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The Burden of Snakebite in Rural Communities in Kenya: A Household Survey

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  • 1 Health Action International, Amsterdam, The Netherlands;
  • | 2 Utrecht Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands;
  • | 3 Access to Medicines Platform Kenya, Nairobi, Kenya

ABSTRACT.

Annually, about 2.7 million snakebite envenomings occur worldwide, primarily affecting those living in rural regions. Effective treatment exists but is scarce, and traditional treatments are commonly used. To inform context-specific policies in Kenya, this study aimed to determine the health-seeking behavior and the health, social, and economic burden of snakebites in rural communities. Nonprobability sampling was used to survey 382 respondents from four snakebite-endemic counties, from February to August 2020, using a structured questionnaire. Descriptive statistics, Fisher’s exact tests, binary logistic regressions, and Mantel-Haenszel tests were used for analysis. Life-time experience with snakebites included 13.1% of respondents who reported being personally bitten and 37.4% who reported knowing of a community member being bitten. Respondents reported death after a snakebite in 9.1% of bitten community members and in 14.6% of bitten family members. Risk of snakebite was not significantly associated with sex, educational level, or occupation. Snakebite victims were most often walking (38%) or farming (24%) when bitten. Of those bitten, 58% went to a health facility, 30% sought traditional treatment, and 12% first went to a traditional healer before visiting a facility. Significant differences existed in perceptions on the financial consequences of snakebites among those who had been personally bitten and those who had observed a snakebite. Most commonly mentioned preventive measures were wearing shoes and carrying a light in the dark. Community engagement, including engagement with traditional healers, is needed to reduce snakebites. This should be done through education and sensitization to improve used preventive measures and effective health-seeking behavior.

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Author Notes

Address correspondence to Gaby I. Ooms, Overtoom 60-2, 1054 HK, Amsterdam, The Netherlands. E-mail: gaby@haiweb.org

Financial support: This work was supported by the Lillian Lincoln Foundation and the Hennecke Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Authors’ addresses: Gaby I. Ooms, Health Action International, Amsterdam, The Netherlands, and Utrecht Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands, E-mail: gaby@haiweb.org. Janneke van Oirschot, Benjamin Waldmann, and Tim Reed, Health Action International, Amsterdam, The Netherlands, E-mails: janneke@haiweb.org, ben@haiweb.org, and tim@haiweb.org. Dorothy Okemo, Access to Medicines Platform Kenya, Nairobi, Kenya, E-mail: dorojuma@gmail.com. Aukje K. Mantel-Teeuwisse and Hendrika A. van den Ham, Utrecht Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands, E-mails: a.k.mantel@uu.nl and h.a.vandenham@uu.nl.

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