Abstract
BackgroundSnakebite is a common neglected public health issue, especially in poor rural areas of sub-Saharan Africa, Asia and Latin America. Passive immunotherapy with safe and effective antivenom is the only approved treatment for it. This study aimed to determine the incidence of snakebites, and to assess the availability and accessibility of antivenoms, from 2010 to 2014, in Burkina Faso.MethodsThe assessment of snakebite cases managed in all health facilities from 2010 to 2014 was performed from the Statistical Yearbook of the Ministry of Health. Antivenom consumption data were collected from the drug wholesalers established in Burkina Faso.ResultsSnakebites are among the five leading causes of consultations in health districts. From 2010 to 2014, 114,126 envenomation cases occurred in Burkina Faso, out of which 62,293 (54.6 %) victims have been hospitalized resulting in 1,362 (2 %) deaths. The annual incidence and mortality were respectively 130 bites and 1.75 deaths per 100,000 inhabitants. The amount of antivenom sold by wholesalers were 5,738 vials with a total cost of US$ 539,055 (annual average = US$ 107,811). The high cost of these antivenoms (between US$ 42 and 170 per dose according to brand) limited their use by rural people, the main victims of snakebites, whose income is insufficient. Thus, only 4 % of patients received antivenom treatment over the past five years. The price of antivenom was reduced in 2015 to US$ 3.4 by a public drug wholesaler.ConclusionThe study confirmed the high burden of snakebites in Burkina Faso. To better manage envenomation, Burkina Faso implemented a strategy consisting in seeking affordable sources of antivenom supply of good quality and innovative mechanisms of subsidy.
Highlights
Snakebite is a common neglected public health issue, especially in poor rural areas of sub-Saharan Africa, Asia and Latin America
We evaluated the availability of antivenom during this period in order to propose some improvements in its accessibility
General population data were provided by the National Institute of Statistics and Demography (INSD), the central organ for official statistics production in Burkina Faso
Summary
Snakebite is a common neglected public health issue, especially in poor rural areas of sub-Saharan Africa, Asia and Latin America. Snakebite envenomation is considered a important and frequent public health hazard in several countries, it remains largely neglected It affects mainly rural areas of tropical and subtropical countries, sub-Saharan Africa where the management is inefficient. A recent meta-analysis of the literature estimated the average annual snakebite incidence and mortality in Burkina Faso, respectively, at 7,341 ± 1,260 envenomations and 343 ± 73 deaths [4] Those figures, useful for a Gampini et al Journal of Venomous Animals and Toxins including Tropical Diseases (2016) 22:10 basic approach to the implementation of snakebite management in health services, are imprecise and subject to biases according to the representativeness of the studies used for the assessment
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