Snakebite epidemiology and health-seeking behavior in fringe communities of the Kakum Conservation Area in Ghana
6 affiliations
- 1Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
- 2Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana
- 3Centre for Migration, Security and International Relations, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
- 4Department of Pharmacotherapeutics and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of Cape Coast, Cape Coast, Ghana
- 5Department of Conservation Biology and Entomology, School of Biological Sciences, University of Cape Coast, Cape Coast, Ghana
- 6Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
Abstract
Background: Snakebite envenomation (SE) is a significant yet under reported public health challenge, especially in rural and forest-fringe communities in sub-Saharan Africa. Despite its recognition by the World Health Organization (WHO) as a Neglected Tropical Disease (NTD), epidemiological data on SE remain scarce in Ghana, particularly in communities fringing protected forest areas such as the Kakum Conservation Area (KCA). Objective: This study sought to examine snakebite epidemiology in the fringe communities of the Kakum Conservation Area (KCA) in the Central region of Ghana. Methods: A cross-sectional household survey was conducted between April and May 2024 in 18 communities fringing the KCA in Ghana's Central Region. The data collection instrument was pretested in a non-study community (n = 30), with Cronbach's alpha ranging from 0.72 to 0.86 for key scales, indicating acceptable internal consistency. A two-stage sampling approach was employed to enumerate a total of 1,445 households for snakebite victims. Descriptive statistics included frequencies, proportions, means, and standard deviations with 95% confidence intervals calculated using binomial approximation. Inferential statistics included chi-square tests for bivariate associations and multivariable logistic regression to calculate adjusted odds ratios (AOR) with 95% confidence intervals. Results: In this study, the reported lifetime occurrence of snakebites was 394/8,518 (4.63%, 95% CI: 4.18–5.07), compared with 164/8,518 (1.93%, 95% CI: 1.63–2.22) and 41/8,518 (0.48%, 95% CI: 0.33–0.63) in the preceding five years and one year, respectively. The mean age of victims was 44.69 (SD ± 18.64) years. Most victims were female (212/394, 53.81%), married (231/394, 58.63%) and engaged in farming (289/394, 73.35%). Most bites occurred in farms/forests (258/394, 65.48%) and affected the lower limbs (345/394, 87.56%). First aid was applied by 295/394 (74.87%) victims, predominantly involving tourniquets (103/295, 34.92%). Overall, 239/394 (60.66%) sought treatment, of whom 170/239 (71.13%) accessed formal healthcare facilities. Among treatment seekers, 124/239 (51.88%) travelled by motor vehicle, while 97/239 (40.59%) travelled on foot. Additionally, 92/239 (38.49%) waited at least one hour before seeking care, while 89/239 (37.24%) spent at least one hour travelling for care. Following snakebite, 373/394 (94.67%) victims recovered, 15/394 (3.81%) experienced disability and 6/394 (1.52%) died. Compared with victims aged under 20 years, those aged 30–39 years had higher adjusted odds of experiencing snakebite in farm/forest settings (AOR = 3.39, 95% CI: 1.07–10.67). Farming was also associated with increased odds of farm/forest snakebite (AOR = 1.88, 95% CI: 1.04–3.40). Regarding facility-based care, victims aged 20–29 years (AOR = 0.20, 95% CI: 0.05–0.88) and ≥60 years (AOR = 0.11, 95% CI: 0.02–0.69) had lower adjusted odds of seeking care compared with those aged under 20 years. Conclusion: Snakebites constitute a major public health concern in communities fringing forested conservation areas, especially for people whose livelihood activities revolve around agricultural activities. Overall, the study underscores the need to establish and strengthen collaborative efforts among primary health authorities, forest conservation managers, and community leaders in the design and implementation of effective interventions to avert snakebite incidents and improve outcomes for victims. Author summary: Snakebite envenomation is a serious yet underreported public health issue particularly in rural forest-fringe communities in Africa. Despite being reclassified by the World Health Organization as a Neglected Tropical Disease, snakebite remains poorly documented in Ghana, especially in communities bordering protected forests where human-snake encounters are more likely.
