Snakebites are a significant health concern, especially in developing countries. According to the World Health Organization, out of the 5 million snakebites that occur annually, 2.7 million result in envenomation, leading to between 81,000 and 139,000 deaths.
In sub-Saharan Africa, about a million people are estimated to be bitten by snakes each year, with estimated 7000-20 000 deaths occurring with West Africa bearing an annual snakebite deaths of 3,557 to 5,450 [5]. Europe, Australia, and North America statistically have the lowest incidence of envenoming [5]. Many people who survive bites nevertheless suffer from permanent tissue damage caused by venom, leading to disability [6].
Despite the number of deaths caused by snakebite annually, it was until June, 2017 that the World Health Organization formally listed snakebite envenoming as a highest priority neglected tropical disease [7].
Therefore, it is important for healthcare providers especially those in rural environments to be well equipped in terms of knowledge on snakes and snakebites which is required for effective management of victims who get bitten by snakes hence the need for this study in three rurally situated Tongu districts of the Volta region of Ghana.
If clinicians are unfamiliar with the different species of snakes and unable to distinguish between venomous and non-venomous snakes, as well as the characteristics of snakebites, it can be difficult to know how to respond appropriately in terms of management in the event of a bite.
Read also: Venomous Snakes: A South African Guide
Injuries, disabilities and deaths from snakebites are something that happens daily in most parts of the world particularly in the poorest communities. Knowledge in relation to the management of snakebite patients is therefore very important.
The study was undertaken in selected health facilities across the three neighbouring districts in the Volta region of Ghana namely South Tongu, North Tongu and Central Tongu.
The Tongu districts are located in the South eastern part of the Ghana and are mainly inhabited by people of the Ewe tribe speaking the Tongu dialect.
A total of 186 respondents across the three Tongu districts participated in the study. The selection of respondents for this study was done through the use of both census and convenience sampling techniques.
Data for the study was collected in the period between May and June, 2019 through the use of a self-administered semi-structured questionnaire designed using google form.
Read also: Identifying Moroccan Snakes
Microsoft Excel spreadsheet was generated from the google form. The data was processed and cleaned after which analysis was done using Statistical Package for the Social Sciences (SPSS) Version 23.
The level of knowledge of respondents on snakes and snakebite were assessed by scoring the answers provided by the respondents which are compared with literature sources.
Permission was sought from the District Health Directorates, Medical Superintendents and the Administrators of the South Tongu, North Tongu and Central Tongu hospitals before the data was collected.
Study tool used for the study was approved by the Ethic Committee of the School of Medicine and Health Sciences of the University for Development Studies.
Table 1 shows the socio-demographic characteristics of respondents in this study. Majority, 95 (51.1%) were males, and were within the age group 30-39 years, 98 (52.7%). Most respondents, 87 (46.8%) were from the South Tongu district, followed by the North Tongu, 54 (29.0%) with Central Tongu having the least number of respondents, 45 (24.2%).
Read also: Deadly Snakes: South Africa Guide
Knowledge of Health Workers on Snakes
Table 2 shows knowledge of respondents on snakes. The top five best answered questions on the knowledge of respondents about snakes were; Snakes being reptiles (99.0%), Cobra being venomous (92.0%), not all snakes are venomous (85%), identification of Cobra (82.0%), Cobra being the snake that spit into the eyes of the perceived enemies and Puff adder being venomous (67.0%).
Five questions about snakes which were most poorly scored were; Identification of Savanna egg eater (2.0%), identification of Boomslang (3.0%), identification of Africa beauty snake (4.0%), Savanna egg eater being nonvenomous (5.0%) and Africa beauty snake being partially venomous (10.0%).
Table 3 shows association between socio-demographic characteristics and knowledge on snakes. For knowledge of respondents about snakes, males significantly scored better than females (9.04 vs. 7.55; p < 0.001).
Respondents working at the lowest part of the health system, the CHPS compound obtained the best scores (9.27), followed by those in the health centres (9.24) while respondents in hospitals scores the least of 8.05 but the differences were not significant.
Respondents who had training on snakebite management significantly scored better than those who did not received training (9.93 vs. 7.60; p < 0.0001).
The knowledge of health workers in the Tongu districts in Ghana on snakes and snakebite was inadequate.
Table 5 shows association between socio-demographic characteristics and knowledge on snakebite. Male respondents had a better means knowledge score on snakebites than their female counterparts (14.49 vs. 13.03) but the difference was not significant.
Respondents who had training on snakebite management significantly scored better than those who had not received training on snakebite management (15.60 vs. 12.98; p < 0.0001).
In West Africa, most of the snakebites occur in the savanna regions with the saw-scaled or carpet viper (Echis ocellatus) being the snake most implicated in causing morbidity and mortality [2]. Other venomous snakes in the West African region include the spitting cobras (Naja nigricollis and N.
Although, the exact number of snakebites globally is not known, the WHO (2019a) estimated that about 5.4 million snake bites occur each year, resulting in 1.8 to 2.7 million cases of envenoming [3]. There are between 81 410 and 137 880 deaths and around three times as many amputations and other permanent disabilities each year.
Most snake envenoming and fatalities occur in South Asia, Southeast Asia, and sub-Sahara Africa, with India reporting the most snakebite deaths of any country [4].
According to the World Health Organization, (2010) when venomous snakes bite, it may not introduce venom into the tissue referred to as dry bite or non-venomous bite [1]. Dry bites may or may not be associated with local inflammation but do not present with systemic manifestations.
Following a dry bite, the victim may present with presence of fang marks, local swelling, pain, redness and bleeding from the bite sites as well as reduced function of the affected body part resulting in anxiety [1].
