Snakebite Clinical Management and Outcomes in the Kingdom of Eswatini - An Analysis of Routine Reports from Public Health Facilities
Abstract:
Snakebite envenoming is a neglected tropical disease that contributes substantially to morbidity, mortality, and disability in sub-Saharan Africa. In Eswatini, snakebites remain a significant public health concern despite recent improvements in surveillance, clinical management, and community awareness. A descriptive correlational secondary data review was conducted using available records of 337 snakebite cases reported at 11 public health facilities in Eswatini between 2020 and 2021. Data was extracted from the Ministry of Health Neglected Tropical Diseases Programme, cleaned, and analyzed using STATA 14/MP. Descriptive statistics summarized patient characteristics, management practices, and treatment outcomes, while logistic regression analyses identified factors associated with antivenom administration, admission, and length of hospitalization. Of the 337 cases, 54% were male and the highest incidence occurred among individuals aged 10–20 years (29%). Most bites occurred while walking on pathways (40.9%) or within household compounds (31.0%), with 66.6% affecting the lower limbs. Cytotoxic envenoming accounted for 59% of cases, while 35% of patients were asymptomatic at presentation. First aid was administered in 71.1% of cases, predominantly through tourniquet use (61.7%). Only 18.5% of patients received antivenom, despite 32.9% presenting clinical syndromes warranting its use. Most patients recovered fully (92.3%), while mortality was 1% (3 patients). Clinically significant envenoming were strongly associated with antivenom administration, hospital admission, and prolonged hospitalization (p < 0.001). Snakebite remains an important public health challenge in Eswatini. Strengthening antivenom availability, healthcare worker capacity, community first-aid education, and surveillance systems is essential to reduce snakebite-related morbidity and mortality and support attainment of the WHO 2030 targets.References:
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