Caring For Snakebite Victims In Sierra Leone.
Snakebite fatality is a growing epidemic that needs to be addressed with urgency. This neglected disease, claimed lives of thousands Sierra Leoneans yearly more than HIV AIDS, Lasser fever and even the recent COVID 19 in Sierra Leone. Most victims are people who depend on the bush for daily survival and can hardly afford meal a day.
Impacting The Lives Of Snakebite Victims In Our Community.
Since the establishment of the Snakebite Treatment Center at the Caring Hands Health and Antivenom Services in March 2019, the treated and survival cases are worth celebrating, but the fatality rate raised an alarm that the government, concerned organizations, and or individuals need to address immediately.
Know More About Snakebite In Sierra Leone
NO | DATE | NAME | # OF VIALS USED | Cost for treatment | COST TO PATIENT | COMMENT |
1 | 27/2/20 | Sorie Kamara | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
2 | 7/3/20 | Bai Kanu | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
3 | 18/3/20 | Alie Kamara | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
4 | 28/3/20 | Abu Shery | 7 | Le. 7M | 0 | Arrived unresponsive with severe respiratory distress, treated and discharged 100% Recovery |
5 | 9/4/20 | Hawa Jalloh | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
6 | 12/4/20 | Alhaji Amadu Sonnie | 0 | Le. 0 | 0 | Treated and discharged. 100% Recovery |
7 | 13/4/20 | Abdulraman Sesay | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
8 | 22/4/20 | Sorie bah Kargbo | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
9 | 27/4/20 | Adama Jalloh | 3 | Le. 3M | 0 | Treated and discharged. 100% Recovery |
10 | 28/4/20 | Prince Jnisa | 0 | Le. 0 | 0 | Treated and discharged. 100% Recovery |
11 | 18/4/20 | Ya Marie Bangura | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
12 | 11/5/20 | Osman Sannoh | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
13 | 20/5/20 | Mohamed Kamara | 5 | Le. 5M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
14 | 21/5/20 | Sinnah Fornah | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
15 | 22/5/20 | Osman Turay | 8 | Le. 8M | 0 | Arrived via ambulance unresponsive, abnormal vital signs. Treated and discharged. 100% Recovery |
16 | 23/5/20 | Neneh Fornah | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
17 | 25/5/20 | Foday Tarawallie | 6 | Le. 6M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
18 | 8/6/20 | Ellien Conteh | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
19 | 11/6/20 | Aminata Bangura | 0 | Le. 0 | 0 | Treated and discharged. 100% Recovery |
20 | 13/6/20 | Dora Kamara | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
21 | 15/6/20 | Kadiatu Sesay | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
22 | 19/6/20 | Rosaline Koroma | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
23 | 21/6/20 | Alpha Koroma | 5 | Le. 5M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
24 | 25/6/20 | Haja Dainka Kamara | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
25 | 27/6/20 | Moses Koroma | 7 | Le. 7M | 0 | Arrived unresponsive with severe respiratory distress, treated and discharged 100% Recovery |
26 | 3/7/20 | Osman Jalloh | 3 | Le. 3M | 0 | Treated and discharged. 100% Recovery |
27 | 21/7/20 | Mohamed Kamara | 0 | Le. 0 | 0 | Treated and discharged. 100% Recovery |
28 | 22/7/20 | Wara Sesay | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
29 | 26/7/20 | Pa Alie Bangura | 5 | Le. 5M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
30 | 31/7/20 | Ismail Kamara | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
