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

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.