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The number of venomous snakebites in rural Africa may be highly underestimated, researchers have suggested, with far more deaths estimated to be occurring than previously thought.
Across the world, there may be as many as 5.4 million snakebites and over 125,000 associated deaths every year, according to a 1998 World Health Organization (WHO) report. Snakebites are a particular hazard in tropical and subtropical developing nations, where there may be a scarcity of antivenoms and a lack of access to health centers.
Between 20,000 and 32,000 snakebite deaths are estimated to occur in sub-Saharan Africa. However, since these figures are based on hospital figures or incomplete data sets, these figures may be underestimated.
This is partly because not everyone in the region will end up going to the hospital as a result of a snakebite, with some residents preferring to use traditional remedies instead. As a result, some people may die at home, and their deaths will not be recorded.
Africa is home to some of the deadliest snakes in the world, including the black mamba, whose venom can kill in under an hour, and the puff adder, a widespread snake that is particularly dangerous because of its camouflage, making it easy to stumble upon.
To get a clearer picture of the problem, researchers gathered snakebite data from households in a part of northern Mozambique and compared it with reports from health centers.
Based on 1,037 households surveyed, the researchers found that 59 percent of snakebites were treated exclusively by traditional doctors, while 25 percent were not seen by any doctor at all.
Using this data, the researchers estimated that at least 69,261 snakebite incidents occur throughout Mozambique every year, with at least 8,950 deaths.
"Our numbers suggest that snakebites in the literature may have been underestimated by an order of 10 and deaths by almost 30 times," the report said.
Harith Farooq, a herpetologist who studies biodiversity threats at the University of Copenhagen and co-author of the study, told Newsweek the results cannot be safely extrapolated to estimate snakebite incidents across the whole of sub-Saharan Africa. That's because of wide variations in culture and economic development that exist in the region.
"However, one fact is true: Our estimates are very conservative," Farooq said. "We used a variety of conservative approaches, and my gut feeling is that these numbers may only be extrapolated to rural areas of the continent where venomous snakes occur in high density. The numbers in the sub-Saharan region are very likely severely underestimated, but we just can't at this point quantify the incidence.
Farooq continued: "Even before our study, snakes were one of the most dangerous animals in Africa, killing more people than crocodiles, hippos, elephants, lions and buffalos combined. So in reality this study just reinforced the status of snakes as a major killer and suggests that the numbers may be even higher. But, for instance, mosquitos are responsible for more deaths since they can cause diseases such as malaria or dengue."
Farooq said that revealing the seriousness of the problem in rural communities could lead to local health centers receiving much-needed doses of antivenom and that local communities, especially traditional doctors, need to receive training on snakebite first aid.
Johan Marais, CEO of the African Snakebite Institute and another co-author of the study, told Newsweek: "The problem is far worse than we think. The WHO has declared snakebite a neglected tropical disease and hope to reduce snakebite fatalities by 50 percent in the next seven years, but that is unlikely.
"Antivenom is made by the South African Vaccine Producers, part of our National Health [Laboratory Service], but they seem to have screwed up production and for the past six months there has been a severe shortage of antivenom and snakebite victims are dying," Marais said.