31 | 6/8/20 | Fatmata Mansaray | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
32 | 11/8/20 | Abu Kamara | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
33 | 15/8/20 | Adiatu Timbo | 3 | Le. 3M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
34 | 21/8/20 | Mariatu Bangura | 3 | Le. 3M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
35 | 3/9/20 | Mariama Sesay | 6 | Le. 6M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
36 | 9/9/20 | Nemahun Will | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
37 | 18/9/20 | Isatu Barrie | 3 | Le. 3M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
38 | 3/10/20 | Alhaji Jalloh | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
39 | 7/10/20 | Sallamatu Kamara | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
40 | 8/10/20 | Daniel Bangura | 3 | Le. 3M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
41 | 1/11/20 | Ibrahim Kamara | 1 | Le. 1M | 0 | Treated and discharged. 100% Recovery |
42 | 3/11/20 | Memena Jabbie | 5 | Le. 5M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
43 | 7/11/20 | Binta Bah | 2 | Le 2M | 0 | Treated and discharged. 100% Recovery |
44 | 8/11/20 | Abdulai Thullah | 4 | Le. 4M | 0 | Arrived with severe respiratory distress, treated and discharged 100% Recovery |
45 | 10/11/20 | Abu Conteh | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
46 | 16/11/20 | Zainab Barrie | 2 | Le. 2M | 0 | Treated and discharged. 100% Recovery |
NO | DATE | SEX | AGE | TOWN | DISTRICT | # OF VIALS | TX COST | COST TO PATIENT | REASON FOR DEATH |
1. | Jan | M | 34 Y | Yifie | Koinodugu | 0 | 0 | 0 | Unable to come due to distance |
2. | Jan | F | 26 Y | Mathokara | Tonkolili | 0 | 0 | 0 | Unable to come due to distance |
3. | Feb | M | 22 Y | Makarie | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
4. | Feb | M | 38 Y | Mamamdu | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
5. | Feb | M | 20 Y | Masanga | Tonkolil | 0 | 0 | 0 | Unable to come due to distance |
6. | Feb | M | 17 Y | Matarrow | Bombali | 0 | 0 | 0 | Unable to come due to distance |
7. | Mar | M | 12 Y | Sanda | Bombali | 0 | 0 | 0 | Do not aware of treatment center |
8. | Mar | M | 43 Y | Masanga | Tonkolili | 0 | 0 | 0 | Unable to come due to distance |
9. | Mar | M | 18 Y | Matarrow | Bombali | 0 | 0 | 0 | Unable to come due to distance |
10. | Mar | M | 23 Y | Masanga | Tonkolili | 0 | 0 | 0 | Unable to come due to distance |
11. | Mar | F | 33 Y | Bafodia | Falaba | 0 | 0 | 0 | Unable to come due to distance |
12. | Apr | M | 15 Y | Makorr | Kono | 0 | 0 | 0 | Unable to come due to distance |
13. | Apr | F | 21 Y | Sorie Bah | Koinadugu | 0 | 0 | 0 | Lack of Transportation |
14. | Apr | M | 26 Y | kangahun | Moyanba | 0 | 0 | 0 | Unable to come due to distance |
15. | April | F | 19 Y | Konta wallah | Kanbia | 0 | 0 | 0 | Unable to come due to distance |
16. | April | M | 28Y | Yanka Bana | Bombali | 0 | 0 | 0 | Traditional healing |
17. | May | F | 17Y | Binkolo | Bombali | 0 | 0 | 0 | Traditional healing |
18. | May | F | 22Y | Magburaka | Tonkolili | 0 | 0 | 0 | Little or no knowledge of Clinic |
19. | May | M | 24Y | Bumpeh | Kono | 0 | 0 | 0 | Unable to come due to distance |
20. | May | M | 19Y | Lunsar | Port Loko | 0 | 0 | 0 | Unable to come due to distance |
21. | May | F | 21Y | Kabala | Koinadugu | 0 | 0 | 0 | Unable to come due to distance |
22. | May | M | 14Y | Yengema | Kono | 0 | 0 | 0 | Unable to come due to distance |
23. | June | M | 32Y | Fadugu | Karene | 0 | 0 | 0 |
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24. | June | F | 19Y | Grafton | Freetown | 0 | 0 | 0 | Unable to come due to distance |
