Diagnostic and therapeutic approaches to management of snake-bites at a public health facility in Kenya

Abstract

Snakebites are a neglected medical problem worldwide; nevertheless they cause considerable suffering to people especially in less privileged areas resulting in significant morbidity and mortality with a considerable number of victims becoming maimed for life. Guidelines for the management of snakebites are not widely available and this gives health care givers little confidence in their diagnosis and management. The purpose of this study was to determine the diagnostic and therapeutic approach used in the management of snakebites in a peripheral health facility in Kenya. The study was descriptive, retrospective and cross sectional in design. It was carried out by collecting data from patient files at the records department in Ishiara Sub District Hospital. For all cases of snakebites from January 2003 to June 2009, the data were collected using a tool and comparative analysis done. The study showed that the syndromic approach can be used to determine signs of envenomation and guide in determining sequelae. There were no criteria for the use of Anti Snake Venom and other medications, both envenomed and non envenomed patients were managed in the same way; This led to irrational use of drugs. Adverse reactions to Anti Snake Venom occurred in 3.8% of the population and only envenomed patients developed the reaction. Where Anti Snake Venom was available, it was dosed inappropriately and where it was not available, there was significant morbidity and mortality.