From injury to outcome: A mixed-methods study of animal-related injuries in a rural district of Tanzania

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.