Introduction Snakebite is a significant public health issue in the Lao People's Democratic Republic (PDR), with victims often seeking traditional healers due to inadequate antivenom supply and high out-of-pocket (OOP) expenses, contributing to inequities between urban and rural populations.Methods An extended cost-effectiveness analysis (ECEA) was conducted to evaluate the distributional impact of improving access to antivenom in urban and rural Lao PDR, where all victims with systemic envenoming clinically indicated for antivenom receive antivenom at conventional hospitals, on disease burdens (deaths and disability-adjusted life years [DALYs]) and economic burden (%household OOP expenditure per monthly income). Sensitivity analyses were performed.Results Rural areas had higher mortality (3.14 vs. 0.35, +2.79 per 100,000 population), DALYs lost (78.97 vs. 8.86, +70.11 per 100,000 population), and household OOP expenses (39% vs. 38%, +1% of household monthly income) than urban areas. Full access to antivenom reduced health inequities in mortality (from +2.79 to +1.22 per 100,000 population) and DALYs (from +70.11 to +32.14 per 100,000 population) but increased inequities in household OOP expenses (from +1% to +39% of household monthly income). These differences had considerable uncertainties. Sensitivity analyses showed that free snakebite treatment and transportation costs with one caregiver reduced household OOP expenses in both areas (5% rural, 6% urban).Conclusions While improving access to snake antivenom mitigates health inequities in disease burden, it exacerbates financial inequities between urban and rural areas. Policies targeting equitable access to care and financial protection are critical to achieving health equity for snakebites in the Lao PDR.

Snakebite envenoming in pregnant women is rare, accounting for approximately 0.5-1.8% of all snakebite cases. A thirty-year-old six months pregnant woman was admitted to Setthatirath Hospital in Vientiane Capital, Lao People's Democratic Republic 2 h after a Malayan pit viper bite at her right lower leg. She developed extensive local swelling affecting the entire right leg and a severe coagulation disorder with clinical signs of bleeding, requiring ten blood transfusions. Due to antivenom shortage only one vial of Hemato Polyvalent snake antivenom produced at Queen Saovabha Memorial Institute (QSMI) in Bangkok, Thailand was given shortly after admission although the recommended initial dose in case of Malayan pit viper envenoming is at least three vials. The patient received ten units of fresh frozen plasma and six platelet transfusion without effect on the unmeasurable prothrombin time or the platelet count of less than 20,000/μl. On day nine, two additional vials of monovalent Malayan pit viper antivenom produced at QSMI were given which eventually normalized the coagulation disorder. There was no vaginal bleeding and repeated ultrasound examinations showed a single live intrauterine pregnancy with a foetal size consistent to a gestational age of 26 weeks. A healthy baby was born three months after the snakebite but the mother retained a permanent nervus peroneus paresis on her right lower leg.

Objective: Snakebite envenoming remains a public health threat in many tropical countries. While community knowledge of local snakes and snakebite first-aid and prevention are needed to reduce snakebite incidence and improve the outcomes for snakebite patients, it is poor in many communities. We assessed community health workers and community members regarding their knowledge on local snakes, snakebite first-aid and prevention in Neno district, Malawi. Methods: In November 2022, we conducted a cross-sectional survey among 312 community health workers and 379 community members in the Neno District of Malawi to assess their knowledge of snake identification, snakebite first-aid, and prevention. Different questions were asked in these sections and summarised as linear scores ranging from 0% to 100%. Scores of 0%-49%, 50%-70%, and >70% were considered inadequate, fairly adequate, and adequate, respectively. Along with data collected during knowledge assessments, the socio-demographic characteristics of participants were collected. To assess knowledge differences between community health workers and community members, Pearson's chi-square or Fisher's exact tests were used, and linear regression was calculated to investigate possible predictors of knowledge. Results: Overall, 66.6% of participants were females with a median age of 39 (IQR = 30-48) years. Of the 89% (n = 615) who agreed to view snake pictures, only 1.3% had adequate snake identification knowledge. Less than 5% (n = 33) had adequate knowledge of first aid measures, and 14.3% (n = 99) had adequate knowledge of prevention practices. Overall, less than 1% (n = 3) had adequate knowledge across the three assessment sections, with no significant difference between community health workers (n = 1, 0.3%) and community members (n = 2, 0.5%) (p > 0.949). Conclusion: Both community health workers and community members had inadequate knowledge regarding local snake species, first aid for snakebites and prevention measures. The effect of awareness campaigns and other education initiatives could be explored to help improve these gaps.

