Barriers to Timely Care Associated with Complications of Snakebite Envenomation amongst Farmers in Northeastern Nigeria

BACKGROUND: Delays in seeking medical care after snakebites are common in rural areas and worsen the risks of complications, disability and death. In North-eastern Nigeria, subsistence farmers struggle to access prompt treatment due to financial, geographic and cultural barriers, posing a public health issue. AIM: We assessed the barriers to timely care associated with the complications of snakebite envenomation amongst farmers in Northeastern Nigeria. SETTINGS AND DESIGN: A community-based, sequential explanatory mixed-methods study was conducted in Kaltungo Local Government Area, a recognised hotspot for carpet viper bites. MATERIALS AND METHODS: Farmers aged 15+ years were surveyed with an interviewer-administered semi-structured questionnaire. Six focus group discussions (FGDs) explored experiences, care-seeking behaviours and barriers to treatment. Statistical analysis included descriptive statistics to summarise the sociodemographic data and bite patterns. Relationships between barriers to care and complications were examined using the Chi-square or Fisher's exact test, followed by multivariable logistic regression to control for confounding factors and determine the independent associations. P < 0.05 was deemed statistically significant. RESULTS: Snakebite prevalence was 42.3% ( n = 160), with 95% reporting symptoms and 91.9% having prolonged complications. Barriers included financial issues (75.5%), transportation (80.9%) and low danger perception (65.5%), all linked to complications ( P < 0.05). FGDs cited hospital cost fears, distance, traditional healer reliance and seasonal exposure as key delay factors. CONCLUSIONS: Snakebite envenoming remains a health threat for rural farmers, worsened by financial, transportation and sociocultural barriers. Improving health insurance, decentralising antivenom and enhancing health education are crucial for better outcomes.