Chuat Manon, Alcoba Gabriel, Eyong Justin, Wanda Franck, Comte Eric, Nkwescheu Armand, Chappuis François, Hudelson Patricia
Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Genève, Geneva, Switzerland.
Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Geneva, Switzerland.
Toxicon X. 2021 Jul 15;9-10:100072. doi: 10.1016/j.toxcx.2021.100072. eCollection 2021 Jul.
Snakebite is a neglected tropical disease (NTD) affecting rural and remote populations globally, who are additionally burdened by poverty and the lack of effective healthcare systems. Delayed healthcare and use of traditional treatments are very frequent. The purpose of our study was to explore perceptions of snakes, impact of snakebite, and knowledge and opinions of different snakebite treatments with the aim of identifying opportunities for improving snakebite management.
This is a qualitative descriptive study based on semi-structured interviews with 21 snakebite victims and 4 traditional healers in 4 villages of Akonolinga health district, Center Region, Cameroon. Analysis focused on describing participants' perceptions of snakes, the impact of snakebite on the victims' lives, and their opinions of different treatment options.
Respondents were fearful of snakes and knowledgeable about envenoming symptoms and treatments. The experience of snakebite led to increased vigilance and avoidance behaviours, which sometimes resulted in financial loss for the victims. A range of traditional treatments were described, including tourniquets, black-stone application and medicinal plant decoctions. However, opinions were ambivalent regarding their efficacy, depending especially on previous personal experiences. Still, traditional treatments were said to be more available and cheaper than hospital care, and in particular, than antivenom. Nevertheless, most victims preferred hospital treatment if the financial and transportation barriers were lifted. Both snakebite victims and traditional healers were of the opinion that collaboration between health services and traditional healers could help to improve snakebite management and outcomes.
Our study shows that snakebite victims are in favour of using antivenom for the treatment of snakebite and would welcome better access to it. However, its current unavailability and high cost pushes them to turn to traditional treatments. On the other hand, traditional healers are in favour of collaborating with health facilities. These results are very encouraging for the improvement of snakebite management in Cameroon along the lines of the WHO Snakebite Envenoming Strategy for Prevention and Control: ensuring access to safe and effective treatment, and increasing partnership and coordination between communities, traditional healers, and conventional caregivers.
蛇咬伤是一种被忽视的热带疾病，影响着全球农村和偏远地区的人口，这些地区还面临着贫困和缺乏有效医疗体系的负担。医疗救治延迟以及使用传统疗法的情况非常普遍。我们研究的目的是探索对蛇的认知、蛇咬伤的影响以及对不同蛇咬伤治疗方法的知识和看法，以确定改善蛇咬伤管理的机会。
这是一项定性描述性研究，基于对喀麦隆中部地区阿科诺林加健康区4个村庄的21名蛇咬伤受害者和4名传统治疗师进行的半结构化访谈。分析重点在于描述参与者对蛇的认知、蛇咬伤对受害者生活的影响以及他们对不同治疗选择的看法。
受访者害怕蛇，了解中毒症状和治疗方法。蛇咬伤的经历导致警惕性提高和回避行为增加，这有时会给受害者造成经济损失。描述了一系列传统治疗方法，包括止血带、敷黑石和药用植物煎剂。然而，对于其疗效的看法存在矛盾，尤其取决于以前的个人经历。尽管如此，据说传统治疗方法比医院治疗更容易获得且更便宜，特别是比抗蛇毒血清便宜。然而，如果消除经济和交通障碍，大多数受害者更喜欢医院治疗。蛇咬伤受害者和传统治疗师都认为，卫生服务机构与传统治疗师之间的合作有助于改善蛇咬伤的管理和治疗效果。
我们的研究表明，蛇咬伤受害者赞成使用抗蛇毒血清治疗蛇咬伤，并希望能更容易获得。然而，目前无法获得且成本高昂促使他们转向传统治疗方法。另一方面，传统治疗师赞成与医疗机构合作。这些结果对于按照世界卫生组织蛇咬伤中毒预防和控制战略改善喀麦隆的蛇咬伤管理非常鼓舞人心：确保获得安全有效的治疗，并加强社区、传统治疗师和传统护理人员之间的伙伴关系与协调。
