Dr Anthony Nsiah-Asare (seated middle), Presidential Advisor on Health, with Dr Hafiz Adam Taher (seated 2nd from right), Ag Director for Technical Coordination Directorate and Director External Health Cooperation, Ministry of Health; Dr Angela Ackon (seated 2nd from left), Technical Officer Quality and Safety, World Health Organisation; Dr John Amuasi (seated right), Leader, Global Health and Infectious Diseases Research Group, and some participants after the forum. Picture: ELVIS NII NOI DOWUONA
Dr Anthony Nsiah-Asare (seated middle), Presidential Advisor on Health, with Dr Hafiz Adam Taher (seated 2nd from right), Ag Director for Technical Coordination Directorate and Director External Health Cooperation, Ministry of Health; Dr Angela Ackon (seated 2nd from left), Technical Officer Quality and Safety, World Health Organisation; Dr John Amuasi (seated right), Leader, Global Health and Infectious Diseases Research Group, and some participants after the forum. Picture: ELVIS NII NOI DOWUONA

Snakebite alert; 9,900 cases recorded annually

The country recorded 59,600 snakebite cases between 2015 and 2020, the first time such data has been put together. 

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This means, on average, 9,900 snakebites are recorded in the country each year. 

The cases were higher in males with an average of 5,600 snakebites per year than in females, which had 4,300 snakebites a year. 

The Programme Manager of the Neglected Tropical Diseases (NTDs) of the Ghana Health Service, Dr Joseph Opare, disclosed this at the launch of the African Snakebite Alliance (ASA) Ghana.

Snakebite is among 20 conditions classified by the World Health Organisation (WHO) as Neglected Tropical Diseases (NTDs). Ghana is endemic to 14 NTDs.

More people reportedly die from venomous snakebites each year than they have died from Ebola. In low and middle-income nations, snakebite envenoming is more deadly than almost any other NTD.

About 5.4 million snakebites occur each year globally, resulting in 1.8 to 2.7 million cases of poisoning. 

There are between 81,410 and 137,880 deaths and around three times as many amputations and other permanent disabilities each year.

In Ghana, according to Dr Opare, the disease affects mainly people in farming, hunting, fishing and other rural communities of the country with the Upper West, Ashanti and Eastern regions recording the highest bites.

Burden of snakebite

Dr Opare said to reduce the snakebite mortality and morbidity, the GHS had instituted measures to improve surveillance and also provided adequate antivenoms.

He said the GHS was also stepping up awareness creation on snakebites to empower victims of remedial measures.

Dr Opare said the exact burden of snakebite envenomation in the country was unknown, explaining that hospital visit rate of snakebite was estimated at 35 per 100,000 persons per year.

Envenomation is the exposure to a poison or toxin resulting from a bite or sting from an animal such as a snake, scorpion, spider, or insect or from marine life.

He mentioned factors slowing down Ghana’s progress in addressing snakebite envenoming to include the unavailability of reliable data on the types and distribution of snakes and the burden of snakebite, antivenoms not always available and accessible and sometimes unaffordable and the unavailability or unaffordability of protective gear for farmers in rural areas.

ASA

The ASA is an organisation aimed at transforming snakebite research fields by linking the international scientific community with local policy and community actors.

The body comprises experts from the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR); the Kenya Institute of Primate Research; the University of Global Health Equity in Rwanda; the Eswatini Antivenom Foundation; the Rwanda Biomedical Centre and the Liverpool School of Tropical Medicine in the United Kingdom, with funding from the Wellcome Trust.

The Principal Investigator of the ASA, Dr John H. Amuasi, said achieving the 2019 WHO roadmap of halving snakebite deaths and disability worldwide by 2030 was considerably hampered by the lack of high-quality research evidence to inform policy and practice.

He said the objectives of the ASA were to undertake high-quality research relevant to improving health outcomes for people affected by snakebite in Africa; develop systems to support national and regional bodies in Africa to incorporate research evidence into decision-making in policy and planning and to develop and support a sustainable and cross-disciplinary capacity for snakebite research in Africa.

Dr Amuasi, who is also the Leader of the Global Health and Infectious Diseases Research Group of the KCCR, said as part of their work, they would be giving out small grants to other researchers who wanted to conduct any kind of research into snakebite and also ensure that the research findings were translated into policies.

Antivenoms

A representative of the WHO Ghana Office, Dr Angela Ackon, described snakebite as a neglected public health issue in many tropical and sub-tropical countries, adding that while highly effective treatments existed, antivenoms were not widely available in the regions where they were needed, pointing out the main challenge to be the preparation of the correct snake venoms.

“At present, very few countries can produce snake venoms of adequate quality for antivenom manufacture and many manufacturers rely on common commercial sources. These may not properly reflect the geographical variation that occurs in the venoms of some widespread species,” she explained.

Furthermore, Dr Ackon said the lack of regulatory capacity for the control of antivenoms in countries with significant snakebite problems resulted in an inability to assess the quality and appropriateness of the antivenoms.

It was for that reason that the WHO prequalification was paying serious attention to the issue and was evaluating other types of antivenoms, Dr Ackon said, adding that if compliant with WHO standards, those products would be listed for international procurement.

The Presidential Advisor on Health, Dr Anthony Nsiah-Asare, said most cases of snakebite were recorded from March to June and October to November of every year, which were the major and minor farming seasons.

The acting Director, Technical Coordination Directorate and Director, External Health Cooperation of the Ministry of Health, Dr Hafez Adam Taher, described snakebite as the most neglected among NTDs even though it was covered under the National Health Insurance Scheme, explaining that there was still scarcity of vaccines for snakebites.

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