An Assessment of Snake Repellants and Snakebite Treatments Sold in Agro-Veternary Sector in Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda.

Snakebite envenomation is a neglected tropical disease predominantly affecting poor rural farmers and their animals. In Sub-Saharan Africa, over 268,000 people are envenomed by snakes annually with an estimated 138,000 deaths and a burden of 1.03 million Disability Adjusted Life Years. Research on the burden of snakebites on animals is limited with one study reporting over 47% global case fatality among animals bitten by snakes. However, there is sale of SRs in agro- veterinaries in East Africa as SBE preventative measures despite undocumented efficacy and safety. This cross-sectional quantitative study aimed to understand the cost, safety, and appropriateness of snakebite treatments (STs) and snake repellents (SRs) sold in agro-veterinary wholesale outlets in East Africa. In total 78 agro-veterinary wholesale workers were interviewed, and online searches of STs and SRs were conducted in Google, Bing, and Yahoo search engines as well as popular online shops. Collected information included product ingredients, country of origin, target snake species, claimed efficacy, and respondent opinions on products' efficacy and market demand. While no antivenoms were documented, a total of seven inflammatory medication and 98 mechanical and chemical SRs were identified. The SR median cost of application to standard farm size in East Africa equated to at least 9.5 workdays, based on the international poverty line of $2.15 per day. On average, the safety of 88.1% of the SRs identified could not be concluded from a One Health perspective due to a lack of information on formulation and ingredient concentration. No products were found to have scientific proof of efficacy in repelling African snakes. The use of acaricides, insecticides, and disinfectants as SRs was also noted in Kenya and Tanzania. Overall, this study highlights the presence of inappropriate SRs and of unknown safety which pose safety concerns to humans, animals, and environmental health, and cause farmer income loss.

Keywords: SBE, One Health, Agro-veterinary, Snake repellent, Snakebite treatment, Snake antivenom, Farmers