Snakebite admissions in Zimbabwe: pattern, clinical presentation and management.

OBJECTIVE: To describe the toxicoepidemiology of snakebite admissions to eight major referral hospitals in Zimbabwe.

DESIGN: Retrospective and descriptive case review.

SETTING: Four central hospitals (i.e., Harare, Parirenyatwa, Mpilo and United Bulawayo Hospitals) and four provincial hospitals (i,e., Gwanda, Bindura, Gweru and Mutare hospitals).

MAIN OUTCOME MEASURES: Parameters assessed for included patient demographics e.g. age and gender, length of hospital stay, circumstances leading to snakebite, season and time of day of bite, culprit species, clinical presentation, management before and after admission, and outcome.

RESULTS: There were a total of 273 admissions due to snakebite. Over 60% of bites were to the feet and about 36% were to the arms and hands. The type of snake involved was recorded in 14.6% (40) the cases with puff adders (Bitis arietans) being the most commonly implicated species. First aid and other pre-hospital treatments were recorded in 38 cases with tourniquets employed in 24 cases (63.2%) and 13 patients visiting a traditional medical practitioner before going to hospital. There were similar proportions of males to females admitted with snakebite and the case fatality rate in this study was 2.9%.

CONCLUSION: Most bites from snakes in Zimbabwe occur to the feet and are probably from puff adders. The torniquet appears to be the most commonly employed first aid measure for snakebite in Zimbabwe, and snakebite victims still consult traditional healers.