Hyuha Gimbo, Nyamle Notikela, Kilonzi Manase, Makoye Paul Malaba, Chuwa Castory Sananga, Aiko Beatrice, Sirili Nathanael
Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLoS Negl Trop Dis. 2025 Sep 2;19(9):e0013494. doi: 10.1371/journal.pntd.0013494. eCollection 2025 Sep.
Animal-related injuries remain a neglected public health issue in rural Tanzania, exacerbated by limited access to care and varied occupational exposures. While some studies have examined bite management in tertiary hospitals, little is known about the situation at the primary healthcare (PHC) level. This study explored clinical presentations, management and outcomes of animal-related injuries in a rural Tanzanian setting, using Mkinga District as a case study.
A mixed-methods study was conducted in February 2024 across 29 PHC facilities in Mkinga, Tanzania. The quantitative component involved a retrospective audit of animal-related injury records from 2019 to 2023. The qualitative component comprised 10 interviews with facility in-charges to explore clinical decision-making, treatment approaches, and outcomes. Quantitative data were analyzed using SPSS; thematic analysis was applied to the qualitative transcript.
A total of 351 cases were documented. Symptom data were missing in over 70% of records, limiting clinical profiling. Among recorded cases, corticosteroids (55%) and antihistamines (53%) were commonly used, especially for insect and dog bites. Antibiotics were administered in insect stings (26%) and dog bites (23%), and analgesics were frequently used for insect bites. Antidotes were most common in dog (58%) and snake bites (26%). Of two cat bite cases, only one received antibiotics; neither received tetanus toxoid, despite the known infection risk. Qualitative findings highlighted three themes: clinical presentations, treatment modalities, and outcomes. Respondents described primary (e.g., bleeding, pain) and systemic (e.g., respiratory distress, neurological signs) symptoms. Treatment involved a mix of pharmacological, non-pharmacological, and traditional methods. While most patients recovered, some experienced complications or death.
PHC facilities manage most animal-related injuries effectively, but gaps in documentation, guideline adherence, and referral systems remain. Strengthening provider training, improving resources, and engaging traditional healers may enhance timely care. Broader surveillance and community education are critical to reducing preventable harm.
在坦桑尼亚农村地区,与动物相关的伤害仍是一个被忽视的公共卫生问题,获得医疗服务的机会有限以及职业暴露多样使这一问题更加严重。虽然一些研究调查了三级医院的咬伤处理情况,但对于初级卫生保健(PHC)层面的情况却知之甚少。本研究以姆金加区为例,探讨了坦桑尼亚农村地区与动物相关伤害的临床表现、处理情况及结果。
2024年2月,在坦桑尼亚姆金加的29个初级卫生保健机构开展了一项混合方法研究。定量部分涉及对2019年至2023年与动物相关伤害记录的回顾性审核。定性部分包括对机构负责人进行10次访谈,以探讨临床决策、治疗方法和结果。定量数据使用SPSS进行分析;对定性转录本进行主题分析。
共记录了351例病例。超过70%的记录缺少症状数据,这限制了临床概况分析。在记录的病例中,常用皮质类固醇(55%)和抗组胺药(53%),尤其是用于昆虫叮咬和狗咬伤。昆虫蜇伤(26%)和狗咬伤(23%)时使用抗生素,昆虫叮咬时经常使用镇痛药。解毒剂在狗咬伤(58%)和蛇咬伤(26%)中最为常见。在两例猫咬伤病例中,只有一例接受了抗生素治疗;尽管已知有感染风险,但两例均未接种破伤风类毒素。定性研究结果突出了三个主题:临床表现治疗方式和结果。受访者描述了主要症状(如出血、疼痛)和全身症状(如呼吸窘迫、神经体征)。治疗涉及药理学、非药理学和传统方法的综合应用。虽然大多数患者康复,但一些患者出现了并发症或死亡。
初级卫生保健机构能有效处理大多数与动物相关的伤害,但在文件记录、遵循指南和转诊系统方面仍存在差距。加强提供者培训、改善资源以及与传统治疗师合作可能会提高及时护理水平。更广泛的监测和社区教育对于减少可预防的伤害至关重要。