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
