Snakebite epidemiology, outcomes and multi-cluster risk modelling in Eswatini

Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment. In line with the World Health Organisation's 2019 Snakebite Strategy, this study sought to investigate Eswatini's snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk. Programmatic data from the Ministry of Health, Government of Eswatini 2019-2021, was used to assess the epidemiology and outcomes of snakebite in Eswatini. We developed a snake species richness map from the occurrence data of all venomous snakes of medical importance in Eswatini that was subjected to niche modelling. We formulated four risk indices using snake species richness, various geospatial datasets and reported snakebites. A multivariate cluster modelling approach using these indices was developed to estimate risk of snakebite and the outcomes of snakebite in Eswatini. An average of 466 snakebites was recorded annually in Eswatini. Bites were recorded across the entire country and peaked in the evening during summer months. Two cluster risk maps indicated areas of the country with a high probability of snakebite and a high probability of poor snakebite outcomes. The areas with the highest rate of snakebite risk were primarily in the rural and agricultural regions of the country. These models can be used to inform better snakebite prevention and treatment measures to enable Eswatini to meet the global goal of reducing snakebite morbidity and mortality by 50% by 2030. The supply chain challenges of antivenom affecting southern Africa and the high rates of snakebite identified in our study highlight the need for improved snakebite prevention and treatment tools that can be employed by health care workers stationed at rural, community clinics. [Abstract copyright: Copyright: © 2023 Padidar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Snakebite epidemiology, outcomes and multicluster risk modelling in Eswatini

DATA AVAILABILITY STATEMENT : The data that supports the findings of this study are held at Harvard Dataverse https://DOI.org/10.7910/DVN/DQ7MDB.SUPPORTING INFORMATION : FIGURE S1. Average temperature and rainfall for each region of Eswatini during October 2019 to September 2019 (data from Eswatini Meteorological Service). Made with Natural Earth. Free vector and raster map data @naturalearthdata.com. FIGURE S2. Time patients bitten by snakebite, between October 2019 to September 2021, in Eswatini. FIGURE S3. Types of adverse reactions to polyvalent snake antivenom recorded from 70 patients. FIGURE S4. Venomous snake species richness in Eswatini. Made with shape files from the Eswatini Central Statistics Office (with permission). TABLE S1. Datasets used in the snakebite risk analysis. TABLE S2. First aid snakebite management implemented by patients.BACKGROUND Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment. In line with the World Health Organisation’s 2019 Snakebite Strategy, this study sought to investigate Eswatini’s snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk. METHODOLOGY Programmatic data from the Ministry of Health, Government of Eswatini 2019–2021, was used to assess the epidemiology and outcomes of snakebite in Eswatini. We developed a snake species richness map from the occurrence data of all venomous snakes of medical importance in Eswatini that was subjected to niche modelling. We formulated four risk indices using snake species richness, various geospatial datasets and reported snakebites. A multivariate cluster modelling approach using these indices was developed to estimate risk of snakebite and the outcomes of snakebite in Eswatini. PRINCIPAL FINDINGS An average of 466 snakebites was recorded annually in Eswatini. Bites were recorded across the entire country and peaked in the evening during summer months. Two cluster risk maps indicated areas of the country with a high probability of snakebite and a high probability of poor snakebite outcomes. The areas with the highest rate of snakebite risk were primarily in the rural and agricultural regions of the country. SIGNIFICANCE These models can be used to inform better snakebite prevention and treatment measures to enable Eswatini to meet the global goal of reducing snakebite morbidity and mortality by 50% by 2030. The supply chain challenges of antivenom affecting southern Africa and the high rates of snakebite identified in our study highlight the need for improved snakebite prevention and treatment tools that can be employed by health care workers stationed at rural, community clinics.The Wellcome Trust.https://journals.plos.org/plosntds/am2024Mammal Research InstituteZoology and EntomologySDG-03:Good heatlh and well-bein

Dataset for the article: Snakebite epidemiology, outcomes and multi-cluster risk modelling in Eswatini

Eswatini snakebite data 2019-202

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