Burden and risk factors of snakebite in Mopeia, Mozambique: Leveraging larger malaria trials to generate data of this neglected tropical disease

PLoS Negl Trop Dis. 2023 Aug 17;17(8):e0011551. doi: 10.1371/journal.pntd.0011551. eCollection 2023 Aug.

Abstract

Background: Snakebite is a neglected disease that disproportionally affects the rural poor. There is a dearth of evidence regarding incidence and risk factors in snakebite-endemic countries. Without this basic data, it will be impossible to achieve the target of a 50% reduction of snakebite morbidity and mortality by 2030 as set by the World Health Organization.

Methods: This was a descriptive analysis nested in a 2021 community-based demographic survey of over 70,000 individuals conducted in Mopeia, Mozambique, in preparation for a cluster randomized trial to test an intervention for malaria. We describe the incidence rate, demographics, socioeconomic indicators and outcomes of snakebite in this population.

Findings: We found the incidence of self-reported snakebite in Mopeia to be 393 bites per 100,000 person-years at risk, with 2% of households affected in the preceding 12 months. Whilst no fatalities were recorded, over 3,000 days of work or school days were lost with an individual household economic impact higher than that of uncomplicated malaria. 1 in 6 of those affected did not fully recover at the time of the study. We found significant relationships between age older than 15, use of firewood for household fuel, and animal possession with snakebite.

Conclusions: This study exposes higher than expected incidence and burden of snakebite in rural Mozambique. Whilst snakebite elimination in Mozambique seems unattainable today, it remains a preventable disease with manageable sequelae. We have shown that snakebite research is particularly easy to nest in larger studies, making this a practical and cost-effective way of estimating its incidence.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Malaria* / epidemiology
  • Malaria* / prevention & control
  • Mozambique / epidemiology
  • Neglected Diseases / epidemiology
  • Neglected Diseases / prevention & control
  • Risk Factors
  • Snake Bites* / epidemiology
  • Snake Bites* / therapy

Grants and funding

This work was funded and supported by Unitaid under the “BOHEMIA” grant (to RR and CCh). ISGlobal acknowledges support from the grant CEX2018-000806-S funded by MCIN/AEI/ 10.13039/501100011033, and support from the Generalitat de Catalunya through the CERCA Program. The Centro de Investigacao em Saude de Manhica is supported by the Government of Mozambique and the Spanish Agency for International Development Cooperation (AECID). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.