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SNAKEBITE IN
TZ
The situation on the ground
A DEARTH OF
INFORMATION
IS THE NORM
 WHICH SPECIES?
 WHEN DID BITE TAKE PLACE?
 UNDER WHAT CIRCUMSTANCES?
MOST PEOPLE LACK
KNOWLEDGE OF
SNAKES
 THE BELIEF IS THAT ONLY GOOD
  SNAKE IS A DEAD SNAKE

 AND ALL SPECIES OF SNAKES ARE
  VENOMOUS AND DANGEROUS
FIRST EXAMPLE

 TANZANIAN STUDENT DIED IN
  UDZUNGWA NATIONAL PARK AFTER
  BEING BITTEN BY A SNAKE NEAR A
  WATERFALL NOT FAR FROM PARK
  HQ
2 ND EXAMPLE

  BRITISH SAFARI/TOUR OPERATOR
   BITTEN IN HIS SITTING ROOM AFTER
   TRYING TO GRAB A SNAKE HE KNEW
   TO BE “HARMLESS” CRAWLING
   ACROSS THE FLOOR
3 RD EXAMPLE

  FEMALE TANZANIAN ACADEMIC
   STAFF MEMBER OF UDSM BITTEN IN
   HER HOUSE WHEN SHE GOT UP AT
   NIGHT TO USE THE TOILET
QUESTIONS

 EXAMPLE 1: WHAT SPECIES OF
  SNAKE CAUSED THE DEATH? WHY
  DID THE SNAKE BITE?
 NO DATA, PROBABLY A COBRA
  (SPITTER OR FOREST COBRA) OR
  MAMBA (EITHER BLACK OR GREEN IS
  POSSIBLE)
QUESTIONS 2 ND
EXAMPLE
 WHY DID PERSON PICK UP THE
  SNAKE? Thought he knew snakes,
  thought it was harmless
 Species: Atractaspis sp. Burrowing Viper,
  one of the few sp. of snakes that cannot
  be handled safely
QUESTIONS, 2 ND CASE
CONTD
 When he described the situation, he
  noted he (and friend who were
  subsequently bitten trying to show that
  HE knew how to handle snakes!) had
  had “a few” (the number was not stated)
  beers….
3 RD EXAMPLE

  THE BODY OF THE SNAKE WAS
   SAVED AND LATER IDENTIFIED AS A.
   BIBRONII. (This species is well known
   for getting under doors and into crevices
   of blockwork.)
WHAT CAN WE LEARN?

 INFORMATION ON BITES IS UNDER
  REPORTED AND MAY BE
  INACCURATELY REPORTED
 MANY PEOPLE MAY NOT KNOW THE
  CORRECT FIRST AID
 MANY HOSPITALS AND CLINICS MAY
  INAPPROPRIATELY USE ANTIVENIN
  (CASE 3)
ECOLOGY MATTERS
SNAKES ARE NOT
EQUALLY
DISTRIBUTED
 FEW PEOPLE IN TZ KNOW THE
  VENOMOUS SNAKES OF THEIR AREA
 DRY AREAS FAVOUR COBRAS,
  MAMBAS
 MOIST FOREST AREAS FAVOUR
  DIFFERENT SPECIES
 SOME SPECIES SUCH AS SPITTING
  COBRAS AND PUFF ADDERS ARE
  WIDE SPREAD
NURSE-LED CLINIC-
MESERANI SNAKE PARK
ARUSHA
 BETWEEN APRIL 2007 AND 2009, 85 patients: 32
  (37%) of the each unable to identify the snake that had
  bitten them. The puff adder (Bitis arietans) caused
  more bites (24) than any other snake.

 The 85 snakebite cases had a mean age of 23 years
  and a male:female ratio of 1.4. Most of the bites
  occurred in the evening or at night and most also
  occurred during the rainy season. In some cases, the
  seeking of treatment from traditional healers delayed
  treatment at the clinic. After being bitten, the snakebite
  cases travelled a mean of 82 km (range=2–550 km) to
  reach the clinic
MESERANI
CONTINUING
 Forty-two of the snakebite cases received
  antivenom. Only one patient (1%), a 12-year-
  old girl, was believed to have died as the result
  of a snakebite another six (7%) each required a
  skin graft or the amputation of a limb or digit.
MESERANI
CONTINUING
 Establishment of the Snake Park clinic
  appears to have improved access to
  snakebite treatment, with cases of
  snakebite travelling long distances to
  reach the clinic (because of the lack of
  any other source of antivenom in
  Tanzania).
WHAT IS NEEDED?

