# Snakebite knowledge among healthcare workers in Gabon: A health facility-based cross-sectional survey

## TL;DR

Healthcare workers in Gabon show significant gaps in snakebite knowledge, with many using incorrect practices and struggling to identify venomous snakes.

## Contribution

This study provides the first assessment of snakebite knowledge among healthcare workers in Gabon's Ogooué et des Lacs region.

## Key findings

- 40% of healthcare workers scored below 50% on symptom recognition questions.
- 66% scored below 50% on management practices, with many recommending tourniquets and venom aspiration.
- Healthcare workers at secondary facilities performed better than those at primary facilities.

## Abstract

Snakebite envenoming remains a neglected health issue in many countries, including Gabon, where the limited availability of snakebite-specific training, clinical guidelines, and essential resources at health facilities may lead to gaps in healthcare workers’ knowledge and confidence and the use of non-recommended treatment practices. This study aimed to assess healthcare workers’ knowledge of snakebite management in the Ogooué et des Lacs department of Moyen-Ogooué province in Gabon.

From June to August 2023, we conducted a cross-sectional survey targeting all healthcare workers in Ogooué et des Lacs who may be involved in snakebite management. We collected information on prior training, self-perceived knowledge of snakebite management, symptom recognition, clinical management practices, and snake identification. Knowledge was assessed using 10 true/false symptom questions and 12 management questions, with one point assigned for each correct response. Generalised linear binomial regression modelling was used to evaluate associations between knowledge and participant characteristics.

A total of 171 healthcare workers (78% of those eligible) participated. Overall, 40% (68/171) scored below 50% on symptom questions, and 66% (113/171) scored below 50% on management questions. Inappropriate practices were frequently recommended, including tourniquet use (70%, 120/171) and venom aspiration (73%, 125/171). Nurse assistants and nurses had a lower odds of correct responses than doctors (OR: 0.68, 95% confidence interval (CI): 0.55-0.84, and OR: 0.78, 95% CI: 0.62-0.98, respectively), while healthcare workers at secondary health facilities performed better than those at primary health facilities (OR: 1.23, 95% CI: 1.04-1.46). Venomous snakes were correctly identified as such in 74% (109/148) of responses, compared with 28% (42/148) for non-venomous snakes.

Gaps in snakebite knowledge and management were identified among healthcare workers in the study region. Targeted training, national clinical guidelines, and improved access to antivenom are needed to strengthen snakebite management in Ogooué et des Lacs and potentially more broadly in Gabon.

Snakebite envenomation remains a neglected public health issue in many countries, including Gabon, where healthcare workers often face significant gaps in the training and resources needed for effective case management. In this study, we aimed to survey all healthcare workers in the department of Ogooué et des Lacs in the Moyen-Ogooué province of Gabon who, in their current role, could be involved in snakebite management. We assessed prior snakebite training and experience and evaluated knowledge of snakebite symptoms, treatment practices, local snake species identification, and familiarity with existing clinical guidelines. Using a structured questionnaire, we found that 40% of respondents scored below 50% on questions related to snakebite symptoms, and two-thirds scored below 50% on management practices. Many health workers also struggled to identify venomous snakes from photographs. These findings highlight important gaps in snakebite knowledge among healthcare workers in this setting and underscore the need for comprehensive and ongoing training programs and the development of standardised national guidelines for snakebite management. Strengthening healthcare workers’ knowledge and clinical competencies in this area could improve the clinical outcomes for snakebite patients in Gabon.