MGHD 2021

Background: Snakebite Envenomation (SBE) is a neglected tropical disease affecting over 2 million people globally. It presents a public health threat to the Rwandan community, both for humans and animals. Between 2017 and 2018, the Eastern province of Rwanda recorded the highest cases of snakebites among human victims (39%) compared to other provinces. Proper and timely management of SBE can be lifesaving but depends on victims’ health-seeking behavior. Therefore, this study was conducted to assess the health-seeking behaviors of SBE human victims and livestock owners whose animals were bitten in Bugesera District of Rwanda in 2020. Methods: A retrospective cross-sectional study was conducted between June and July 2021, among 395 snakebite victims from three sectors in Bugesera District, in the Eastern Province of Rwanda. A quantitative questionnaire was used to assess forms of care sought by snakebite victims in the study location. Results: Seeking care through informal sources was the most common source of care for snakebite victims, both human and livestock owners (96.1%), followed by seeking care from formal sources such as health facilities and veterinarians (5.4%). Nearly half (44.6%) of human victims considered trust in the service provider to be the most important factor affecting their choice of where to seek care. This was followed by proximity, affordability, and other factors such as recommendations from neighbors. Having health insurance in 2020 and past snakebite experience were significantly (p=0.017 and p=0.021 respectively) associated with the type of care sought. Conclusion: This study highlights care seeking behavior gaps impacting the effective management of SBE in Rwanda. The health-seeking behaviors not only affect access to timely treatment but presents a challenge to Rwanda’s 2024 roadmap to eliminate NTDs and reduce the national burden of SBE by 50%. Therefore, community education on recommended first-aid practices and appropriate health-seeking channels and collaborations with traditional healers, present important avenues through which Rwanda can disseminate formal care for snakebite victims