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Snakebite Envenomation in Rwanda: Patient Demographics, Medical Care, and Antivenom Availability in the Formal Healthcare Sector
- Source :
- Am J Trop Med Hyg
- Publication Year :
- 2021
- Publisher :
- American Society of Tropical Medicine and Hygiene, 2021.
-
Abstract
- Snakebite envenomation (SBE) is a neglected One Health issue that overwhelmingly affects people living in rural and impoverished regions of Africa and Asia. Information on SBE is scarce in Rwanda; thus, our objectives were to 1) describe the demographics of SBE patients seeking hospital care, 2) evaluate physician adherence to national treatment guidelines, and 3) assess availability of snake antivenom at hospitals in Rwanda. To achieve these goals, we obtained national data on animal bites/stings and visited every district and provincial hospital in Rwanda to obtain physical records of SBE patients treated in 2017 and 2018. Hospital pharmacies were assessed for antivenom availability. We identified snakes as the second leading cause of animal bites, after dogs, among patients who sought hospital care in 2017 and 2018. Of 363 SBE patients, the highest number of cases occurred among children (< 18 years; 32%) and young adults (18–30 years; 33%), females (61%), farmers (82%), and those living in Eastern Province (37%). Overall, physician adherence to treatment guidelines was 63%. Prescriptions of vitamin K and antivenom were low (4% and 13%, respectively), and only 8% of hospital pharmacies had antivenom in stock throughout the study period. The antivenom stocked was an Indian generic suited for Asian snakes. This minimum estimate of hospitalization cases does not include individuals who died in communities or sought care outside the formal sector. Our study highlights the need to map incidence, risk factors, and patient experiences to mitigate human–snake conflicts and improve patient outcomes.
- Subjects :
- Adult
Male
Rural Population
0301 basic medicine
medicine.medical_specialty
Adolescent
030231 tropical medicine
Antivenom
Health Care Sector
Snake Bites
complex mixtures
Young Adult
03 medical and health sciences
0302 clinical medicine
Virology
Health care
medicine
Animals
Humans
Snake antivenom
Medical prescription
Hospital pharmacy
Child
Envenomation
Retrospective Studies
Animal Bites
Antivenins
business.industry
Rwanda
Snakes
Articles
Middle Aged
030104 developmental biology
Infectious Diseases
One Health
Family medicine
Female
Parasitology
business
Subjects
Details
- ISSN :
- 14761645 and 00029637
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- The American Journal of Tropical Medicine and Hygiene
- Accession number :
- edsair.doi.dedup.....5414c8510f942cbc53b90caa3e3aad8b