Snakebite frequencies and envenomation case management in primary health centers of the Bobo-Dioulasso health district (Burkina Faso) from 2014 to 2018

Abstract

Background: Snakebite envenomation is a significant public health problem in Burkina Faso. Our study describes the epidemiological and therapeutic aspects of snakebite cases at primary health centers in Houet Province, which is located in the western area of Burkina Faso.

Methods: We conducted a retrospective study of 664 snakebite cases occurring at 10 primary health centers in Houet Province from January 2014 to December 2018. Data were collected from the patient consultation recording database registry system.

Results: Affected individuals had a male/female ratio of 1.31. The lowest annual incidences (0.02 [95% CI -0.01 to 0.05] and 0.24 [95% CI 0.05 to 0.43]) were observed in the urban primary health centers of Bolomakoté and Sarfalao, respectively. Rural primary health centers in Nasso in 2016 and in Soumousso in 2014 had the highest annual incidence (13.80 [95% CI 7.59 to 20.00] and 3.92 [95% CI 2.99 to 4.86], respectively). Of the 664 registered snakebite victims, none received antivenom immunotherapy treatment.

Conclusion: Our study shows that snakebite envenomation incidents are common at the 10 primary health centers in Houet Province. Furthermore, despite the lack of antivenom and often inadequate treatment at these primary health centers, they remain the first point of care for snakebite victims.

Keywords: Hauts-Bassins; envenomation; epidemiology; frequencies; snakebites.

Figure 1.

Survey site location in the health district of Bobo-Dioulasso (Hauts-Bassins). The red crosses represent the exact locations of each study site. The black bars represent the boundaries of each health district.

Figure 2.

Pyramid of the ages of males and females of the population affected by snakebites. On the right is the frequency of snakebites for females by age group. On the left is the frequency of snakebites for males by age group.

Figure 3.

The evolution of the annual incidence by period and by primary health center. The x-axis represents the annual incidence by primary health center. The y-axis represents the change in incidence over time in years per 1000 persons. Bol, Bolomaké; Bou, Bouendé; Kir, Kiri; Leg, Leguema; Log, Logofourousso; Mat, Matourkou; Nas, Nasso; Sar, Sarfalao; Sou, Soumousso; Val, Vallée du Kou.

Figure 4.

The proportions of drugs administered to patients bitten by snakes during their treatment.

Figure 5.

Distribution of the snake species involved in the biting cases recorded. (A) Echis ocellatus in the Viperidae family (village in Nasso); (B) Echis ocellatus in the Viperidae family (village in Matourkou); (C) Atractaspis watsoni in the Lamprophiidae family (village in Nasso); and (D) Lycophidion semicinctum in the Colubridae family (village in Nasso).