Snakebite: The neglected ‘medical crisis’

Dr. Suzan Kizito

Since 2018, the world holds the International Snakebite Awareness every September 19 to increase the populations’ knowledge of this ignored medical crisis.  Each year 5.4 million people are bitten by snakes of which close to 130,000 die and 400,000 of the snakebite victims survive with long-term disability, disfigurement and amputated limbs. Majority of the victims are women and children from poor rural communities with limited access to medical services in Sub-Africa and Asia.

The study conducted by Makerere University School of Public Health (MakSPH) with funds from the Uganda government through the Makerere University Research Innovation Fund (Mak-RIF) provided insights on the burden of snakebite in the country. In Uganda, 32 percent of the households have ever had a snakebite victim and in every 100,000 population, 101 are bitten by snakes each year. Snakebites also constitute a relatively big proportion of medical consultation, for every 100,000 population who seek medical care in health facilities, 72 are due to snakebites. 

In 2017, the World Health Organization (WHO) set a target to reduce by half the number of deaths and disabilities due to snakebite globally by 2030. To achieve this objective, the control and prevention strategy advocates for a systemic and multidisciplinary approach focused on improving treatments, strengthening health systems, engaging communities, building partnerships and mobilizing resources.

Uganda responded to WHO strategy by integrating snakebite envenoming into the country’s neglected tropical diseases program, developing a national snakebite prevention and management strategy as well as supporting research.  However achieving the target by 2030 is threatened by the numerous barriers including; limited community awareness on snakebites, a wide range of harmful practices related with snakebites as well as inadequate capacity of the health system to manage snakebites.

Snake Antivenom remain the gold standard for managing of snakebite envenoming to avoid mortality and minimize long-term disabilities. However access to Antivenom is still a big challenge to the country as Antivenom are very expensive, and the currently available Antivenom are of low efficacy since they are not based on venoms of the local snake types. If the country is to achieve the desired target to reduce the snakebite mortality and disability by half, there is a need to; increase awareness on snakebite, advocate among leaders and policy makers to prioritize, allocate funds for snakebite, address the harmful practices related with snakebites, and strengthen capacity of health facilities to manage snakebite.

We would like to call on all Ugandans to appreciate the burden and join efforts to raise awareness on the burden of snakebites in Uganda.

Snakebites have been re-classified as the latest neglected tropical disease (NTD) causing enormous morbidity and mortality among the rural poor communities in low-income snake-endemic countries of the world like Uganda.

Our study observed an increase in snakebites during the peak of the rain season. While a specific antidote for snakebite envenoming is the use of snake antivenom, the development of snake-specific antivenom ideal for Uganda snake species is yet to be commissioned. In the meantime, there is a need for massive awareness campaigns to create awareness of snakebites in schools, churches, parliament, communities among others. Equally important, we need to incorporate into the primary, secondary as well as institutional/university school curriculum snakebite knowledge to address the wide knowledge gap of both community members and healthcare providers on the management of snakebites. We call up on leaders and policy makers to prioritize, budget and support NTD program specific activities to promote health risks snakebites pause, how to mitigate them and above all prevent them in our communities.

Equally important, we also need to strategize ways of providing emphasize that most snakebite victims are managed in the community and very few make it to health facilities. In some communities, cultural norms and practices are used in managing snakebites that are unsafe, an indication of gross lack of knowledge in managing snakebites. There is still limited data on the burden of snakebites and we call for continued research in Uganda.

Authored by Dr. Suzan Kizito, is a researcher in the Department of Disease Control and Environmental Health Science, Makerere University School of Public Health