Sofanne J, Dari Chrisantus Danaah, Abass Kabiru Mohammed, Mireku Samuel Osei, Adu Poku Joseph Ken, Enuameh Yeetey A K, Blessmann Jörg, Harrison Robert A, Amuasi John H, Stienstra Ymkje
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Kumasi Center for Collaborative Research, Global Health and Infectious Diseases Group, Kumasi, Ghana.
PLoS Negl Trop Dis. 2021 Apr 16;15(4):e0009298. doi: 10.1371/journal.pntd.0009298. eCollection 2021 Apr.
Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare.
The study was approached from the interpretive paradigm with phenomenology as a methodology. Semi-structured interviews were conducted with 19 traditional healers who treat snakebite patients in two rural settings in Ghana. From the Ashanti and Upper West regions respectively, 11 and 8 healers were purposively sampled. Interview data was coded, collated and analysed thematically using ATLAS.ti 8 software. Demographic statistics were analysed using IBM SPSS Statistics version 26.
Snakebite was reportedly a frequent occurrence, perceived as dangerous and often deadly by healers. Healers felt optimistic in establishing a diagnosis of snakebite using a multitude of methods, ranging from herbal applications to spiritual consultations. They were equally confident about their therapies; encompassing the administration of plant and animal-based concoctions and manipulations of bite wounds. Traditional healers were consulted for both physical and spiritual manifestations of snakebite or after insufficient pain control and lack of antivenom at hospitals; referrals by healers to hospitals were primarily done to receive antivenom and care for wound complications. Most healers welcomed opportunities to engage more productively with hospitals and clinical staff.
The fact that traditional healers did sometimes refer victims to hospitals indicates that improvement of antivenom stocks, pain management and wound care can potentially improve health seeking at hospitals. Our results emphasize the need to explore future avenues for communication and collaboration with traditional healers to improve health seeking behaviour and the delivery of much-needed healthcare to snakebite victims.
蛇咬伤中毒是一种医疗急症，在许多热带低收入和中等收入国家很常见。在困境中的蛇咬伤受害者常将传统治疗师作为主要护理人员咨询。因此，传统治疗师是有关社区层面如何认识和处理蛇咬伤的宝贵信息来源，了解这一点对于改善和扩大与蛇咬伤相关的医疗保健至关重要。
本研究采用解释性范式，以现象学为方法。对加纳两个农村地区治疗蛇咬伤患者的19名传统治疗师进行了半结构化访谈。分别从阿散蒂和上西部地区有目的地抽取了11名和8名治疗师。访谈数据进行编码、整理，并使用ATLAS.ti 8软件进行主题分析。使用IBM SPSS Statistics 26版本分析人口统计学统计数据。
据报道，蛇咬伤事件频繁发生，治疗师认为其危险且往往致命。治疗师对使用多种方法诊断蛇咬伤感到乐观，这些方法从草药应用到精神咨询不等。他们对自己的治疗方法同样有信心；包括施用基于植物和动物的药剂以及处理咬伤伤口。蛇咬伤的身体和精神症状出现后，或在医院疼痛控制不足和缺乏抗蛇毒血清时，患者会咨询传统治疗师；治疗师将患者转诊至医院主要是为了获取抗蛇毒血清并治疗伤口并发症。大多数治疗师欢迎有机会与医院和临床工作人员更有效地合作。
传统治疗师有时会将受害者转诊至医院，这一事实表明，增加抗蛇毒血清储备、改善疼痛管理和伤口护理可能会改善患者到医院就诊的情况。我们的结果强调，有必要探索未来与传统治疗师沟通与合作的途径，以改善患者的就诊行为，并为蛇咬伤受害者提供急需的医疗保健。
