Survey on the burden, epidemiological and clinical characteristics of snakebite envenoming in the Health Demographic Surveillance System (HDSS) of Taabo (Southern Côte d’Ivoire)

Abstract

Background In Sub-Saharan Africa, reliable data on the burden, clinical epidemiology and management of snakebites remains scarce. Mostly, crude population and institution-based estimates have been reported. The aim of this study was to estimate the burden and describe the epidemiological and clinical characteristics of snakebite envenoming based on population-(HDSS) data. Methods A cross-sectional snakebite survey was conducted in all households in the Ahondo Health Area (AHA), a sub-population of the Taabo Health and Demographic Surveillance System (HDSS) between October 2 to December 22, 2023. All household members were interviewed, and a questionnaire was administered to snakebite cases. Epidemiological and clinical characteristics were described, and the annual snakebite incidence calculated. Results 795 households were surveyed, representing 3,924 people in the AHA. The annual incidence of snakebites per 100,000 population was 280.3 (CI: 140.0-501.0), the case-fatality rate 2.0% (95%CI: 0.04-10.5) and the median age of snakebite victims 43 years. The annual incidence of snakebites was significantly higher in the seasonally used agricultural camps (3296.7 cases per 100,000 inhabitants) than in the villages (208.7 cases per 100,000 inhabitants). Snakebites most frequently occurred in the morning and at night. Patients employed dangerous “first aid” measures. Most snakebite victims were treated by traditional healers. None of the cases attending the health services received antivenoms. Conclusion Snakebite envenoming remains a threat for rural communities at an unacceptable high level unchanged since the second half of the last century. Reliable community-based data on the incidence, circumstances and management of snakebite envenoming is only the first step to mitigate the neglected health problem. Implementation of prevention measures, first aid and clinical management, including access to antivenoms, must immediately follow.