“At the hospital they do not treat venom from snakebites”: A qualitative assessment of health seeking perspectives and experiences among snakebite victims in Rwanda

IF 3.6 Q2 TOXICOLOGY
Janna M. Schurer , Aleta Dam , Marie Thérèse Mutuyimana , Daniel Muhire Runanira , Richard Nduwayezu , J. Hellen Amuguni
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引用次数: 9

Abstract

Snakebite envenomation (SBE) is a serious medical condition with human, animal, and environmental factors driving occurrence. In Rwanda, the number of SBE cases reported by the medical system is far lower than regional estimates for SBE incidence, suggesting that victims might be seeking care outside of formal medical structures. Our goals were to describe circumstances surrounding snakebite and to explore experiences of snakebite victims in accessing treatment. For this qualitative study, our team recruited individuals bitten by snakes between 2013 and 2018, who sought care either from traditional healers (N = 40) or hospitals (N = 65). In-depth interviews based on a semi-structured interview guide were conducted by telephone in Kinyarwanda. Inductive thematic analysis was conducted by two team members. Our respondents reported similar environmental circumstances surrounding their snake encounters; namely, farm fields, roads, and their homes, as well as inadequate lighting. Unsafe First Aid practices, including burning/sucking/cutting the skin and tourniquet, were often performed immediately after bites. Respondents reported various reasons for seeking traditional or hospital care, such as perceived cost, distance, transportation, and especially, community beliefs and treatment outcomes of other victims. Respondents described envenomation of livestock as well as the sale of livestock to pay SBE-related medical expenses. Improving trust and use of formal medical services will require enhanced hospital delivery of high quality medical services for SBE through improved stocking of appropriate anti-venom and reduced delays during intake. Communities might also benefit from education campaigns that discourage unsafe First Aid practices and address the common misperception that physicians are not trained to treat SBE.

Abstract Image

"在医院,他们不治疗蛇咬伤的毒液":对卢旺达蛇咬伤受害者寻求保健的观点和经验的定性评估
蛇咬中毒(SBE)是一种严重的疾病,与人类、动物和环境因素有关。在卢旺达,医疗系统报告的SBE病例数量远低于该地区对SBE发病率的估计,这表明受害者可能在正规医疗机构之外寻求治疗。我们的目标是描述蛇咬伤周围的情况,并探索蛇咬伤受害者在获得治疗方面的经历。在这项定性研究中,我们的团队招募了2013年至2018年间被蛇咬伤的个体,他们从传统治疗师(N = 40)或医院(N = 65)那里寻求治疗。根据半结构化访谈指南,在卢旺达通过电话进行了深度访谈。由两名组员进行归纳性专题分析。我们的受访者报告了他们遇到蛇的类似环境;也就是说,农田、道路和他们的家,以及照明不足。不安全的急救做法,包括烧伤/吸吮/切割皮肤和止血带,通常在咬伤后立即进行。答复者报告了寻求传统或医院治疗的各种原因,例如认为费用、距离、交通,特别是社区信仰和其他受害者的治疗结果。受访者描述了对牲畜的毒害以及出售牲畜以支付与sbe相关的医疗费用。提高对正规医疗服务的信任和使用,需要医院通过改善适当抗蛇毒血清的储存和减少摄入期间的延误,加强为SBE提供高质量的医疗服务。社区也可以从教育活动中受益,这些教育活动可以阻止不安全的急救做法,并解决医生没有接受过治疗SBE培训的普遍误解。
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来源期刊
Toxicon: X
Toxicon: X Pharmacology, Toxicology and Pharmaceutics-Toxicology
CiteScore
6.50
自引率
0.00%
发文量
33
审稿时长
14 weeks
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