Epidemiologic and spatiotemporal study on access to snakebite care in Northern Nigeria

IF 3.3 4区 医学 Q2 TOXICOLOGY Toxin Reviews Pub Date : 2023-02-11 DOI:10.1080/15569543.2023.2177873
Naziru Halliru, M. M. Badamasi, I. Y. Tudunwada, Titus B Dajel, S. Abubakar, Auwalu S. Hamza, Sandra B. Oluwashola, Nasiru K. Nalado, M. Dahiru, Ibrahim Na’abdu, Umar N. Saleh, A. M. Daiyab, S. Mohammed, G. Iliyasu, H. Muhammad, A. Habib
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Abstract

Abstract The role of epidemiologic and spatiotemporal factors affecting access to care among snakebite patients in Nigeria are determined. In 2021 a total of 2,942 snakebite patients were prospectively studied at four designated Health Facilities for Managing Snakebites (HFMS). The patients came from 94 Local Government Areas (LGAs) in 12 states in northern Nigeria. It was found that 435 (14.8%) patients actually accessed care within ≤2 hours of bite although 38.0% could have reached the HFMS within the time by car. In certain areas 92% of patients would have been able to reach a secondary or tertiary facility within ≤2 hours. Similarly, 437 (14.9%) patients traveled distances of ≤20 Km to reach a designated HFMS although 86% of patients resided within 5 Km of a road network. There was longer median delay to access care (15 hours), more patients (365) and higher proportion not treated with antivenom (22%) in August the wettest month of the year. Furthermore the patients who died (47) took a median time of 48 hours compared to 11 hours among known survivors (2,649) to access care. Expanding antivenom access to other secondary and tertiary HF in high burden areas especially during peak seasons will potentially improve the outcome among patients.
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尼日利亚北部获得蛇咬伤护理的流行病学和时空研究
摘要确定了影响尼日利亚蛇咬伤患者获得护理的流行病学和时空因素的作用。2021年,在四个指定的蛇咬伤管理卫生机构(HFMS)对2942名蛇咬伤患者进行了前瞻性研究。患者来自尼日利亚北部12个州的94个地方政府区。研究发现,435名(14.8%)患者在≤2 尽管38.0%的人可能在乘车时间内达到HFMS。在某些地区,92%的患者能够在≤2内到达二级或三级机构 小时。同样,437名(14.9%)患者的旅行距离≤20 Km达到指定的HFMS,尽管86%的患者居住在5 公路网的公里数。获得护理的中位延迟时间更长(15 小时),在一年中最潮湿的八月,更多的患者(365人)和更高比例的未接受抗蛇毒血清治疗(22%)。此外,死亡患者(47人)的中位时间为48 小时,相比之下为11 已知幸存者(2649人)获得护理的时间。在高负荷地区,特别是在高峰季节,扩大抗蛇毒血清对其他二级和三级HF的使用范围,可能会改善患者的预后。
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来源期刊
Toxin Reviews
Toxin Reviews 医学-毒理学
CiteScore
6.80
自引率
0.00%
发文量
36
审稿时长
>12 weeks
期刊介绍: Toxin Reviews provides an international forum for publishing state-of-the-art reviews and guest-edited single topic special issues covering the multidisciplinary research in the area of toxins derived from animals, plants and microorganisms. Our aim is to publish reviews that are of broad interest and importance to the toxinology as well as other life science communities. Toxin Reviews aims to encourage scientists to highlight the contribution of toxins as research tools in deciphering molecular and cellular mechanisms, and as prototypes of therapeutic agents. Reviews should emphasize the role of toxins in enhancing our fundamental understanding of life sciences, protein chemistry, structural biology, pharmacology, clinical toxinology and evolution. Prominence will be given to reviews that propose new ideas or approaches and further the knowledge of toxinology.
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