Factors That Influence Clinical Outcomes of Snake Bites With Special Reference to Supply of Anti-snake Venom and Related Drugs at Kilifi County Referal Hospital in Coastal Kenya

Abstract

Background: Envenomation with snake venom is one of the life threatening hazards affecting people residing in the tropics. World Health Organization (WHO) recognized snake envenomation as one of the important Neglected Tropical Disease (NTD) conditions in the year 2017. Objective: The main objective of the study was to determine the distribution, types, seasonality and management of snake bites at Kilifi County Referral Hospital in coastal Kenya. Methods: This retrospective study was conducted at the Hospital pharmacy and the health records office of Kilifi County Hospital by extracting data from patient files and pharmacy records. The demographic and clinical data was obtained from the files using a standardized data collection tool. Descriptive statistics were used to determine prevalence, frequencies, means and standard deviation. Multivariate logistic regression was conducted to assess the relationship between the ASV use and selected predictor variables. Results: The study established that snake bites are more prevalent in June and December of every year. Out of a total of 255 cases of snake bite cases identified, there was no mortality despite the fact that only 19% had been treated with anti-snake venom (ASV), no victim received adrenaline as part of treatment while 67% received hydrocortisone injection. Only one patient was scheduled for amputation of which he declined to give consent. The average admission period was 2 days. The only available anti-snake venom was the polyvalent type. Non-steroidal anti-inflammatory drugs were widely used to treat pain related with snake bites (63.1%), despite the risk of hemorrhage. There was no stock out of ASV, hydrocortisone and adrenaline injections in the pharmacy. Conclusion: The prevalence of snake bites was varying throughout the study period, with the peak being around June and December of each year. All the required drugs and anti-snake venom were available in the pharmacy. There was no snake-bite related mortality during the study period. More concerted public health effort should be put in place to prevent, identify and manage snake bites during the peak period of June to December every year.