25. | June | F | 44Y | Gbomsanba | Port Loko | 0 | 0 | 0 | Little or no knowledge of Clinic |
26. | June | M | 31Y | Daru | Moyamba | 0 | 0 | 0 | Unable to come due to distance |
27. | June | M | 24Y | Konsho | Bombali | 0 | 0 | 0 | Traditional healing |
28. | June | M | 21Y | Sefadu | Kono | 0 | 0 | 0 | Unable to come due to distance |
29. | June | M | 24Y | Bumbuna | Tonkolili | 0 | 0 | 0 | Unable to come due to distance |
30. | June | M | 12Y | Yele | Tonkolili | 0 | 0 | 0 | Unable to come due to distance |
31. | July | F | 41Y | Makari | Bombali | 0 | 0 | 0 | Traditional healing |
32. | July | F | 11Y | Konsho | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
33. | July | M | 20 | makomray | Bombali | 0 | 0 | 0 | Unable to come due to distance |
34. | August | F | 28Y | Masuba/Makeni | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
35. | August | M | 44 | Yengema | Kono | 0 | 0 | 0 | Unable to come due to distance |
36. | August | M | 15Y | Kamakwe | Karene | 0 | 0 | 0 | Unable to come due to distance |
37. | August | F | 19Y | Waterloo | Freetown | 0 | 0 | 0 | Unable to come due to distance |
38. | August | M | 42Y | Bumpeh | Kono | 0 | 0 | 0 | Unable to come due to distance |
39. | August | F | 21Y | Kamabai | Karene | 0 | 0 | 0 | Traditional |
40. | August | M | 19Y | Mangay | Bombali | 0 | 0 | 0 | Traditional healing |
41. | August | M | 17Y | Batkanu | Karene | 0 | 0 | 0 | Traditional healing |
42. | August | M | 26Y | Mongoh Bendugu | Koinadugu | 0 | 0 | 0 | Unable to come due to distance |
43. | Sept | M | 30Y | Masongbo | Bombali | 0 | 0 | 0 | Traditional healing |
44. | Sept | F | 47Y | Karena village | Karene | 0 | 0 | 0 | Little or no knowledge of Clinic |
45. | Oct | F | 30Y | Magbana | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
46. | Oct | M | 13Y | Lunsar | Port Loko | 0 | 0 | 0 | Little or no knowledge of Clinic |
47. | Oct | M | 22Y | Makama | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
48. | Nov | F | 17Y | Binkolo | Bombali | 0 | 0 | 0 | Little or no knowledge of Clinic |
According to community dead reports on snake bites victims, out of 10 death 6 death caused by mamba bites, 3 is Cobra bite, 1 deaths caused by puff Adda and other deaths caused by unknown snakes. Moreover, these snakes (Mambas and Puff Addas) killed our people in very short range of hours after carnivorously encounter and more farmers involved.
NO | DATE | SEX | AGE | ADDRESS | CHIEFDOM | DISTRICT |
1 | Jan | M | 34 Y | Yifie village | Yiffie | Koinodugu |
2 | Jan | F | 26 Y | Mathokara village | Matotoka | Tonkolili |
3 | Feb | M | 22 Y | Makarie village | Makarie | Bombali |
4 | Feb | M | 38 Y | Mamamdu village | Malal | Bombali |
5 | Feb | M | 20 Y | Masanga village | Kolifa Rowalah | Tonkolil |
6 | Feb | M | 17 Y | Matarrow village | Malal | Bombali |
7 | Mar | M | 12 Y | Sanda village | Sanda Tandaren | Bombali |
8 | Mar | M | 43 Y | Masanga village | Kolifa Rowalah | Tonkolili |
9 | Mar | M | 18 Y | Matarrow village | Malal | Bombali |
10 | Mar | M | 23 Y | Masanga village | Kolifa Rowalah | Tonkolili |
11 | Mar | F | 33 Y | Bafodia village | Mongo | Falaba |
12 | Apr | M | 15 | Makorr village | Sefadu | Kono |
13 | Apr | F | 21 Y | Sorie Bah | Yiffi | Koinodugu |
14 | Apr | M | 26 Y | kangahun | Kangahun | Moyanba |
15 | April | F | 19 | Konta wallah | Mambolo | Kanbia |
Rapid acting venom in the body: Snakes like mamba, cobra, produce fast acting venoms that rapidly infused in the human circulatory, if not treated with in four (4) damages of tissues, organs or death occurs within 6 hours of bite. The victim should have access to treatment center in 4 hours or less.’
