The role of social media in public health awareness during times of war in Sudan: snakebites and scorpion stings

Abstract

Background: Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments.

Methods: We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, "Scorpions and Snakes of Sudan", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy.

Results: The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member's queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy.

Conclusion: In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.

Keywords: Citizen science; Data; Envenomation; Facebook; Identification kits; Scorpions; Snakes; Social media; Species conservation through positive cultural change; Sudan; e-Awareness; eHealth.

Fig. 1

Distribution of participants’ age and sex. a) Age group distribution among female participants, b) age group distribution among male participants

Fig. 2

Geographical distribution of participants from each state from the 18 states of Sudan. Abbreviations BNS= Blue Nile state, WDS= West Darfur state, NDS= North Darfur state, CDS= Central Darfur state, SDS= South Darfur state, EDS= East Darfur state, WKS= West Kordofan state, SKS= South Kordofan state, NKS= North Kordofan state, ALQ = Gedarif state, ALJ= Gezira state, KAS= Kassala state, KRT= Khartoum state, NOR= Northern state, RSS = Red Sea state, RNS = River Nile state, SEN= Sennar state, WNS= White Nile state

Fig. 3

Geographical distribution of received enquiries from 9 countries: ordered from the country with the highest to the lowest enquiries: Sudan, Saudi Arabia, Oman, Yemen, Egypt, Libya, Uganda, South Sudan, and Kenya. A single inquiry was received from India as well

Fig. 4

Chronology of snake enquiries from Sudan: a) for all species, b) for elapids, c) for vipers, d) for burrowing asps, e) for sand racers, f) for colubrids, g) for python and boas and h) for blind and house snakes

Fig. 5

Chronology of scorpion’s enquiries from Sudan: a) all species, b) highly venomous scorpions, c) moderately venomous scorpions and d) mildly venomous scorpions

Fig. 6

Diversity of snakes in Sudan: a) 28 species of snakes enquired about with Myriophils spp. showing the highest number of enquiries followed by Atractaspisphillipsi, Echis pyramidum and Psammophis sudanensis, b) The number of enquiries about snakes received from each of the 18 Sudanese states

Fig. 7

Scorpion Diversity in Sudan: a) We received enquiries about 10 scorpion species, with the highest number of enquiries being about the highly venomous death stalker (Leiurus quinquestriatus), followed by the mildly venomous species Compsobuthus werneri, b) The number of enquiries about scorpions received from each of the 18 Sudanese states

Fig. 8

Example of scorpion species photographs submitted to the Facebook group for identification: a) Androctonus amoreuxi from Sudan, b) Parabuthus abbysinicus from Sudan, c) Leiurus quinquestriatus from Sudan, d) Compsobuthus werneri from Sudan, e) Hottentotta niloticus from Sudan, f) Hottentota trailini from Sudan, g) Heterometrus sp. from Oman, h) Opisthacanthus sp. from India, i) Apistobuthus pterygocercus from Oman, j) Buthacus sp. from Saudi Arabia, k) Androctonus crassicauda from Saudi Arabia and l) Parabuthus liosoma from Saudi Arabia

Fig. 9

Example of the snake species submitted to the Facebook group for identification: a) Naja nigricollis from Sudan, b) Cerastes cerastes from Sudan, c) Atractaspis phillipsi from Sudna, d) Psammophis mossambicus from Sudan, e) Echis carinatus from Saudi Arabia, e f) Naja haje from Sudan, g) Myriophils sp from Sudna, h) Naja arabica from Yemen, and i) Echis pyramidum from Sudan

Fig. 10

Rare species and first records from Sudan: a) observation of the rare Blue Nile cat snake (Telescopus gezirae) and b) first record of Montpellier Snake (Malpolon monspessulanus) juvenile from Sudan

Fig. 11

Example of other organisms submitted to the group for identification: a) juvenile Nile monitor lizard (Varanus niloticus), b) Basilisk chameleon (Chamaeleo africanus), c) and f) tiger centipede (Scolopendra sp.) d) soil centipede, e) male Malaba Rock Agama/Finch’s Agama (Agama finchi), g) Scolopendra sp., h) Cactoblastis cactorum larva, i-kEusparassus sp. l) Wolf spider (Family: Lycosidae)

Fig. 12

Examples of produced ID cards are color-coded from red to green, with red indicating highly venomous or medically important species, yellow for moderately venomous and green for nonvenomous species

Fig. 13

The detailed structure of an identification card, clockwise: each card is composed of the following sections: a) Scientific and local names, b) level of dangerousness, venom type and immediate first aid required, c) Photos representing the species, d) description, e) developed by TORC, f) geographical distribution, g) symptoms, and h) The centres’ logo

Fig. 14

Echis romani from west of Kadugli in South Kordofan state, Sudan

Fig. 15

Causus resimus from Sudan