Designing an intervention for snakebite prevention; a community-based participatory research approach

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Snakebite is extremely common in the rural areas of many tropical low-income countries. Many patients are bitten during cultivation of land, whilst herding livestock or when working in plantations. The rural location of most snakebites means that access to rapid care and treatment is very difficult and so outcomes are often poor. Prevention of snakebites in these populations is therefore crucial. We plan to build on preliminary work in Eswatini to explore how effective prevention programmes could be developed in occupational settings. We will look at the risk factors for snakebite in a number of high-risk occupational settings (eg agricultural companies, mining) in Rwanda and Eswatini. These two countries have been chosen to enable us to look at a range of settings and different species of snake to help ensure that any solutions that we find can be used in other countries as well. Community members will be heavily involved in the project; we will undertake group discussions and key informant interviews with community members, people affected by snakebite, employers and community leaders about their perception of the prevention of snakebite and the factors they think predicts success or failure of interventions. In partnership with the community, we will then design a pilot prevention intervention will be developed and undergo a pilot evaluation. The final product will be a co-designed prevention intervention which is feasible and acceptable for use and can be tested for its effectiveness in a subsequent trial.