Costly Snake Bites Call for More Attention

By Charity Jepkoech

Snake bite is a neglected public health issue in many tropical and subtropical countries. Most of these occur in Africa, Asia, and Latin America. In Asia, up to a million people are envenomed by snakes each year, while in Africa there are an estimated 435,000 to 580,000 snake bites that need treatment, according to the World Health Organization report of September 2024.

 Envenoming affects women, children, and farmers in poor rural communities in low- and middle-income countries. The highest burden occurs in countries where health systems are weakest and medical resources are sparse.

An estimated 5.4 million people worldwide are bitten by snakes each year, with 1.8 to 2.7 million cases of envenoming. Around 81,410 to 137,880 people die each year due to snake bites, and around three times as many amputations and other permanent disabilities are caused by snakebites annually.

In Kenya, about 20000 people are bitten by snakes annually. Out of this, an estimated 4000 people die from snake bites annually, with 7000 experiencing paralysis and other health complications.

The most affected counties include Kilifi, Kitui, Kajiado and Samburu, with Kilifi showing a high annual incidence with 150 cases per 100000 inhabitants, followed by Kitui with over 800 cases reported annually, and then followed by Kajiado and Samburu simultaneously, according to the Local Institute of Primate Research.

Other affected areas include Baringo, Wajir, Garissa, Marsabit, Isiolo and Taita Taveta. While there is no dedicated snakebite hotline in Kenya, one can contact the Kenya Wildlife Service toll-free number at 0800597000 for assistance with snakebite incidents

Bite by venomous snakes can cause paralysis that may prevent breathing, bleeding disorders that lead to fatal hemorrhage, irreversible kidney failure, and tissue damage that causes permanent disability and limb amputation. Agricultural workers and children are most affected. Children suffer more severe effects than adults due to their smaller body mass.

In contrast to many serious health conditions, a highly effective treatment exists. Most deaths and serious consequences of snakebites are entirely preventable by making safe and effective antivenom more widely available and accessible. High-quality snake antivenoms are the most effective treatment to prevent or reverse most of the venomous effects of snakebites

However, the whole process of manufacturing antivenom has been countered by various challenges, including the preparation of correct immunogens. At present, very few countries have

Capacity to produce immunogens of adequate quality for antivenom manufacture, and many manufacturers rely on common commercial sources. These may not properly reflect the geographical variation that occurs in venoms or are common widespread species. In addition, the lack of regulatory capacity in several antivenom countries with significant snake bite problems results in an inability to assess the quality and appropriateness of their antivenom.

A combination of factors has led to the present crisis. Poor data on the number of snakebites has led to difficulty in estimating needs, and the deficient distribution of policies has further contributed to manufacturers reducing or stopping production or increasing the prices of antivenom. Weak regulation and inappropriate or poor-quality antivenom have also resulted in a lack of confidence in some of the available antivenom by clinicians, health managers, and patients, which has further eroded demand.

To curb this problem, WHO has taken steps to raise awareness in health authorities and policymakers on this issue. In December 2015, a programme to evaluate the potential safety and effectiveness of current antivenom products intended for use in sub-Saharan Africa was launched by WHO. This process has subsequently been extended to WHO South-East Asia and to Eastern Mediterranean Regions.

The results of this detailed technical and laboratory assessment provide regulators and procurement agencies with informed guidance on which antivenoms best suit their needs.

Following a request by several UN member states, WHO formally listed snakebite envenoming as a highest-priority neglected tropical disease in June 2017.

In conclusion, snakebites are fatal incidences that claim the lives of most people, and proper measures should be put in place to deal with the incidences when they arise.