 MORE INFORMATION!
  STANDARDISED RECORDING OF
  DATA FOR BITES

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Snakebite in Tanzania - 2012

  • 2. A DEARTH OF INFORMATION IS THE NORM  WHICH SPECIES?  WHEN DID BITE TAKE PLACE?  UNDER WHAT CIRCUMSTANCES?
  • 3. MOST PEOPLE LACK KNOWLEDGE OF SNAKES  THE BELIEF IS THAT ONLY GOOD SNAKE IS A DEAD SNAKE  AND ALL SPECIES OF SNAKES ARE VENOMOUS AND DANGEROUS
  • 4. FIRST EXAMPLE  TANZANIAN STUDENT DIED IN UDZUNGWA NATIONAL PARK AFTER BEING BITTEN BY A SNAKE NEAR A WATERFALL NOT FAR FROM PARK HQ
  • 5. 2 ND EXAMPLE  BRITISH SAFARI/TOUR OPERATOR BITTEN IN HIS SITTING ROOM AFTER TRYING TO GRAB A SNAKE HE KNEW TO BE “HARMLESS” CRAWLING ACROSS THE FLOOR
  • 6. 3 RD EXAMPLE  FEMALE TANZANIAN ACADEMIC STAFF MEMBER OF UDSM BITTEN IN HER HOUSE WHEN SHE GOT UP AT NIGHT TO USE THE TOILET
  • 7. QUESTIONS  EXAMPLE 1: WHAT SPECIES OF SNAKE CAUSED THE DEATH? WHY DID THE SNAKE BITE?  NO DATA, PROBABLY A COBRA (SPITTER OR FOREST COBRA) OR MAMBA (EITHER BLACK OR GREEN IS POSSIBLE)
  • 8. QUESTIONS 2 ND EXAMPLE  WHY DID PERSON PICK UP THE SNAKE? Thought he knew snakes, thought it was harmless  Species: Atractaspis sp. Burrowing Viper, one of the few sp. of snakes that cannot be handled safely
  • 9. QUESTIONS, 2 ND CASE CONTD  When he described the situation, he noted he (and friend who were subsequently bitten trying to show that HE knew how to handle snakes!) had had “a few” (the number was not stated) beers….
  • 10. 3 RD EXAMPLE  THE BODY OF THE SNAKE WAS SAVED AND LATER IDENTIFIED AS A. BIBRONII. (This species is well known for getting under doors and into crevices of blockwork.)
  • 11. WHAT CAN WE LEARN?  INFORMATION ON BITES IS UNDER REPORTED AND MAY BE INACCURATELY REPORTED  MANY PEOPLE MAY NOT KNOW THE CORRECT FIRST AID  MANY HOSPITALS AND CLINICS MAY INAPPROPRIATELY USE ANTIVENIN (CASE 3)
  • 13. SNAKES ARE NOT EQUALLY DISTRIBUTED  FEW PEOPLE IN TZ KNOW THE VENOMOUS SNAKES OF THEIR AREA  DRY AREAS FAVOUR COBRAS, MAMBAS  MOIST FOREST AREAS FAVOUR DIFFERENT SPECIES  SOME SPECIES SUCH AS SPITTING COBRAS AND PUFF ADDERS ARE WIDE SPREAD
  • 14. NURSE-LED CLINIC- MESERANI SNAKE PARK ARUSHA  BETWEEN APRIL 2007 AND 2009, 85 patients: 32 (37%) of the each unable to identify the snake that had bitten them. The puff adder (Bitis arietans) caused more bites (24) than any other snake.  The 85 snakebite cases had a mean age of 23 years and a male:female ratio of 1.4. Most of the bites occurred in the evening or at night and most also occurred during the rainy season. In some cases, the seeking of treatment from traditional healers delayed treatment at the clinic. After being bitten, the snakebite cases travelled a mean of 82 km (range=2–550 km) to reach the clinic
  • 15. MESERANI CONTINUING  Forty-two of the snakebite cases received antivenom. Only one patient (1%), a 12-year- old girl, was believed to have died as the result of a snakebite another six (7%) each required a skin graft or the amputation of a limb or digit.
  • 16. MESERANI CONTINUING  Establishment of the Snake Park clinic appears to have improved access to snakebite treatment, with cases of snakebite travelling long distances to reach the clinic (because of the lack of any other source of antivenom in Tanzania).
  • 17. WHAT IS NEEDED?  MORE INFORMATION! STANDARDISED RECORDING OF DATA FOR BITES