02927nas a2200337   4500000000100000008004100001260003700042653002400079653005700103100001400160700001400174700001300188700001700201700001200218700001200230700001800242700001600260700001600276700001400292700001600306700001300322700001600335700001600351700001300367245012700380856009900507300001300606490000700619520194900626022001402575       2022                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health1 aAglanu LM1 aAmuasi JH1 aSchut BA1 aSteinhorst J1 aBeyuo A1 aDari CD1 aAgbogbatey MK1 aBlankson ES1 aPunguyire D1 aLalloo DG1 aBlessmann J1 aAbass KM1 aHarrison RA1 aStienstra Y1 aHabib AG00aWhat the snake leaves in its wake: Functional limitations and disabilities among snakebite victims in Ghanaian communities  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0010322&type=printable  ae00103220 v163 a<p>Background The estimated five million snakebites per year are an important health problem that mainly affect rural poor populations. The global goal is to halve both mortality and morbidity from this neglected tropical disease by 2030. Data on snakebite morbidity are sparse and mainly obtained from hospital records.</p>

<p>Methods This community-based study was conducted among 379 rural residents with or without a history of snakebite in the Ashanti and Upper West regions of Ghana. All participants in the snakebite group were bitten at least six months before the day of survey. The World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Buruli Ulcer Functional Limitation Score were used to obtain patient-reported measure of functioning and disability. Long-term consequences were evaluated based on the severity of the symptoms at the time of the snakebite.</p>

<p>Findings The median (IQR) time since the snakebite was 8.0 (3.5–16.5) years. The relative risk of disability was 1.54 (95% CI, 1.17–2.03) in the snakebite group compared to the community controls. Among patients with clinical symptoms suggesting envenoming at the time of bite, 35% had mild/moderate disabilities compared to 20% in the control group. The disability domains mainly affected by snakebite envenoming were cognition level, mobility, life activities and participation in society. A combination of the severity of symptoms at the time of the bite, age, gender and region of residence most accurately predicted the odds of having functional limitations and disabilities.</p>

<p>Conclusion The burden of snakebite in the community includes long-term disabilities of mild to moderate severity, which need to be considered when designing appropriate public health interventions. Estimating the total burden of snakebite is complicated by geographic differences in types of snakes and their clinical manifestations.</p>
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