Retrospective analysis of snakebite at a rural hospital in Zululand

Aspects of the epidemiology and clinical features of 81 consecutive patients admitted with snakebite to a rural hospital in Zululand are reviewed. Most bites occurred during the hot season, 40% in children under 10 years of age. Thirty per cent of bites occurred at night. Most bites showed features of local envenoming only, but systemic features (neurotoxicity and haemorrhage) were encountered. Snakebite caused significant morbidity and mortality. Thirty-one per cent of admissions needed surgery; almost 50% needed more than one operation. Five per cent, all children, died. The extent of local envenoming on admission proved to be a highly sensitive indicator of risk of worsening of local envenoming, and of the development of systemic signs. The analysis has allowed the development of rational guidelines on the management of snakebite in this hospital which, it is hoped, will reduce mortality rates, and has identified several areas warranting further research.