Snakebite epidemiology and health-seeking behaviour in fringe communities of the Kakum Conservation Area in Ghana

Abstract Background Snakebite envenomation (SE) remains a significant yet underreported public health challenge, especially in rural and forest-fringe communities in sub-Saharan Africa. Despite its recognition by the World Health Organization (WHO) as a Neglected Tropical Disease (NTD), epidemiological data on SE remain scarce in Ghana, particularly in communities fringing protected forest areas such as the Kakum Conservation Area (KCA). Objective This study aimed to quantify and characterize the epidemiology of snakebite envenomation and explore the health-seeking behaviours among residents in the fringe communities of the KCA in the Central Region of Ghana. Methods A cross-sectional household survey was conducted between April and May 2024 in 18 communities fringing the KCA in Ghana’s Central Region. A two-stage sampling approach was employed to enumerate a total of 1,445 households for snakebite victims. The survey instrument was programmed into KoBoCollect software and administered to snakebite victim of household heads using the one-on-one interview method. Mainly descriptive statistical analytical analyses were conducted using STATA version 14.0. Results In this study, the lifetime number of snakebites reported was 394 (4.6%), while 164 (1.9%) and 41 (0.5%) snakebites reported in the last 5 years and one (1) year preceding the survey, respectively. The average age of a snakebite victim was 44 years. Snakebite victims were typically female (54%), married (59%), and mainly engaged in farming (73%) for livelihood. Most snakebites occurred during the morning (42%), in the farm field/forest (66%) and along the victims’ lower limbs (88%). Over seven-in-ten victims sought first aid, with tourniquet (35%) mostly applied. Majority (69%) of victims sought treatment in a healthcare facility, mostly in Community-based Health Planning and Services (CHPS) compounds (32%). Conclusion Snakebites constitute a major public health concern in communities fringing the KCA, especially for those whose livelihoods revolve around agricultural activities. There is the need to establish and strengthen collaborative efforts among primary health authorities, forest conservation managers, and community leaders in the design and implementation of effective interventions to avert snakebite incidents and improve outcomes for victims. Author summary Snakebite envenomation is a serious yet underreported public health issue particularly in rural forest-fringe communities in Africa. Despite being reclassified by the World Health Organization as a Neglected Tropical Disease, snakebite remains poorly documented in Ghana, especially in communities bordering protected forests where human-snake encounters are more likely. We surveyed over 1,400 households in 18 communities surrounding the Kakum Conservation Area in southern Ghana to understand how common snakebites are, the kind of people affected, and how they seek treatment after snakebites. We found a relatively high number of snakebites, mostly affecting adult farmers while working on their farms or in nearby forests. Bites typically occurred on the legs and were often followed by symptoms such as swelling and bleeding. While over two-thirds of victims received some form of formal medical care, some continued to seek traditional remedies even after visiting a health facility. Our findings suggest snakebite is a persistent health threat in rural forest-fringe communities and that health-seeking behaviour after snakebite is shaped by a combination of accessibility, cultural beliefs, and resource limitations. Therefore, strengthening rural health systems and improving community education at the local level are crucial steps to reduce the burden of snakebite in Ghana and similar settings.