Burden and Epidemiology of Snakebite Envenoming in Tanzania
Main Article Content
Abstract
Background: Snakebite envenoming (SBE) is a pressing public health issue in tropical countries. However, there is a paucity of data regarding the burden and epidemiology of SBE in Tanzania, undermining advocacy and the implementation of necessary prevention and control measures.
Methods: From June to September 2022, both health facility-based and community-based survey was conducted to collect data of the snakebite incidents that occurred between 2017 and 2021 in five regions of Tanzania; Pwani, Manyara, Tabora, Katavi, and Ruvuma. Data were analysed using STATA and summarized by tables and narrative descriptions.
Results: A total of 869 snakebite incidents were registered, resulting in 18 deaths. The estimated annual incidence, and mortality rates were 105.6, and 2.2 per 100,000 people, respectively. Pwani and Tabora regions exhibited a higher proportion of cases, accounting for 26% (226) and 23.4% (203) respectively. Males constituted the majority of cases, representing 52.5% (456), and individuals aged 10 to 59 years were most affected, accounting for approximately 85% of cases. The incidents commonly occurred during agricultural activities (31.5% or 219 cases) and while walking on rural roads (32% or 221 cases). Furthermore, snakebites were more prevalent during the dry season (34% or 295 cases) and the rainy season (25% or 218 cases). Factors such as time of day, season, circumstances/activities, occupation, age, and education level were found to be significantly associated with snakebite incidents.
Conclusion: This study underscore the significant impact of SBE in Tanzania, affecting individuals of all age groups, particularly farmers. Urgent collaborative efforts are required to address and mitigate the consequences of SBE in the country.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Kasturiratne A, Wickremasinghe AR, De Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5(11):1591–604.
II. Bagcchi S. Experts call for snakebite to be re-established as a neglected tropical disease. BMJ. 2015;351(October):h5313.
III. Chippaux JP. Snakebite envenomation turns again into a neglected tropical disease! J Venom Anim Toxins Incl Trop Dis. 2017;23(1):1–2.
IV. World Health Organization (WHO). snakebite-envenoming [Internet]. 2023 [cited 2023 Dec 8]. p. 1. Available from: https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming
V. Halilu S, Iliyasu G, Hamza M, Chippaux J-P, Kuznik A, Habib AG. Snakebite burden in Sub-Saharan Africa: estimates from 41 countries. Toxicon. 2019 Mar;159:1–4.
VI. Habib AG, Kuznik A, Hamza M, Abdullahi MI, Chedi BA, Chippaux JP, et al. Snakebite is Under Appreciated: Appraisal of Burden from West Africa. PLoS Negl Trop Dis. 2015;9(9):4–11.
VII. Minghui R, Malecela MN, Cooke E, Abela-Ridder B. WHO’s Snakebite Envenoming Strategy for prevention and control. Lancet Glob Heal [Internet]. 2019;7(7):e837–8. Available from: http://dx.doi.org/10.1016/S2214-109X(19)30225-6
VIII. Harrison RA, Hargreaves A, Wagstaff SC, Faragher B, Lalloo DG. Snake envenoming: A disease of poverty. PLoS Negl Trop Dis. 2009;3(12).
IX. Ralph R, Faiz MA, Sharma SK, Ribeiro I, Chappuis F. Managing snakebite. BMJ. 2022;376(fig 1):1–10.
X. Kasturiratne A, Pathmeswaran A, Wickremasinghe AR, Jayamanne SF, Dawson A, Isbister GK, et al. The socio-economic burden of snakebite in Sri Lanka. PLoS Negl Trop Dis. 2017;11(7):1–9.
XI. Jayakrishnan MP, Geeta MG, Krishnakumar P, Rajesh T V., George B. Snake bite mortality in children: Beyond bite to needle time. Arch Dis Child. 2017;102(5):445–9.
XII. Iliyasu G, Dayyab FM, Michael GC, Hamza M, Habib MA, Gutiérrez JM, et al. Case fatality rate and burden of snakebite envenoming in children – A systematic review and meta-analysis. Toxicon [Internet]. 2023;234:107299. Available from: https://www.sciencedirect.com/science/article/pii/S0041010123002854
XIII. Gutiérrez JM, Calvete JJ, Habib AG, Harrison RA, Williams DJ, Warrell DA. Snakebite envenoming. Nat Rev Dis Prim. 2017;3(17063):1.
XIV. Vesey-Fitzgerald DF. A guide to the snakes of the Tanzania and Kenya borderlands [Internet]. Kenya Litho Ltd., editor. Vol. June 1974, Journal of East Africa National History Society and National Museum. Nairobi, Kenya: The East Africa Natural History Society; 1975. 1–26 p. Available from: https://www.biodiversitylibrary.org/content/part/EANHS/149_1975_Vesey-FitzGerald.pdf
XV. WHO AFRICA. Snakes and Snakebites-part1: Prevention of Snake Bites. WHO Reg Off Africa. 2007;4(1):1–4.
XVI. Brent J, Burkhart K, Dargan P, Hatten B, Megarbane B, Palmer R, et al. Non-Front-Fanged Colubroid Snakes. Crit Care Toxicol Diagnosis Manag Crit Poisoned Patient. 2017;(June 2017):1–3058.
XVII. Kipanyula MJ, Kimaro WH. Snakes and snakebite envenoming in Northern Tanzania: A neglected tropical health problem. J Venom Anim Toxins Incl Trop Dis [Internet]. 2015;21(1):1–8. Available from: http://dx.doi.org/10.1186/s40409-015-0033-8
XVIII. Nonga HE, Haruna A. Assessment of human-snake interaction and its outcomes in monduli district, northern tanzania. Tanzan J Health Res. 2015;17(1):1–12.