The top five best answered questions on the knowledge of respondents about snakebite were; the local signs and symptoms of snakebite (93.0%), ways of preventing snakebite (84.0%), handling of a death snake not being safe enough (78.0%), signs and symptoms of snakebite being determined by the type of snake responsible for the bite (78.0%), the rainy season being the season with most snakebite incidence in Ghana (74.3%).
The five most poorly scored questions on knowledge about snakebite were; percentage of snakebite (out of hundred percent) that may come from venomous snakes (1.1%), walking on a log of wood being the best thing to do to prevent snakebite when you come across a log of wood on your path in the forest (11.2%), number of times a venom will be injected into a victim out of hundred bites (13.4%), sleeping under mosquito nets preventing snakebites (32.1%) and the day being the most common time of snakebite (37.0%).
The overall average knowledge score of the respondents on snakebite was 13.78 ± 4.000/22 (63%).
Global distribution of snakebite incidence.
Common Snakes in Ghana
If so, you have come to the right place. In the article below, I have listed the MOST COMMON snakes you can expect to see. Unfortunately, there are so many snakes that live in Ghana that it would be impossible to list each one. You’ll see that the snakes in Ghana are very different from each other. They range from venomous species to snakes that use constriction to immobilize their prey. In addition, certain snakes are common to find living around people.
- Cape House Snake (Boaedon capensis): Adults are 60 cm (24 in) on average, but they can grow up to 120 cm (47 in). The belly is creamy white, with stripes running along the body. The Cape House Snake is frequently seen in grassy and suburban areas, but it doesn’t stop there. Luckily, these snakes are harmless to humans. They slowly drag themselves around at night to catch unsuspecting rodents, lizards, and birds. The Cape House Snake is popular among exotic pet owners due to being low-maintenance. However, owners should be careful to keep these snakes separated.
- Red-lipped Snake (Crotaphopeltis hotamboeia): This snake can grow to 70-100 cm (28-39 in) long. Coloration is usually olive green or gray on the back, sometimes speckled white. Its head is notably black. The head is broad and triangular, while the tail is short. You’ll find Red-lipped Snakes near marshlands, bogs, and lowland forests in Ghana. They also gravitate towards the suburbs, so you might bump into one in your backyard after an evening rain. Most active during the night, these land snakes prey on amphibians such as toads and frogs. Their venom is mild, effective only on their chosen prey, and harmless to humans. Don’t test your luck, though. Red-lipped snakes have a trigger-happy temper when provoked. Interestingly, the Red-lipped Snake got its other common name, the Herald Snake, from a newspaper story.
- Ball Python (Python regius): They have small heads and thin necks. Ball Pythons can be black or brown-bodied with light and dark blotches on the back. As you might have guessed from its name, the Ball Python is more likely to curl into a ball than bite if threatened. However, because of their docile behavior, many people choose to keep them as pets. Unfortunately, the pet trade has wreaked havoc on their worldwide distribution. Because of poaching, habitat destruction, and egg hunting for trade, Ball Pythons are listed as a Near Threatened species by the IUCN. In the wild, the smaller males hunt birds and bats in trees, while the larger females hunt rodents or small mammals on land. Both males and females incapacitate their prey with crushing constriction, then swallow it whole.
- Central African Rock Python (Python sebae): Striped blotches decorate the body, colored olive, brown, or yellow. The Central African Rock Python is the longest snake in Ghana! Central African Rock Pythons may be non-venomous, but don’t let that give you a false sense of security. This species is strong enough to kill a human with its powerful constriction. Unlike most snakes, Central African Rock Pythons are protective mothers. They fiercely guard their nest after laying eggs, protecting their young from predators and lashing out at unsuspecting passersby.
- Rhinoceros Viper (Bitis nasicornis): You can easily identify this viper by its striking geometric markings in shades of blue, green, yellow, and black. The Rhinoceros Viper is named for its elongated scales on top of its nose, which resemble rhinoceros horns. It prefers forested and marshy areas and is mostly terrestrial. If patience is your virtue, then you might appreciate this ambush predator. Most of the Rhinoceros Viper’s life is spent lying motionless, waiting for prey to pass by. This snake’s venom is incredibly potent and lethal to humans. The poison attacks cell tissue and blood vessels, leading to internal bleeding.
- Blanding’s Tree Snake (Thrasops flavigularis): Vertical slits punctuate their large, dark eyes. The Blanding’s Tree Snake makes its home in rainforests and wooded savannas south of the Sahara desert. This rear-fanged snake hunts by moving slowly across intertwining branches to inspect the cracks and hollows of trunks. You might chance upon it in parks and gardens searching for prey. Occasionally, this snake wanders inside buildings to hunt roosting bats. It inflates its body and opens its mouth wide as a warning before striking.
- Emerald Snake (Gastropyxis smaragdina): The short head is strongly arched between the eyes. As an arboreal species, the Emerald Snake in Ghana spends most of its life climbing, hunting, and traveling from tree to tree. Its deep green camouflage and slender vine-like appearance make it nearly invisible among vines and foliage! Emerald Snakes have a particularly interesting defense mechanism that starts with inflating the skin of its neck. Once inflated, a pattern of black skin, light blue spots, and green scales are revealed, startling and confusing the predator. Emerald Snakes are non-venomous and non-aggressive, but their bites may cause rashes and itchiness.
- Black-necked Spitting Cobra (Naja nigricollis): Look for these snakes in Ghana near streams and rivers in savannas. Black-necked Spitting Cobras are highly adaptable and can be active day or night. When confronting possible threats, Black-necked Spitting Cobras rise from the ground and spread their impressive neck hoods. Then, true to their name, they will spit venom to blind their aggressors. Black-necked Spitting Cobra bites can cause symptoms such as swelling, blistering, extreme pain, and loss of limb function.
Deadly MAMBA or HARMLESS Bush Snake?
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