Snakebite envenoming may be responsible for a far greater health burden in Africa than previously recognised, with sub-Saharan Africa accounting for nearly half of the world’s estimated snakebite-related illness and deaths, according to a new global study.
The study, published in PLOS Medicine, estimates that at least 2.1 million people worldwide suffer snake envenoming every year, resulting in about 274,000 deaths.
But under a higher-burden scenario, the number could rise to as many as seven million envenomings and 513,000 deaths annually.
The researchers discovered that sub-Saharan Africa carries the largest regional burden, accounting for about 45% of global snake envenomings and deaths.
“Sub-Saharan Africa accounts for 45% of global snake envenomings and deaths, with nearly three times the incidence rates compared to South Asia, a pattern not previously identified,” researchers wrote.
The findings point to a potentially much larger African burden than figures traditionally used by global health agencies.
According to the World Health Organization (WHO), up to one million people are bitten by snakes each year in sub-Saharan Africa, with an estimated 7,000 to 20,000 deaths annually.
However, the agency cautions that those figures are likely to be substantially underestimated because many victims never reach health facilities and rely instead on traditional treatments.
Globally, WHO estimates that 4.5 million to 5.4 million people are bitten by snakes every year, with between 1.8 million and 2.7 million developing clinical illness from envenoming.
Hence, between 81,000 and 138,000 people are estimated to die annually, while as many as 400,000 survivors suffer permanent disabilities, including amputations.
The new study challenges those earlier estimates, arguing that the true burden is considerably higher because of gaps in surveillance and mortality reporting, particularly in rural and underserved communities.
Besides, poor and rural communities are particularly vulnerable because people working in agriculture are frequently exposed to snakes. At the same time, access to health facilities, antivenom and specialized treatment remains limited in many areas.
WHO identifies agricultural workers, herders, fishermen, hunters and working children among those at highest risk. It notes that children can suffer more severe consequences because the same amount of venom can have a greater effect on a smaller body mass.
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