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BibTeX
@article{tuoyire2026snakebite,
title = {{Snakebite epidemiology and health-seeking behavior in fringe communities of the Kakum Conservation Area in Ghana}},
author = {Derek Anamaale Tuoyire and Linus Baatiema and Robert Peter Biney and Justus Precious Deikumah and John Koku Awoonor-Williams and Mawuli Kotope Gyakobo},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = oct,
doi = {10.1371/journal.pntd.0013288},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0013288},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Snakebite epidemiology and health-seeking behavior in fringe communities of the Kakum Conservation Area in Ghana
AU - Derek Anamaale Tuoyire
AU - Linus Baatiema
AU - Robert Peter Biney
AU - Justus Precious Deikumah
AU - John Koku Awoonor-Williams
AU - Mawuli Kotope Gyakobo
PY - 2026
DA - 2026/10/30
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0013288
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0013288
AB - Background: Snakebite envenomation (SE) is a significant yet under reported public health challenge, especially in rural and forest-fringe communities in sub-Saharan Africa. Despite its recognition by the World Health Organization (WHO) as a Neglected Tropical Disease (NTD), epidemiological data on SE remain scarce in Ghana, particularly in communities fringing protected forest areas such as the Kakum Conservation Area (KCA). Objective: This study sought to examine snakebite epidemiology in the fringe communities of the Kakum Conservation Area (KCA) in the Central region of Ghana. Methods: A cross-sectional household survey was conducted between April and May 2024 in 18 communities fringing the KCA in Ghana's Central Region. The data collection instrument was pretested in a non-study community (n = 30), with Cronbach's alpha ranging from 0.72 to 0.86 for key scales, indicating acceptable internal consistency. A two-stage sampling approach was employed to enumerate a total of 1,445 households for snakebite victims. Descriptive statistics included frequencies, proportions, means, and standard deviations with 95% confidence intervals calculated using binomial approximation. Inferential statistics included chi-square tests for bivariate associations and multivariable logistic regression to calculate adjusted odds ratios (AOR) with 95% confidence intervals. Results: In this study, the reported lifetime occurrence of snakebites was 394/8,518 (4.63%, 95% CI: 4.18–5.07), compared with 164/8,518 (1.93%, 95% CI: 1.63–2.22) and 41/8,518 (0.48%, 95% CI: 0.33–0.63) in the preceding five years and one year, respectively. The mean age of victims was 44.69 (SD ± 18.64) years. Most victims were female (212/394, 53.81%), married (231/394, 58.63%) and engaged in farming (289/394, 73.35%). Most bites occurred in farms/forests (258/394, 65.48%) and affected the lower limbs (345/394, 87.56%). First aid was applied by 295/394 (74.87%) victims, predominantly involving tourniquets (103/295, 34.92%). Overall, 239/394 (60.66%) sought treatment, of whom 170/239 (71.13%) accessed formal healthcare facilities. Among treatment seekers, 124/239 (51.88%) travelled by motor vehicle, while 97/239 (40.59%) travelled on foot. Additionally, 92/239 (38.49%) waited at least one hour before seeking care, while 89/239 (37.24%) spent at least one hour travelling for care. Following snakebite, 373/394 (94.67%) victims recovered, 15/394 (3.81%) experienced disability and 6/394 (1.52%) died. Compared with victims aged under 20 years, those aged 30–39 years had higher adjusted odds of experiencing snakebite in farm/forest settings (AOR = 3.39, 95% CI: 1.07–10.67). Farming was also associated with increased odds of farm/forest snakebite (AOR = 1.88, 95% CI: 1.04–3.40). Regarding facility-based care, victims aged 20–29 years (AOR = 0.20, 95% CI: 0.05–0.88) and ≥60 years (AOR = 0.11, 95% CI: 0.02–0.69) had lower adjusted odds of seeking care compared with those aged under 20 years. Conclusion: Snakebites constitute a major public health concern in communities fringing forested conservation areas, especially for people whose livelihood activities revolve around agricultural activities. Overall, the study underscores the need to establish and strengthen collaborative efforts among primary health authorities, forest conservation managers, and community leaders in the design and implementation of effective interventions to avert snakebite incidents and improve outcomes for victims. Author summary: Snakebite envenomation is a serious yet underreported public health issue particularly in rural forest-fringe communities in Africa. Despite being reclassified by the World Health Organization as a Neglected Tropical Disease, snakebite remains poorly documented in Ghana, especially in communities bordering protected forests where human-snake encounters are more likely.
SN - 1935-2735
ER -