Healthcare-seeking behaviour and use of traditional healers after snakebite in Hlabisa sub-district, KwaZulu Natal

OBJECTIVE: To quantify snakebite incidence in Hlabisa sub-district and examine healthcare seeking behaviour, focussing on the use of traditional healers and medications.METHODS: Snakebite incidence was calculated by retrospective register review at Hlabisa Hospital for the period 2000-2005 and at associated primary health care clinics for 2005. Fifty consecutive in-patient snakebite victims were interviewed. Treatment-seeking pathways, bite-to-admission times and factors associated with delay or use of traditional therapy were analysed.RESULTS: The annual hospital snakebite incidence was 53 bites per 100,000 population. In 2005, combined hospital and community incidence was 58 per 100,000. Eighty per cent of admitted snakebite victims used traditional medicine and 62.5% of these consulted a traditional health practitioner (THP). The median time until admission was 7 h 15 min (interquartile range: 4-14.25 h). The median time until THP consultation was 15 min (interquartile range 5-50 min). THP consultation was associated with bite-to-hospital admission delays of more than 6 h [relative risk: 1.82, 95% confidence interval (CI): 1.09-3.03, P = 0.0016). Non-statistically significant trends towards THP use were observed if hospital access was poor or if patients were younger than 9 years.