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蛇咬伤:一个被忽视的公共卫生问题——对2018年至2023年加纳沃尔特地区医疗机构报告的蛇咬伤病例的分布、趋势和发病率分析

Snakebites, a neglected public health concern: an analysis of distribution, trends and incidence of snakebite cases reported to health facilities in the Volta Region of Ghana, 2018-2023.

作者信息

Bosoka Samuel Adolf, Jerela Joseph Yaw, Nambagyira Amatus, Bonsu Emmanuel Yaw, Korang Felix Kwame, Djokoto Senanu Kwesi, Kubio Chrysantus

机构信息

Volta Regional Health Directorate, Ghana Health Service, Ho, Box 72, Ghana.

Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, PMB 31, Ghana.

出版信息

Trans R Soc Trop Med Hyg. 2025 Apr 1;119(4):443-452. doi: 10.1093/trstmh/trae113.

Abstract

BACKGROUND

Snakebite affects 5.4 million people annually, causing up to 2.7 million envenoming cases and 137 880 deaths. Its rise has been linked to flooding. This study examines the distribution, trends and incidence of snakebite cases in the Volta Region and identifies snakebite outbreaks in flood-affected districts.

METHODS

We undertook a descriptive secondary data analysis of 2018-2023 snakebite cases from the District Health Information and Management Systems II database for the Volta Region. Cumulative Sum was used to identify missed outbreaks. The results are presented in tables, graphs and maps.

RESULTS

A total of 1637 snakebite cases were reported across the 6-y study period, with an overall incidence rate of 15.8 cases per 100 000 population and a case fatality rate of 0.4% (7/1637). Case patients aged 20-34 y were the most affected (26.7%; 437/1637). Most of the cases peaked in March during the rainy season. The incidence of snakebites decreased from 18 cases per 100 000 population in 2018 to 15.8 cases per 100 000 population in 2023. Each of the flood-affected districts reported snakebite outbreaks before the flooding event. No new outbreaks were detected during or after the floods as of December 2023.

CONCLUSIONS

While snakebite incidence has decreased overall in the Volta Region, the burden remains alarmingly high in Ketu North. Young adults are particularly vulnerable. Urgent efforts are needed to enhance education, emphasising the importance of protective attire during the wet season for community safety.

摘要

背景

每年有540万人被蛇咬伤,导致多达270万例蛇毒中毒病例和137880人死亡。蛇咬伤事件的增加与洪水有关。本研究调查了沃尔特地区蛇咬伤病例的分布、趋势和发病率,并确定了受洪水影响地区的蛇咬伤疫情。

方法

我们对沃尔特地区2018 - 2023年地区卫生信息和管理系统II数据库中的蛇咬伤病例进行了描述性二次数据分析。采用累积和法识别漏报的疫情。结果以表格、图表和地图形式呈现。

结果

在6年的研究期内,共报告了1637例蛇咬伤病例,总体发病率为每10万人15.8例,病死率为0.4%(7/1637)。20 - 34岁的病例患者受影响最大(26.7%;437/1637)。大多数病例在雨季的3月达到峰值。蛇咬伤的发病率从2018年的每10万人18例降至2023年的每10万人15.8例。每个受洪水影响的地区在洪水事件之前都报告了蛇咬伤疫情。截至2023年12月,洪水期间及之后未发现新的疫情。

结论

虽然沃尔特地区蛇咬伤的总体发病率有所下降,但凯图北区的负担仍然高得惊人。年轻人尤其脆弱。需要紧急努力加强教育,强调雨季穿着防护服对社区安全的重要性。

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