Poverty: Most low income people who depends on the bush for daily bread are more vulnerable to snakebites. These people cannot afford a meal for the day let alone treatment cost. They prefer going to traditional healer since they afford money to pay conventional treatment. This group experience higher rate of fatality.
Distance: Having only one treatment centre across the country, victim from Daru, Kalaihun Find it difficult to reach the center on time for early treatment. The Caring Hands and antivenom Health Center has experienced two fatality cases related to this factor. The only two fatalities since the inception of the antivenom treatment program in February 2020.
Lack of Transportation: Hard to reach areas or lack of means of transportation related to poor roads structure, broken bridged eg. Is a major factor for delay in care. This increases the rate of fatality.
Traditional belief: This is a practice of about 80% of Sierra Leoneans in rural areas. In most villages, snakebite is associated with witch craft, devils or bad people. They believe that only traditional people, witch doctors or spiritual leaders can cast out this evil act.
Lack of information awareness: The treatmentsis less than one year since it was opened. Communities with in the Makeni area are not well informed of the type treatment and location of treatment. Dissemination is not reached other areas.
Delay in making decisions: Communities contributions on where to go, how to get there and who will make final decision. Debate on Traditional Healing vs Conventional Healing influence this factor.
Possible Solutions To Avert This Epidemic
Based on calls and reports on causalities and fatalities on snakebites from unable to reach areas, the Caring Hands and Antivenom Health Services is appealing to all stake holders to support the strengthening and expansion of treatment centers and recruitment of staff Nation wide to minimize the causality rate. With your support, hard to reach areas will have access to very close treatment centers with trained professionals ready for robust treatment.
Most causalities are victims as a result of searching for daily living, such as farming fetching woods or harvesting food and that is the only way of survival. These victims can not pay the cost associated to the treatment, a good Samaritan like you will save this victim life either direct or indirect by supporting and disseminating this program.
A 35 years old Sierra Leonean man brought in our hospital (Caring Hands Health Services) on the noon 0f 27 June, 2020. Immediately after sustaining a Black Mamba bite to his right leg. The victim arrived to the hospital one hour after the carnivore at his farm. On arrival, he presented with pain, vomiting, mild dyspnea, confusion, Tem: 37.4oc, blood pressure 136/92mmHg, pulse 76 B/M, RR 26 b/m, No visual bleeding. He was treated with 2 vials of INOSERP Anti venom ( Inoserp Polyvalent F(ab’)2 Immunogloulin Fragments of 250mg) Ho = 2v. Reassessment was done at H1 patient rapidly developing severe signs of ptosis, dyspnea (RR= 30 b/m) which shallow in character, elevated blood pressure of 140/92 mmHg, Heart rate of 80 b/m WBCT= -ve but no evidence of external bleeding, iv metoclopromide50mg/2ml given. At H2 reassessment, more ptosis, dyspnea, RR =32 b/m shallow, BP= 145/95 mmHg, pulse 80 b/m, Tem 37.3oc, poor lungs sound, WBCT +VE, HB= 12.6mmol/dl, AVPU 30%.
There were on line doctors from Asclepius Snake bite Foundation ASF collectively advised our team on given immediately 4 vials Inoserp intravenous push per protocol and it was done. I anticipate the situation together with them. At H4 reassessment, patient started improving gradually, AVPU 75%, ptosis and paralysis improved about 80%, BP= 130/7=85mmHg, RR=23 b/m deep in character, pulse 75 b/m, spo2=97%, Tem= 37.5oc, limb painful with mild swelling and 1 vial AV added, Tab panadol 1g 8hourly for 3 days, Cap Amoxicilline 500mg 8hourly for 5days. H6 patient improved greatly.
BP= 104/62mmHg, PULSE 95 B/M, Tem 37.3oc, RR= 20 b/m and deep, SPO2=98%, and iv infusion NS 500mls alternate with RL 500 cc one hour apart.
At H12 the paralysis normalized and a repeat lungs sounds showed clear and normal breathing, confirming complete resolution of the neurotoxic syndrome. He received the above treatments and was discharged from the hospital with a complete recovery and no prognosis H24 /D1 after treatment with Anti venom (INOSERP).
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