ABSTRACT
Background: Snakebite is a public health problem afflicting mainly rural farmers. We seek to examine the profile and management of snakebite cases presenting to the Tamale Teaching Hospital of Ghana over a 30-month period.Methods: One hundred and ninety-two cases of snakebites presenting to the Tamale Teaching Hospital over a 30-month period from January 2016 to June 2018 were retrospectively analyzed. Information about the clinical manifestation of the snakebites, treatment instituted as well as the outcome was extracted from patient folders for the analysis.Results: Out of the 192 cases of snakebite, 131 (68.2%) occurred in males. The mean age of the victims was 26.5 years. The major patterns of envenomation were coagulopathy (84.9%) and local swelling/pain (82.8%). The causative snake species was identified in only 11.5% of cases, all of which were vipers. Antivenom was administered in 94.8% of the victims and the average amount administered was 84.64 milliliters (approximately 8 vials). Reaction to antivenoms was observed in 13.5% of cases, comprising mostly minor reactions. Antibiotics were utilized in 99.5% of cases with more than half receiving more than one type of antibiotic. Steroids use was common (62%) whilst 22.9% received antifibrinolytics despite the absence of evidence supporting their use in snakebite.Conclusions: Snakebite is an occupational health hazard of mainly rural farmers. The unwarranted use of non-beneficial medications is still rife. In addition to ensuring the continuous availability of effective antivenoms, there is the need for the development and adherence to protocols that take into consideration the prevailing local conditions.
ABSTRACT
<p><b>OBJECTIVE</b>In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana.</p><p><b>METHODS</b>In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.</p><p><b>RESULTS</b>Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana.</p><p><b>CONCLUSION</b>In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.</p>