Presentation, management, and outcome of snake-bites in two districts hospitals in Ghana

Abstract

Introduction: the burden of disease represented by snakebites is widely underestimated and often neglected public health problem in the tropics. There is insufficient epidemiological data to guide distribution of antivenin and proper management of venomous snakebites. We describe the presentation, management and outcome of snakebites in two district hospitals in Ghana.

Methods: using data collection sheet, we prospectively documented information on all snakebite victims presenting at two Ghanaian district hospitals from 1st January 2011 to 31st December 2011.

Results: 163 snakebites representing incidence of 92/100,000 were recorded with mean age of 24 (16SD) years. 62.0% were males and 41.7% were farmers. Most bites occurred in April (14.3%), June (12.4%) and November (12.4%) and had occurred when victims were involved in farm- related activities (50.3%). Average time of presentation after snakebite was 3.6 (1.0 SD) hours and commonest clinical  presentations were pain (93.0%), swelling (84.0%) and bleeding (51%). Of the total cases 76.7% were given antivenon, 96.3% were given antibiotics, 91.4% corticosteroids and 58.3% antihistamines. No mortality was recorded.

Conclusion: provision of protocols and their strict adherence in the management of snakebites is required to limit unwarranted use of antibiotics and steroids in the management of snakebite. We  recommend evaluation of all antivenins imported for management of snakebites to ascertain their effectiveness so as to reduce morbidity and mortality associated with snakebites in this region.

Key words: Antivenon, envenomation, snakebites, epidemiology, sub-Saharan Africa