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Annals of African Surgery

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Venomous Snake Bite Injuries at Kitui District Hospital

D Kihiko

Abstract


Background
Snake bites are a neglected public health issue in poor rural communities, and the true burden of snake bites is not known. Kitui County has a high incidence of snake bites and no functional snake bite control programs
exists. Diagnostic tests for snake species identification are not available and management mainly relies on clinical findings and administration of polyvalent antivenin. This study sought to describe common presentation patterns and treatments offered for snake bites at Kitui District Hospital, and to characterize the causative venomous snakes.
Patients and methods
This was a prospective case series carried out over a period of 8 months. Patients presenting at the hospital with snake bites were included in the study. A pre set questionnaire in was administered by doctors in the
surgical team

Results
A total of 70 patients were recruited. The M:F ratio was 1:1.4, and an age range 4-60y (median 8y). 51.4% were school going children who lived in houses mostly made of earthen bricks and thatch (n=38, 54.3%).
The relationship between local names and physical description of the snakes, and scientific identification from the description and clinical presentation was significant(p=0.05). Most patients achieved complete
recovery (n=62, 88.6%) No death was recorded.
Conclusion
Snake bites are common in Kitui County. In spite of the high rates of compartment syndrome and focal gangrene, all the patients were managed locally with excellent outcomes.
Recommendation
Care-givers need better training and sensitization. Formulation of regionalized guidelines fed by evidencebased data is needed. Improved infrastructure including a regional centre of excellence, and education will be the best preventive strategy.




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