Epidemiologic and spatiotemporal study on access to snakebite care in Northern Nigeria

The role of epidemiologic and spatiotemporal factors affecting access to care among snakebite patients in Nigeria are determined. In 2021 a total of 2,942 snakebite patients were prospectively studied at four designated Health Facilities for Managing Snakebites (HFMS). The patients came from 94 Local Government Areas (LGAs) in 12 states in northern Nigeria. It was found that 435 (14.8%) patients actually accessed care within ≤2 hours of bite although 38.0% could have reached the HFMS within the time by car. In certain areas 92% of patients would have been able to reach a secondary or tertiary facility within ≤2 hours. Similarly, 437 (14.9%) patients traveled distances of ≤20 Km to reach a designated HFMS although 86% of patients resided within 5 Km of a road network. There was longer median delay to access care (15 hours), more patients (365) and higher proportion not treated with antivenom (22%) in August the wettest month of the year. Furthermore the patients who died (47) took a median time of 48 hours compared to 11 hours among known survivors (2,649) to access care. Expanding antivenom access to other secondary and tertiary HF in high burden areas especially during peak seasons will potentially improve the outcome among patients.