XIX. The United Republic of Tanzania (URT), Ministry of Finance and Planning T, National Bureau of Statistics and President’s Office - Finance and Planning O of the, Chief Government Statistician Z. The 2022 Population and Housing Census: Administrative Units Population Distribution Report; Tanzania, December 2022. 2022.
XX. Salve PS, Vatavati S, Hallad J. Clustering the envenoming of snakebite in India: The district level analysis using Health Management Information System data. Clin Epidemiol Glob Heal [Internet]. 2020;8(3):733–8. Available from: https://doi.org/10.1016/j.cegh.2020.01.011
XXI. Rahman R, Faiz MA, Selim S, Rahman B, Basher A, Jones A, et al. Annual Incidence of Snake Bite in Rural Bangladesh. PLoS Negl Trop Dis. 2010;4(10):1–6.
XXII. Sharma SK, Jha N, Bovier PA. Impact of snake bites and determinants of fatal outcomes in Southeastern Nepal. Am Soc Trop Med Hyg [Internet]. 2004;71(2):234–8. Available from: https://www.researchgate.net/publication/8404009_Impact_of_snake_bites_and_determinants_of_fatal_outcomes_in_Southeastern_Nepal
XXIII. Theakston DG. INCIDENCE AND MORTALITY OF SNAKE BITE IN SAVANNA NIGERIA. Lancet. 1980;NOVEMBER 2:1181–3.
XXIV. Lalloo DG, Trevett AJ, Saweri A, Naraqi S, Theakston RDG, Warrellz DA. The epidemiology of snake bite in Central District , Papua New Guinea Province and National Capital. Trans R Soc Trop Med Hyg. 1995;(89):178–82.
XXV. Ddamulirare JBM. Makerere Study Edges to Close Critical Data gaps on Uganda ’ s snakebite burden and incidence [Internet]. Makerere University - School of Public Health. 2021 [cited 2022 Dec 7]. p. 1. Available from:
https://sph.mak.ac.ug/news/makerere-study-edges-close-critical-data-gaps-ugandas-snakebite-burden-and-incidence#:~:text=The findings show that there,period when it had occurred.
XXVI. Access O. Epidemiology of snake bites in selected areas of Kenya. Pan Afr Med J. 2018;8688(1937):1–14.
XXVII. Alirol E, Sharma SK, Bawaskar HS, Kuch U, Chappuis F. Snake bite in south asia: A review. PLoS Negl Trop Dis. 2010;4(1).
XXVIII. Campbell BT, Corsi JM, Boneti C, Jackson RJ, Smith SD, Kokoska ER. Pediatric snakebites: lessons learned from 114 cases. J Pediatr Surg. 2008;43(7):1338–41.
XXIX. Le Geyt J, Pach S, Gutiérrez JM, Habib AG, Maduwage KP, Hardcastle TC, et al. Paediatric snakebite envenoming: Recognition and management of cases. Arch Dis Child. 2021;106(1):14–9.
XXX. Bochner R, Struchiner C. [Exploratory analysis of environmental and socioeconomic factors related to snakebite incidence in Rio de Janeiro from 1990 to 1996]. Cad saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Esc Nac Saúde Pública. 2004 Aug 1;20(4):976–85.
XXXI. Bertolozzi MR, Scatena CM da C, França FO de S. Vulnerabilities in snakebites in Sao Paulo, Brazil. Rev Saude Publica. 2015;49.
XXXII. Pandey DP. Epidemiology of snakebites based on field survey in Chitwan and Nawalparasi districts, Nepal. J Med Toxicol. 2007;3(4):164–8.
XXXIII. Birhanu Hurisa AMA. Epidemiological Survey of Snake Bite in Ethiopia. Epidemiol Open Access. 2014;04(04):1–5.
XXXIV. Alam AS, Islam AM, Jesmin H. Snake Bite as a Public Health Problem: Bangladesh Perspective. BIRDEM Med J. 2016;5(1):24–9.
XXXV. Da Silva CJ, Jorge MT, Ribeiro LA. Epidemiology of snakebite in a central region of Brazil. Toxicon. 2003;41(2):251–5.
XXXVI. Ribeiro LA, Puorto G, Jorge MT. Bites by the colubrid snake Philodryas olfersii: A clinical and epidemiological study of 43 cases. Toxicon. 1999;37(6):943–8.
XXXVII. Vaiyapuri S, Vaiyapuri R, Ashokan R, Ramasamy K, Nattamaisundar K, Jeyaraj A, et al. Snakebite and its socio-economic impact on the rural population of Tamil Nadu, India. PLoS One. 2013;8(11):10–3.
XXXVIII. Ebrahimi V, Hamdami E, Khademian MH, Moemenbellah-Fard MD, Vazirianzadeh B. Epidemiologic prediction of snake bites in tropical south Iran: Using seasonal time series methods. Clin Epidemiol Glob Heal [Internet]. 2018;6(4):208–15. Available from:
https://doi.org/10.1016/j.cegh.2018.06.005
XXXIX. Ediriweera DS, Diggle PJ, Kasturiratne A, Pathmeswaran A, Gunawardena NK, Jayamanne SF, et al. Evaluating temporal patterns of snakebite in Sri Lanka: The potential for higher snakebite burdens with climate change. Int J Epidemiol. 2018;47(6):2049–58.
XL. Bernardino FS, Dalrymple GH. Seasonal activity and road mortality of the snakes of the Pa-hay-okee wetlands of Everglades National Park, USA. Biol Conserv. 1992;62(2):71–5.
XLI. Karki D, Sharma B, Koirala R, Nagila A. Epidemiology and Clinical Outcome of Snakebite in Western Nepal: A Retrospective Study. J Gandaki Med Coll. 2019;12(1):53–7.