Age distribution of all snakebite victims.

BackgroundSnakebite is a neglected disease that disproportionally affects the rural poor. There is a dearth of evidence regarding incidence and risk factors in snakebite-endemic countries. Without this basic data, it will be impossible to achieve the target of a 50% reduction of snakebite morbidity and mortality by 2030 as set by the World Health Organization.MethodsThis was a descriptive analysis nested in a 2021 community-based demographic survey of over 70,000 individuals conducted in Mopeia, Mozambique, in preparation for a cluster randomized trial to test an intervention for malaria. We describe the incidence rate, demographics, socioeconomic indicators and outcomes of snakebite in this population.FindingsWe found the incidence of self-reported snakebite in Mopeia to be 393 bites per 100,000 person-years at risk, with 2% of households affected in the preceding 12 months. Whilst no fatalities were recorded, over 3,000 days of work or school days were lost with an individual household economic impact higher than that of uncomplicated malaria. 1 in 6 of those affected did not fully recover at the time of the study. We found significant relationships between age older than 15, use of firewood for household fuel, and animal possession with snakebite.ConclusionsThis study exposes higher than expected incidence and burden of snakebite in rural Mozambique. Whilst snakebite elimination in Mozambique seems unattainable today, it remains a preventable disease with manageable sequelae. We have shown that snakebite research is particularly easy to nest in larger studies, making this a practical and cost-effective way of estimating its incidence.</div

Heatmap of snakebite occurrence in Mopeia.

Contains information from OpenStreetMap and OpenStreetMap Foundation, which is made available under the open database license. URL https://www.openstreetmap.org/.</p

Self-reported recovery after snakebite by age group.

Self-reported recovery after snakebite by age group.</p

Snakebite frequency by month of the year.

In Mopeia, in 2022, rains reached a peak in March with 500 mm; May was abnormally wet with precipitations of 150 mm, there were no more than 30 mm of rain per month until December.</p

The nine questions about snakebite embedded in the larger demography questionnaire.

Beyond these, one question about livestock morbidity/mortality also allowed for the answer “killed by a snake” but there were zero answers with that option. “Loss of limb” was operationally defined as amputation (medical or necrosis) or loss of function.</p

Medically significant snake species likely to be found in Mopeia [13–15].

Medically significant snake species likely to be found in Mopeia [13–15].</p

Household risk factors for snakebite.

BackgroundSnakebite is a neglected disease that disproportionally affects the rural poor. There is a dearth of evidence regarding incidence and risk factors in snakebite-endemic countries. Without this basic data, it will be impossible to achieve the target of a 50% reduction of snakebite morbidity and mortality by 2030 as set by the World Health Organization.MethodsThis was a descriptive analysis nested in a 2021 community-based demographic survey of over 70,000 individuals conducted in Mopeia, Mozambique, in preparation for a cluster randomized trial to test an intervention for malaria. We describe the incidence rate, demographics, socioeconomic indicators and outcomes of snakebite in this population.FindingsWe found the incidence of self-reported snakebite in Mopeia to be 393 bites per 100,000 person-years at risk, with 2% of households affected in the preceding 12 months. Whilst no fatalities were recorded, over 3,000 days of work or school days were lost with an individual household economic impact higher than that of uncomplicated malaria. 1 in 6 of those affected did not fully recover at the time of the study. We found significant relationships between age older than 15, use of firewood for household fuel, and animal possession with snakebite.ConclusionsThis study exposes higher than expected incidence and burden of snakebite in rural Mozambique. Whilst snakebite elimination in Mozambique seems unattainable today, it remains a preventable disease with manageable sequelae. We have shown that snakebite research is particularly easy to nest in larger studies, making this a practical and cost-effective way of estimating its incidence.</div

Basic socio-economic data from Mopeia at household and individual levels.

Basic socio-economic data from Mopeia at household and individual levels.</p

Descriptive of consequences of snakebite, location and seasonality.

Descriptive of consequences of snakebite, location and seasonality.</p

Map of Mopeia showing location of households of those bitten by a snake (circles), further divided by month of bite (see key).

Black lines are roads, blue lines are rivers, red cross are health facilities. Contains information from OpenStreetMap and OpenStreetMap Foundation, which is made available under the open database license. URL https://www.openstreetmap.org/.</p