RESUMO
Introduction: Dog bites continue to be a serious public health issue due to their association with the transmission of rabies virus. In Kenya, there are no studies estimating dog-bite incidence. Annual mortalities resulting from dog-mediated rabies are estimated at 523 (95% confidence interval 134-1100). The main objective of this study was to assess major risk factors associated with dog bites in Kitui South subcounty, Kenya, between 2017 and 2021. Methods: We recruited 387 dog-bite patients (cases) and 387 non-bite patients (controls) for the case-control study from the Mutomo Mission Hospital and the Ikutha Level 4 Hospital records. Multivariable logistic regression analysis evaluated the association between risk factors and dog-bite cases. In the final model, pairwise interactions among variables were evaluated. The model fit was evaluated using receiver operating characteristics and area under the curve. Results: The study found that the dog-bite incidence was highest in Kanziko ward in Kitui South subcounty. Fifty-one percent (108 bites) of dog-bite victims were children under 15 years of age, with 53% (N = 68) being men and 36% (N = 77) being bitten on the limbs. Dog bites mostly (44%, N = 93) occurred between October and December (short rainy season). Age group and season were identified as the most significant variables for high dog-bite incidence in Kitui South subcounty. Conclusions: Promotion of responsible dog ownership and reinforcement of dog control policies may prove more effective in reducing dog-bite injuries in Kitui South subcounty.
RESUMO
BACKGROUND: Seeking traditional remedies following snakebites leads to avoidable deaths in rural settings in developing countries. METHODS: In this case series study, we identified and recruited 169 snakebite survivors in Baringo county, a hard-to-reach region in northwestern Kenya, who experienced snakebites from 2010 to 2020 using a snowballing technique. We explored associations between traditional and hospital care in managing snakebites and other characteristics. χ2 tests assessed these categorical differences. RESULTS: Fifty-four (33%) of the survivors used traditional remedies to manage snakebites. The majority (56%) were men and aged >18 y (72%); 59% had low education levels and income. They sourced water from rivers or lakes (93%) and used charcoal as an energy source (74%). These survivors (>67%) resided in households practicing free-range and stall-feeding animal husbandry systems and in houses with thatch roofing or an earthen floor structure. Also, >62% reported muscle tremors, fever and chills, while 80% visited health facilities for further treatment. CONCLUSION: Community sensitization covering the risks of non-effective remedies and escalation of training to traditional healers could improve the speed of referrals in hard-to-reach snakebite hotspots. Medical anthropology studies could explore the enablers of continued use of traditional remedies in snakebite management in rural communities.
