Characteristic and outcomes of human and animal bites in Malawi. Issue 8 (August 2021)

• Record Type: Journal Article
• Authors: Williams, Brittney M.; Purcell, Laura; Kayange, Linda; Gallaher, Jared; Charles, Anthony
• Is Part Of: Injury. Volume 52:Issue 8(2021)
• Page Start: 2188
• Page End: 2193
• Publication Date: 2021-08
• Subjects: Animal bites -- human bites; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2021.03.045
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: Bite injuries account for 3% of the trauma burden at a Kamuzu Central Hospital, a tertiary care center in Malawi. Animal bites in Malawi result in more serious complications than human bites, such as amputation and in rare cases, death. In addition to the expected risk of bites on a farm, domestic animals pose an increased risk of bites in Malawi. Alcohol-related, in-home interpersonal violence is a risk factor for suffering a human bite. Abstract: Introduction: Bites are an important contributor to traumatic injury worldwide. In low- and middle-income countries, data regarding bite injuries outside of rabies is limited. Therefore, we sought to describe the injury characteristics and outcomes of bites in Lilongwe, Malawi, and determine risk factors for animals and human bites. Methods: We performed a retrospective analysis of the Kamuzu Central Hospital trauma registry from 2008-2018. We performed Bivariate analyses comparing bite to non-bite trauma and human to animal bites. Multivariable Poisson regression modeling then estimated risk factors for bites. Results: A total of 124, 394 patients were captured by the registry, of which 3, 680 (3%) had a bite injury mechanism. Human bites accounted for 14.5% of bite injuries, and animals represented the remaining 85.5%. In rare cases, animal bite victims had serious complications, such as amputation (n = 6, 0.2%), orthopedic procedures (n = 5, 0.2%), and death (n = 7, 0.2%). Risk factors for an animal bite included being on a farm, field, or lake and being at home, whereas risk factors for a human bite included alcohol use and being at home. Conclusion: Animal bite injuries in Malawi can confer a risk of serious complications, such as amputation and, in rare cases, death. Alcohol-associated, in-home interpersonal violence is a significant risk factor for human bite injuries. Further studies are needed to identify risk factors for complications and mortality.