02815nas a2200301   4500000000100000008004100001260001200042653002300054653002800077653001500105653003000120653002300150653002500173653002100198100001200219700001200231700001600243700001300259700001300272700001200285700001400297245010000311856008700411300000900498490000600507520198600513022001402499       2019                            d  c01/201910acosts of snakebite10amanagement of snakebite10aSnakebites10aUniversal health coverage10aSub-Saharan Africa10aSnakebite envenoming10aSnakebite burden1 aOkumu M1 aPatel M1 aBhogayata F1 aOchola F1 aOlweny I1 aOnono J1 aGikunju J00aManagement and cost of snakebite injuries at a teaching and referral hospital in Western Kenya.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892383/pdf/f1000research-8-22270.pdf  a15880 v83 a<p> Data on the cost of snakebite injuries may inform key pillars of universal health coverage including proper planning, allocation, and utility of resources. This study evaluated the injuries, management, and costs resulting from snakebites at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kenya.   In total, medical records of 127 snakebite victims attending JOOTRH between January 2011 and December 2016 were purposely selected and data on the age, gender, type of residence (urban or rural), part of the body bitten, time of bite, injuries, pre-hospital first aid, time to hospital, length of stay, treatment, and costs were collected. Regression analysis was used to predict the total indirect cost of snakebite injuries and  was considered significant. Mortality and loss of income of hospitalized victims were considered as direct costs.  It was found that 43 victims were 13-24 years of age, 64 were female, 94 were from rural areas, 92 were bitten on the lower limbs, 49 were bitten between 6.00 pm and midnight, 43 attempted pre-hospital first aid, and the median time to hospital was 4.5 hours. Antivenom, supportive therapy, antibiotics, antihistamines, corticosteroids, analgesics, and non-steroidal anti-inflammatory drugs were used. Cellulitis, compartment syndrome, gangrenous foot, psychiatric disorder, and death were the main complications. Most victims spent 1-5 days in hospital and the median cost of treating a snakebite was 2652 KES (~$26). Drugs, ward charges, and nursing procedures were the highest contributors to the total indirect cost. Victims hospitalized for 6-10 days and >10 days incurred 32% and 62% more costs, respectively, compared to those hospitalized for 1-5 days.   The longer snakebite victims are hospitalized, the higher the cost incurred. Continuous medical education on the correct management of snakebites should be encouraged to minimize complications that may increase hospital stays and costs incurred.</p>  a2046-1402