Neuromuscular paralysis because of snakebite envenoming is a life-threatening and common clinical syndrome caused by most elapids (family Elapidae) and few species of pit vipers and true vipers (family Viperidae) [1].In Southeast Asia, cobras and kraits are responsible for most cases of neurotoxic envenoming.Two major neurotoxin classes, alpha-neurotoxins (α-NTs) and beta-neurotoxins (β-NTs), target the neuromuscular junction and cause flaccid muscle paralysis [2].Beta-neurotoxins belong to the group I phospholipases A 2 and act at the presynaptic motor nerve terminal.They are the major neurotoxins in krait venom and cause synaptic vesicle depletion with declining acetylcholine release and degeneration of the nerve terminal [3].Phospholipases A 2 have a molecular mass of 13 to 16 kDa which corresponds to 115 to 125 amino acids [2].After subcutaneous injection of venom during the bite, toxins are resorbed from the interstitial space into the blood circulation either directly or through lymphatic vessels and leave the blood circulation to reach and act at the neuromuscular junction [4,5].The small molecular size of neurotoxins facilitates the journey and most victims develop neurotoxic signs within 6 h after the bite [6].Once neurotoxic signs are present and nerve terminals damaged, administration of antivenom will likely be ineffective.Here, we propose the administration of antivenom to all patients with a confirmed krait bite who present within the first 6 h after the bite, regardless of neurotoxic signs, and present arguments for this approach. Frequency of neurotoxic signs and duration of muscle paralysis after krait envenomingFlaccid muscle paralysis of varying degrees is the major clinical symptom caused by β-NTs in krait venom.This becomes life-threatening when respiratory muscles are affected and immediate intubation and mechanical ventilation are necessary to save the victim's life.Krait bite envenoming often leads to prolonged failure of neuromuscular transmission caused by morphological damage to motor neuron endings.Animal studies in rats found full recovery of muscle strength 7 days after β-bungarotoxins were injected into the musculus soleus, without the use of antivenom [3].In a retrospective case series of patients bitten by Bungarus species in Thailand, including 68 bites of Bungarus candidus, 9 of Bungarus fasciatus, and 1 of Bungarus flaviceps, 88.6% of the patients showed neurotoxic signs within the first 8 h after the bite and 76% required mechanical ventilation (Table 1).The median time between bite and antivenom administration was 5 h and the median time on the ventilator was 6 days [6].

Background: Interdisciplinary approaches are particularly important when it comes to complex research areas such as snakebite envenoming. To achieve the World Health Organization's (WHO) goal of halving the number of deaths and disabilities from snakebite by 2030, researchers and experts from different fields need to work together. To promote interdisciplinarity in snakebite research and educational work, a one-week hybrid summer school was organised in September 2023 at the Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany. The week's topics were arranged logically, from snake biology and venomics to clinical implications, new therapeutics and public policy. All lectures were held in English. Methodology/Principal Findings: Attendance was recorded for in-person and online participants, transcribed into Excel, and anonymised. Data were then summarised according to the participant's field of expertise, country of residence, and attendance at each session. Results: The summer school successfully promoted interdisciplinarity, with individuals attending from a wide range of scientific fields. However, fluctuations in attendance over the week highlight some challenges in maintaining interdisciplinarity at such events. By mode of attendance, in-person participants attended more of the sessions (76.9%) than those joining in a hybrid format (50.0%) or online only (32.0%).  Among those who did not attend all sessions, attendance was highest on Monday (77.6%) and Wednesday (81.3%) but decreased for individuals from all fields over the week. Conclusion/Significance: For future international interdisciplinary events, we suggest hybrid events with in-person and online options to encourage more international participation, supported by travel grants. However, the online experience could be improved through online networking and interdisciplinary activities. Future events should also consider hosting events in low- and middle-income countries or satellite locations. An appeal to organizers of future events is that participant data should be collected, analysed and published for continuous improvement of such interdisciplinary events.### Competing Interest StatementThe authors have declared no competing interest.### Funding StatementYes### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:A protocol for analysis of the data was submitted to the Ethics Committee of the Hamburg State Medical Association for approval. In view of the fact that the data subject of the study was anonymised and can no longer be attributed to a human being, the committee approved the project as not requiring consultation with the Ethics Committee of the Hamburg Medical Association (2023-300415-WF).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesThe underlying data is available on request.

Snakebite envenoming (SBE) is a neglected tropical disease (NTD). Community-based studies from sub-Saharan Africa are urgently required as data on the incidence are scarce. This study aimed to determine the lifetime prevalence of snakebites in rural Gabon by preparing the conduct of a larger regional survey. A cross-sectional community-based epidemiological survey in Sindara, Ngounie province, was conducted. Households were interviewed about the history of snakebites of household members to calculate lifetime prevalence. In addition, the average annual incidence rate per 100,000 over the last 5 years was calculated. A total of 771 inhabitants were enrolled, of which 5 (0.65%; 95% confidence interval (95% CI: 0.2–1.5%)) were victims of snakebites. Over the past 5 years, annual incidence was 77 bites per 100,000 (95% CI: 0–620). This study provides a first rough estimate of the incidence of SBE from rural central Gabon, demonstrating the importance of this NTD. Key Contribution: The estimated annual incidence of snakebites found was 77 per 100,000. Snakebites occurred mainly during agricultural activities.

