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A long-term observational study of paediatric snakebite in Kilifi County, south-east Kenya

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Abouyannis, Michael ORCID: https://orcid.org/0000-0003-4856-4334, Boga, Mwanamvua, Amadi, David, Ouma, Nelson, Nyaguara, Amek, Mturi, Neema, Berkley, James A., Adetifa, Ifedayo M., Casewell, Nicholas ORCID: https://orcid.org/0000-0002-8035-4719, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200 and Hamaluba, Mainga (2023) 'A long-term observational study of paediatric snakebite in Kilifi County, south-east Kenya'. PLoS Neglected Tropical Diseases, Vol 17, Issue 7, e0010987.

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Official URL: https://doi.org/10.1371/journal.pntd.0010987

Abstract

Introduction
Estimates suggest that one-third of snakebite cases in sub-Saharan Africa affect children. Despite children being at a greater risk of disability and death, there are limited published data. This study has determined the: population-incidence and mortality rate of hospital-attended paediatric snakebite; clinical syndromes of snakebite envenoming; and predictors of severe local tissue damage.

Methods
All children presenting to Kilifi County Hospital, Kenya with snakebite were identified through the Kilifi Health and Demographic Surveillance System (KHDSS). Cases were prospectively registered, admitted for at least 24-hours, and managed on a paediatric high dependency unit (HDU). Households within the KHDSS study area have been included in 4-monthly surveillance and verbal autopsy, enabling calculation of population-incidence and mortality. Predictors of severe local tissue damage were identified using a multivariate logistic regression analysis.

Results
Between 2003 and 2021, there were 19,606 admissions to the paediatric HDU, of which 584 were due to snakebite. Amongst young children (≤5-years age) the population-incidence of hospital-attended snakebite was 11.3/100,000 person-years; for children aged 6–12 years this was 29.1/100,000 person-years. Incidence remained consistent over the study period despite the population size increasing (98,967 person-years in 2006; and 153,453 person-years in 2021). Most cases had local envenoming alone, but there were five snakebite associated deaths. Low haemoglobin; raised white blood cell count; low serum sodium; high systolic blood pressure; and an upper limb bite-site were independently associated with the development of severe local tissue damage.

Conclusion
There is a substantial burden of disease due to paediatric snakebite, and the annual number of cases has increased in-line with population growth. The mortality rate was low, which may reflect the species causing snakebite in this region. The identification of independent predictors of severe local tissue damage can help to inform future research to better understand the pathophysiology of this important complication.

Item Type:

Article

Subjects:

WS Pediatrics > WS 20 Research (General)

Repository link:

Item title	Item URI
Dataset for the article: A long-term observational study of paediatric snakebite in Kilifi County, south-east Kenya	https://archive.lstmed.ac.uk/id/eprint/22999

Faculty: Department:

Biological Sciences > Department of Tropical Disease Biology

Digital Object Identifer (DOI):

https://doi.org/10.1371/journal.pntd.0010987

SWORD Depositor:

JISC Pubrouter

Depositing User:

JISC Pubrouter

Date Deposited:

27 Jul 2023 08:10

Last Modified:

21 Aug 2023 14:49