Burden of snakebite envenoming in northern Benin: A Retrospective Cross-Sectional Study in the Tchaourou District

Background: SBE is a significant public health problem, yet its incidence and associated disabilities and fatalities have been vastly underestimated. Objective: To estimate the burden of snakebite envenoming in rural Tchaourou, Northern Benin. Methods: A retrospective descriptive and analytical cross-sectional survey was conducted from 2018 to 2023 in the Tchaourou district. Data were collected through household interviews among participants of the ENABLE Lassa research program. Statistical analyses included incidence-rate calculations and multivariable logistic regression. Results: Among 261 household respondents, 74 reported snakebites, yielding an incidence of 399 per 100,000 person-years [95% CI 314-501]. These 74 victims had a median age of 25.5 years and a male/female distribution of 55%:45% (41:33). Of the 74 victims, 32 (43%) reported that snakebites occurred while farming; and snakebites were most frequent during the rainy season (June and July) when farming activity was at its most intense. The most frequently bitten of the body was the foot or leg (74%), and the most reported symptoms included local swelling (78%), pain (78%), bleeding (66%), and headache (64%). The complications were reported by 22/74 (30%) victims. The risk of a snakebite complication was 3.0 times higher for female (14/33) than male victims (8/41; p=.032) and appeared to be higher when the first point of care was a traditional healer (12/44) or treatment at home (10/24) rather than at a health centre (0/6). Ultimately, only 18/74 (24%) victims attended a health centre. Conclusion: Snakebite envenoming poses a significant health problem in Benin. Comprehensive strategies involving training of healthcare providers, community engagement, and improved immediate access to health centres should reduce morbidity.