<p>Hospitalisation and clinical features.</p>

Background Snakebite envenoming is among the top five emergency health conditions in northern Ghana. Among the four genera of snake species classified to be of highest medical importance, species with haemotoxic venom are responsible for about 90% of all snakebite case presentations in the region. However, there is a dearth of clinical data on signs and symptoms of envenoming, treatment practices and health outcomes. We examined the signs and symptoms of envenoming and clinical management practices at referral hospitals in northern Ghana. Methods Medical records of patients reporting on account of snakebite between 2016 and 2020 at the Wa Municipal Hospital in the Upper West region and the Baptist Medical Centre in the North East region of Ghana were reviewed. Demographic characteristics, patients’ clinical data and management practices were analysed and evaluated taking into consideration the national standard treatment guideline. Results A total of 2,684 records of patients reporting on account of snakebite were accessed at both health facilities over the five-year period. 91% of the patients were admitted to the ward. Swelling, severe pain and bleeding were the most common clinical signs upon presentation. A total of 1,670 (64.7%) of all the patients tested had at least one abnormal blood clotting result suggesting haemotoxicity. Antivenom was administered to 84.3% of the patients. Antibiotics were administered to 70.5% with amoxicillin with clavulanic acid, flucloxacillin and metronidazole accounting for 59.2% of all antibiotics administered. The recorded case-fatality rate was 1.9%. Conclusion The annual hospital attendance rate on account of snakebite to the Wa Municipal Hospital and the Baptist Medical Centre is estimated at 55 persons per 100,000 population per year. Mortality was low, with antivenom available to most of the patients. More evidence is needed on the indication and dosing of antivenom and to improve appropriate ancillary care.研究背景 蛇咬伤中毒是加纳北部五大急诊健康病症之一。在被列为具有最高医学重要性的4个蛇属中，分泌血循毒（haemotoxic venom）的蛇类导致了该地区约90%的蛇咬伤就诊病例。然而，目前关于蛇咬伤中毒的临床表现、治疗方案与健康结局的临床数据仍较为匮乏。本研究针对加纳北部地区转诊医院的蛇咬伤中毒临床表现与临床诊疗实践展开了调查分析。 研究方法 本研究回顾性分析了2016至2020年期间，加纳上西部省瓦市立医院以及东北部省浸信会医疗中心收治的蛇咬伤患者的医疗记录。结合加纳国家标准化治疗指南，对患者的人口统计学特征、临床数据及诊疗实践进行了分析与评估。 研究结果 五年间，两家医疗机构共纳入2684份蛇咬伤患者就诊记录。其中91%的患者收入住院病房。患者就诊时最常见的临床表现为肿胀、剧烈疼痛与出血。共1670例（占比64.7%）接受检测的患者出现至少一项凝血功能异常结果，提示存在血循毒中毒。84.3%的患者接受了抗蛇毒血清（antivenom）治疗。70.5%的患者接受了抗生素治疗，其中阿莫西林克拉维酸钾、氟氯西林与甲硝唑占所有抗生素使用量的59.2%。本次研究记录的病例病死率为1.9%。 研究结论 据估算，瓦市立医院与浸信会医疗中心的蛇咬伤年就诊率为每10万人口每年55人次。本次研究中病死率较低，多数患者均可获得抗蛇毒血清治疗。未来仍需更多研究明确抗蛇毒血清的使用指征与给药剂量，并优化配套辅助治疗方案。