Department of Global Health and Biomedical Sciences, School of Life Sciences and Bio-Engineering, Nelson Mandela - African Institution of Science and Technology, Arusha, Tanzania.
Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
PLoS One. 2023 Feb 10;18(2):e0280836. doi: 10.1371/journal.pone.0280836. eCollection 2023.
Continuous occurrence of snakebite incidences and the vulnerability of some communities remain a critical problem in sub-Saharan Africa. Despite causing permanent disability to almost half a million people annually and numerous deaths, snakebite and associated complications are still largely neglected. This study aimed at elucidating risk factors associated with snakebite cases, treatment availability and case management practices for vulnerable agro-pastoralist communities in Northern Tanzania.
Data was collected in the Monduli (Arusha region) and the Simanjiro (Manyara region) districts in Tanzania. Interviews with 101 snakebite victims or their guardians and 13 health professionals from 3 health centers in the districts were conducted. Additionally, case records of patients admitted between 2007 and 2019 to the Meserani Snakebite Clinic were obtained.
This study showed that appropriate treatment for snakebite including anti-venom, is difficult to access and that snakebite incidences were significantly linked to factors such as gender, age, socio-economic activity, season of the year, and whether being at home or out in the fields. Anti-venom and trained health professionals were only available at the Meserani Snake Park Clinic. Men were bitten most often (χ2 = 62.08, df = 4, p-value < 0.0001). Overall, adults between the ages of 18 and 60 years (χ2 = 62.08, df = 4, p-value < 0.0001) received most bites, usually while outdoors herding cattle in the dry season. A significant majority of victims looked for traditional treatment first (52.7%, χ2 = 29.541, df = 2, p-value = 0.0001). The results of this study present crucial information on what is needed to improve the accessibility to appropriate treatment after a snakebite among agro-pastoral communities.
The situation regarding morbidity and mortality due to the inaccessibility of common treatment for snakebite in northern Tanzania is challenging. Reliance on traditional medicine exacerbates the situation. There is dire need to involve affected communities, researchers, the government, clinicians and the public in general, to work together and take part in the global snakebite initiative. Communities and health professionals recognise the underlying challenges and have valuable suggestions on how to improve the situation.
在撒哈拉以南非洲，蛇伤事件持续发生，一些社区易受伤害，这仍是一个严峻的问题。尽管每年有近 50 万人因此永久残疾，还有许多人因此死亡，但蛇伤及其相关并发症仍然在很大程度上被忽视。本研究旨在阐明坦桑尼亚北部农牧民社区中与蛇伤病例相关的风险因素、治疗的可及性和病例管理做法。
在坦桑尼亚的蒙杜利（阿鲁沙地区）和西曼吉罗（马尼亚拉地区）地区收集数据。对来自该地区 3 个卫生中心的 101 名蛇伤受害者或其监护人以及 13 名卫生专业人员进行了访谈。此外，还获得了 2007 年至 2019 年期间在梅塞拉尼蛇伤诊所住院的患者的病例记录。
本研究表明，获得包括抗蛇毒血清在内的适当蛇伤治疗较为困难，蛇伤发生率与性别、年龄、社会经济活动、一年中的季节以及是在家还是在田间等因素显著相关。抗蛇毒血清和经过培训的卫生专业人员仅在梅塞拉尼蛇公园诊所提供。男性（χ2=62.08，df=4，p 值<0.0001）最常被咬伤。总体而言，18 至 60 岁的成年人（χ2=62.08，df=4，p 值<0.0001）最常被咬伤，通常是在旱季外出放牧时。绝大多数受害者首先寻求传统治疗（52.7%，χ2=29.541，df=2，p 值=0.0001）。本研究结果提供了关于在农牧民社区中改善获得适当蛇伤治疗的关键信息。
在坦桑尼亚北部，由于无法获得常见的蛇伤治疗方法而导致发病率和死亡率的情况具有挑战性。对传统医学的依赖使情况更加恶化。需要社区、研究人员、政府、临床医生和公众共同参与全球蛇伤倡议，共同努力。社区和卫生专业人员认识到存在的挑战，并就如何改善这种情况提出了宝贵的建议。
