Australian Venom Research Unit, Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.
PLoS Negl Trop Dis. 2023 Feb 9;17(2):e0011048. doi: 10.1371/journal.pntd.0011048. eCollection 2023 Feb.
Snakebite envenoming is a serious and life-threatening medical condition that predominantly affects people living in rural communities across Africa, Asia, and Latin America. As our climate changes, there is a growing concern that negative human-snake interactions will increase. Our ability to prevent and manage snakebite requires effective antivenoms as well as knowledge regarding the prevention and management of snakebite among healthcare workers and affected communities across the globe. This systematic review aims to assess existing levels of knowledge regarding snakebite prevention and management in both healthcare workers and affected communities.
This review was conducted on studies reporting quantitative measurements to evaluate knowledge and practice regarding snakebite prevention and management published in major databases between 1 January 2000 and 31 December 2021. Random effects modelling was used to obtain the pooled proportion. Heterogeneity (I2) was tested, and sensitivity analyses performed.
Out of 3,697 records, 16 studies from 12 countries assessing 7,640 participants were included. Four of the studies were ranked as good quality studies, 9 as fair, and 3 as poor. This study results demonstrated that 56% of the study population answered the knowledge question correctly (95% CI 48% to 63%, p < 0.001). High heterogeneity was observed (I2 = 97.29%), with marginal publication bias (Egger's regression test, p = 0.0814). Participants had relatively higher knowledge concerning use of antivenom as preferred treatment, followed by snakebite prevention, knowledge of signs and symptoms of snakebite, knowledge of first-aid, and knowledge of treatment. Participants had lower knowledge relating to types of snakes and the identification of snakes.
Adequate knowledge about snakebites and its management among the general population and healthcare workers was 56%. Healthcare workers and communities across Asia showed higher relative knowledge compared to those in Africa and the Middle East. These data suggest that further education is needed in both the general population and among healthcare workers to ensure that appropriate preventative and patient management techniques are being utilised in snakebite endemic regions. Greater local awareness of the risks and appropriate management of snakebite is required to reduce the burden of snakebite mortality and morbidity.
蛇伤中毒是一种严重的、危及生命的医疗状况，主要影响非洲、亚洲和拉丁美洲农村社区的人群。随着我们的气候发生变化，人们越来越担心人类与蛇的负面互动会增加。我们预防和管理蛇伤的能力需要有效的抗蛇毒血清，以及全球医疗工作者和受影响社区在预防和管理蛇伤方面的相关知识。本系统评价旨在评估医疗工作者和受影响社区在蛇伤预防和管理方面的现有知识水平。
本综述对 2000 年 1 月 1 日至 2021 年 12 月 31 日期间在主要数据库中发表的定量评估蛇伤预防和管理知识和实践的研究进行了评估。使用随机效应模型获得汇总比例。测试了异质性（I2），并进行了敏感性分析。
在 3697 条记录中，纳入了来自 12 个国家的 16 项研究，涉及 7640 名参与者。其中 4 项研究被评为高质量研究，9 项为中等质量，3 项为低质量。本研究结果表明，56%的研究人群正确回答了知识问题（95%置信区间为 48%至 63%，p<0.001）。观察到高度异质性（I2=97.29%），边缘发表偏倚（Egger 回归检验，p=0.0814）。参与者在使用抗蛇毒血清作为首选治疗方法、预防蛇伤、识别蛇伤的症状和体征、急救知识以及治疗知识方面的知识相对较高。参与者在与蛇的种类和识别蛇有关的知识方面的知识较低。
一般人群和医疗工作者对蛇咬伤及其管理的充分认识为 56%。亚洲的医疗工作者和社区相对于非洲和中东地区的医疗工作者和社区，其相对知识水平更高。这些数据表明，在蛇咬伤流行地区，需要在普通人群和医疗工作者中进一步开展教育，以确保使用适当的预防和患者管理技术。需要提高对风险的认识，并适当管理蛇咬伤，以降低蛇伤死亡率和发病率的负担。
