# Health professionals’ knowledge, attitudes, and practices in snakebite management: A study from high-burden areas in the Afar Region, Ethiopia

## TL;DR

Healthcare workers in Ethiopia's Afar Region lack training and resources for managing snakebites, leading to poor patient outcomes.

## Contribution

The study identifies specific gaps in snakebite management training, antivenom availability, and clinical protocols among healthcare professionals in a high-burden region.

## Key findings

- Only 1.4% of healthcare professionals had received snakebite management training.
- 56% of respondents reported antivenom unavailability due to high cost and shortages.
- Standardized protocols and follow-up care for snakebite patients were lacking in most facilities.

## Abstract

Snakebite envenoming remains a significant public health challenge, particularly in rural and resource-limited tropical regions such as sub-Saharan Africa. In Ethiopia, the Afar Region bears a disproportionate burden due to environmental exposure, pastoralist livelihoods, and limited access to timely medical care. This study aimed to assess the knowledge, attitudes, practices (KAP), and capacity gaps among healthcare professionals in selected snakebite hotspot areas of the Afar Region.

A cross-sectional descriptive study was conducted in five hospitals across snakebite hotspot areas in Afar. A purposive sample of 141 healthcare professionals selected, including nurses, doctors, and other clinical staff. Data were collected using structured questionnaires addressing knowledge of envenoming, antivenom use, clinical management protocols, and facility readiness.

Among the healthcare professionals surveyed, nurses comprised the largest group (61%), followed by medical doctors (30.5%), with the majority of respondents (54.6%) having less than three years of professional experience. Despite their frontline role, only 1.4% of participants had received specific training related to snakebite management, while 48.9% expressed need for such training. Antivenom unavailability reported by 56% of respondents indicating high cost (17%) and frequent shortages (25.5%) as key barriers to access. Standardized clinical protocols and post-discharge follow-up practices were lacking, with 61% of care providers reporting patients did not receive any follow-up care. Snakebite cases were regularly encountered, with 36.2% of respondents indicating monthly cases and 31.2% weekly. Although antivenom was the primary first-line treatment (60.3%), the use of diagnostic methods to support case identification was not available.

This study highlights critical deficiencies in healthcare provider training, clinical capacity, and practical experience for effective snakebite case management. Addressing these gaps requires urgent implementation of targeted training programs, development of standardized treatment protocols, and reinforcement of antivenom supply systems. Integrating snakebite management into medical and health science curricula is essential to build sustainable clinical competency and enhance patient outcomes in high-burden settings.

Snakebite envenoming is a major public health problem in many low-resource settings, causing significant morbidity and mortality, yet it often receives limited attention in healthcare training. This study assessed the knowledge, attitudes, and practices of healthcare professionals involved in snakebite management in high-burden areas of the Afar Region, Ethiopia. Using a cross-sectional survey, we included doctors, nurses, and laboratory personnel who play active roles in patient care, from first response to follow-up. Our findings revealed critical gaps as very few healthcare workers had received specific training on snakebite, antivenom availability was limited, and standardized management protocols were often lacking. Laboratory staff, in particular, contribute directly to patient assessment and antivenom preparation, highlighting the multidisciplinary nature of care in resource-limited settings. These results emphasize the need for targeted training programs, improved antivenom supply, and integration of snakebite management into medical education, to reduce complications and improve outcomes for affected communities.