FACTORS ASSOCIATED WITH SNAKE BITE AND HEALTH SEEKING BEHAVIOR AMONG RESIDENTS OF KALTUNGO LGA, GOMBE STATE, NIGERIA


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TABLE OF CONTENTS

Title page
Table of content
List of acronyms
Summary

Chapter One – Introduction
1.1       Background
1.2       Problem Statement
1.3       Justification/Rationale
1.4       Research Questions
1.5       General and Specific Objectives
1.5.1    General Objective
1.5.2    Specific Objectives

Chapter Two – Literature Review
2.1       Historical background
2.2       Classification of snakes
2.3       Snake Venom
2.4       Treatment of Snakebite
2.4.1    Anti-Snake Venom
2.4.2    Other treatment modalities
2.5       Socio-demographic factors
2.6       Environmental factors
2.7       Treatment-seeking behavior
2.8       Prevention of snakebite

Chapter Three – Methodology
3.1       Background of Study Area
3.2       Study Design
3.3       Study Population
3.3.1 Inclusion Criteria
3.3.2 Exclusion Criteria
3.4       Sample Size Determination
3.5       Sampling Technique
3.6       Study Instruments
3.7       Data Collection Methods
3.8       Data Management
3.8.1 Measurement of Variables
3.8.2 Statistical Analysis
3.9       Ethical Considerations
3.10 Limitations

Chapter Four – Results
Result

Chapter Five – Discussion
Discussion

Chapter Six – Conclusion and Recommendations
6.1       Conclusion
6.2       Recommendations
References
Appendices



SUMMARY

Snakebite is a significant cause of morbidity and mortality, with an annual incidence of about 497 cases per 100,000 populations, in Nigeria. Studies revealed that only about 8.5% Nigerian snakebite victims sought treatment in hospitals. The aim is to identify the factors associated with snakebite and assess the health seeking behavior among residents of Kaltungo LGA.

This Cross sectional study used structured questionnaire to elicit relevant information from adult victims of snakebite, heads of households (or next most senior member) in households with history of snakebites involving someone below the age of 18 years, and in households without history of snakebite. A multi-stage sampling technique was used.

A total of 422 households were visited. Majority of the respondents had either secondary or post secondary education [169 (40.0%) and 162 (38.4%) respectively]. From those 422 households visited (containing 961 people), a total of 191 snakebites were reported (Prevalence of 19.9%). However, only 142 snakebite victims were traced and interviewed. Of the 142 snakebite victims interviewed, 78 (54.9%) were males. About 40.8% snakebites occurred on farms and farming was the commonly engaged activity, 50 (35.2%), at the times of bites. Those who processed palmyra palm were 310 (73.5%). Males were 1.6 times more at risk. People with educational level below secondary school were 1.8 times at risk of snakebite. Similarly, people who processed Palmyra palm fruits were about two times more likely to be bitten by snakes. Generally, 47.2% of respondents first patronized local medicine vendors when sick, while 29.6% ignored it until it became very severe. However, among the snakebite victims, 64.3% accessed health-care within 2 hours after the bite.

Snakebite is still a public health problem in Kaltungo LGA. Significant associated factors found were; Male sex, Not attaining educational level up to secondary school level, and Processing Palmyra palm fruits. About 60% of the snakebite victims sought treatment in Hospital.




CHAPTER ONE

INTRODUCTION

1.1        Background

Bites and stings are a common occurrence worldwide, and especially in the tropical and sub-tropical regions. While stings are associated more with pains, for instance, scorpion sting and sting by bees, bites on the other hand are especially more important when it is associated with either inoculation of highly virulent pathogens, as in the case of bites from rabid dogs or when there is injection of a lethal poisonous substances, as is the case with bite of poisonous snakes. Some snakebite may be associated with both severe pains as well as the systemic effects from the presence of poisonous venom in the circulation. However, victims of snakebites are perhaps often more concerned with the perception of sudden imminent death than with pain or other symptoms.1

Snakes are cold blooded reptiles belonging to the Phylum Chordata, sub-phylum Vertebrata. They are widely distributed in the world, although, certain species are more common in some regions than others. For example, while a place like Lithuania has the common adder (Vipera berus) as the only venomous specie of snake, Nigeria on the other hand, has 4 venomous species of snakes (Carpet viper, black-necked spitting cobra, puff adder and Actraspididae).2 In fact, Nigerian Echis was described as the world most dangerous snake.3 The incidence of snakebite appears to correlate (in addition to other factors) with the number of venomous snake species present in the given area, the anti-predatory behavior of the snake species found in the given area, population density of rural dwellers engaging in farming and other activities that increases contact with snakes (such as hunting), and the seasonal pattern of such activities.4 Thus, Nigeria has an estimated annual incidence of snakebites of 497 per 100,000 populations, with.....

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