Disability and Impairment Following Snakebite in Africa

Abstract

Snakebite is a neglected disease that constitutes major health crisis in poor resource rural areas of Sub-Saharan Africa (SSA). Young people in the productive age group that are involved in farming activities are commonly affected. The complex physiological effects of snake venom either systemically or locally leads to organ dysfunction with resultant disabilities and impairments if not properly managed. About 6000 amputations occur annually in SSA due to snakebite. Other disabilities and impairments are chronic non healing leg ulcers, visual loss, chronic kidney disease, myocardial ischemia, foetal loss, stroke and depression. Several factors that are associated with increased risk of developing these disabilities include poor health care delivery services, shortage of medical personnel and lack of appropriate potent antivenom. Other environmental triggers are poor housing facilities, lack of protective clothing during farming, specie of snake, site of snakebite, severity of envenomation and involvement in high risk activities like snake charmers. The risk of morbidity and disability exponentially increases with increasing bite-to-hospital time which ranges from 0.5 to 216 hours. Difficult transportation terrain, harmful ineffective traditional practices and visiting local traditional/spiritual healers immensely contributes to delay in presentation to health care facilities. Ultimately the delay in commencing antivenom and other supportive therapy accelerates the development of disabilities and impairments that are preventable. Provision of antivenom, educating patients and health workers on first aid measures and providing easier means of transporting patients to health care facilities could reduce the burden of disability and impairment from snakebite in Africa.