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[贝宁坦吉埃塔圣若德医院蛇咬伤治疗成本评估]

[Evaluation of snakebite management cost at Saint Jean de Dieu Hospital in Tanguiéta, Benin].

作者信息

Tourita Naryanan, Sodjinou Noé, Ouorou Seidou Alassane, Ganhouingnon Éric, Massougbodji Achille, Chippaux Jean-Philippe, Larréché Sébastien

机构信息

Département Santé, Université Senghor, 1, Place Ahmed Orabi, Al Mancheya, BP 415, 21111 Alexandrie, Égypte.

Institut de recherche clinique du Bénin, Abomey-Calavi, Bénin.

出版信息

Med Trop Sante Int. 2024 Dec 10;4(4). doi: 10.48327/mtsi.v4i4.2024.522. eCollection 2024 Dec 31.

Abstract

INTRODUCTION

Snakebite envenomations are a real public health problem in rural areas of sub-Saharan Africa, especially as the cost of management is often beyond the reach of the victims. The aim of our study was to evaluate the costs of treating snakebite envenomations at the Saint Jean de Dieu hospital in Tanguiéta, northern Benin, in a savannah area.

METHODS

This was a descriptive cross-sectional study conducted over a three-month period from May 25 to August 25, 2023. Snakebite patients were followed from admission to hospital discharge. All care-related expenses incurred by patients and/or their families were accounted for on a daily basis.

RESULTS

Fifty-seven patients were included. The median age (interquartile range) of the patients was 27 years (16-40), and the sex ratio was 1.6 (35 males and 22 females). In 81% of cases, the bites were associated with agricultural activities. Approximately 72% of the patients had sought traditional care before coming to the hospital. The median time from bite to admission was 7 hours (2-52) and the median hospital stay was 4 days (2-5). The median cost of care was €168 (154-242). It varied according to the severity of the bite: €31 for a dry bite (26-47); €179 for external bleeding (154-286). The only antivenom used was Inoserp™ PAN-AFRICA (Inosan Biopharma). Its average cost was €128 and was the main expense.

CONCLUSION

The cost of treating snakebite is high and dominated by the cost of antivenom. These economic constraints reinforce the vicious circle of poverty in an already vulnerable population. It is therefore important to find a financing mechanism for this treatment in the most exposed areas.

摘要

引言

在撒哈拉以南非洲的农村地区,蛇咬伤中毒是一个切实存在的公共卫生问题,尤其是治疗费用往往超出受害者的承受能力。我们研究的目的是评估在贝宁北部热带草原地区坦吉埃塔的圣若望医院治疗蛇咬伤中毒的费用。

方法

这是一项描述性横断面研究,于2023年5月25日至8月25日进行,为期三个月。对蛇咬伤患者从入院到出院进行跟踪。患者和/或其家属产生的所有与护理相关的费用按日记录。

结果

纳入了57名患者。患者的中位年龄(四分位间距)为27岁(16 - 40岁),性别比为1.6(35名男性和22名女性)。在81%的病例中,咬伤与农业活动有关。约72%的患者在来医院之前寻求过传统治疗。从咬伤到入院的中位时间为7小时(2 - 52小时),中位住院时间为4天(2 - 5天)。护理的中位费用为168欧元(154 - 242欧元)。费用因咬伤的严重程度而异:干咬为31欧元(26 - 47欧元);外出血为179欧元(154 - 286欧元)。唯一使用的抗蛇毒血清是Inoserp™ PAN - AFRICA(Inosan生物制药公司生产)。其平均费用为128欧元,是主要开支。

结论

蛇咬伤的治疗费用高昂,且以抗蛇毒血清的费用为主。这些经济限制加剧了本就脆弱人群的贫困恶性循环。因此,在受影响最严重的地区找到这种治疗的融资机制很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b691/11895845/bc38ef4283a6/mtsi-04-5619-g002.jpg

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