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A best-worst scaling statistical design of experiment study to model healthcare workers' prioritization of snake antivenoms available in sub-Saharan Africa for treating snakebite envenoming: Perspectives from Ghana

 


A best-worst scaling statistical design of experiment study to model healthcare workers' prioritization of snake antivenoms available in sub-Saharan Africa for treating snakebite envenoming: Perspectives from Ghana

Abstract

Introduction

In low- and middle-income countries (LMICs) with tropical or subtropical climates and a high poverty rate, the risk of snakebite envenoming (SBE) is high. Healthcare workers, together with patients, are the end-users of antivenom. This study aimed to assess healthcare workers' antivenom prioritization by providing quantitative evidence to guide policymakers to make better decisions to improve the procurement and supply of antivenoms, enhance the effectiveness of snakebite treatment, and improve patient care quality in Ghana.

Method

We gathered data through an interview-based survey, selecting a random sample of 203 healthcare workers from two districts in the Eastern Region of Ghana in August 2023. We employed the best-worst scaling method to evaluate how healthcare workers prioritize antivenoms.

Result

Participants highly prioritized Inoserp Pan-Africa polyvalent antivenom. Snake Venom Antiserum -PanAfrica is also commonly prioritized, followed by EchiTabPlus, ASNA antivenom D, ASNA antivenom C, Snake Venom Antiserum African, Anti Snake Venom Serum Pan Africa, and Fav-Afrique. However, some antivenoms are least commonly prioritized, such as SAIMR Echis, Combipack of Snake Venom Antiserum, Anti Snake Venom Serum Central Africa, Anti-Snake Venom Serum Central Africa, Snake Venom Antiserum Echiven Plus, Antivipmyn-Africa, Menaven, Snake Venom Antitoxin, Echiven, Anti Snake Venom Serum Monovalent Echis ocellatus, EchiTAbG, and VINS-Echis. In comparison to other antivenoms, Inoserp Pan-Africa is more frequently prioritized. At the same time, Snake Venom Antiserum - PanAfrica is less frequently prioritized but is still more likely than other options. EchiTabPlus is more likely to be prioritized than other antivenom options.

Conclusion

Our findings provide valuable insights to inform policy discussions on the use of available antivenoms in treating SBE. There is an urgent need to implement regulations on antivenom products, improve procurement and supply, and provide training to healthcare workers to combat SBE.
Nyarko, E., & Ameho, E. K. (2025). A best-worst scaling statistical design of experiment study to model healthcare workers' prioritization of snake antivenoms available in sub-Saharan Africa for treating snakebite envenoming: Perspectives from Ghana. Toxicon, 266, 108544. https://doi.org/10.1016/j.toxicon.2025.108544