Objectives: To evaluate the safety and efficacy of expired lyophilized snake antivenom of Thai origin during a medical emergency in 2020/2021 in Lao People's Democratic Republic. Methods: Observational case series of patients with potentially life-threatening envenoming who consented to the administration of expired antivenom between August 2020 and May 2022. Results: A total of 31 patients received the expired antivenom. Malayan pit vipers (Calloselasma rhodostoma) were responsible for 26 (84%) cases and green pit vipers (Trimeresurus species) for two cases (6%). In three patients (10%) the responsible snake could not be identified. Of these, two presented with signs of neurotoxicity and one with coagulopathy. A total of 124 vials of expired antivenom were administered. Fifty-nine vials had expired 2-18 months earlier, 56 vials 19-36 months and nine vials 37-60 months before. Adverse effects of variable severity were observed in seven (23%) patients. All 31 patients fully recovered from systemic envenoming. Conclusions: Under closely controlled conditions and monitoring the use of expired snake antivenom proved to be effective and safe. Discarding this precious medication is an unnecessary waste, and it could be a valuable resource in ameliorating the current shortage of antivenom. Emergency use authorization granted by health authorities and preclinical testing of expired antivenoms could provide the support and legal basis for such an approach.

BACKGROUND:The estimated five million snakebites per year are an important health problem that mainly affect rural poor populations. The global goal is to halve both mortality and morbidity from this neglected tropical disease by 2030. Data on snakebite morbidity are sparse and mainly obtained from hospital records.METHODS:This community-based study was conducted among 379 rural residents with or without a history of snakebite in the Ashanti and Upper West regions of Ghana. All participants in the snakebite group were bitten at least six months before the day of survey. The World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Buruli Ulcer Functional Limitation Score were used to obtain patient-reported measure of functioning and disability. Long-term consequences were evaluated based on the severity of the symptoms at the time of the snakebite.FINDINGS:The median (IQR) time since the snakebite was 8.0 (3.5-16.5) years. The relative risk of disability was 1.54 (95% CI, 1.17-2.03) in the snakebite group compared to the community controls. Among patients with clinical symptoms suggesting envenoming at the time of bite, 35% had mild/moderate disabilities compared to 20% in the control group. The disability domains mainly affected by snakebite envenoming were cognition level, mobility, life activities and participation in society. A combination of the severity of symptoms at the time of the bite, age, gender and region of residence most accurately predicted the odds of having functional limitations and disabilities.CONCLUSION:The burden of snakebite in the community includes long-term disabilities of mild to moderate severity, which need to be considered when designing appropriate public health interventions. Estimating the total burden of snakebite is complicated by geographic differences in types of snakes and their clinical manifestations.

Snakebite envenoming remains a public health threat in many African countries, including Malawi. However, there is a shortage of literature on the knowledge of Health Care Workers (HCWs) and the prevalence of snakebite cases in Malawi. We interviewed HCWs in Neno District to assess their knowledge of snake identification and management of snakebites. We further reviewed patient registers from 2018 to 2021 in all 15 health facilities in the district. We used descriptive statistics to characterize the survey population, knowledge, snake antivenom (SAV) administration, and snake identification. Using "shapefiles" from Open Street Maps, we mapped villages with snakebite cases. Of the 105 HCWs interviewed, 58% were males, and 60% had worked for less than five years. The majority (n = 93, 89%) reported that snakebite envenoming was a problem in the district. Among the clinicians, 42% said they had prescribed SAV previously, while among nurses, only 26% had ever administered SAV. There were discrepancies among clinicians regarding the dosing of snake antivenom. Significant gaps in knowledge also existed regarding snake identification. While two-thirds of HCWs could correctly name and identify venomous snake species, most (> 90%) failed for non-venomous snakes. Most (n = 100, 95%) reported that snakebite victims visit traditional healers more than the hospital. Between 2018 and 2021, the Neno District registered 185 snakebites with a yearly average of 36 cases per 100,000 population. Fifty-two percent (n = 97) were treated as an inpatient; of these cases, 72% were discharged in less than three days, and two died. More snakebite cases were recorded in the eastern part of the district. Significant knowledge gaps exist among HCWs in Neno regarding prescription and administration of SAV and snake identification, which likely challenges the quality of services offered to snakebite victims.

IntroductionSnakebite envenoming is a neglected tropical disease posing public health challenges globally. The Association of Southeast Asian Nations (ASEAN) countries are among the tropical regions with disproportionately high incidence of snakebite. Hence, this study aimed to review the situation of snakebite, antivenom market and access to antivenoms in ASEAN.MethodsThis mixed-methods study included comprehensive literature review and in-depth interviews with key informants to assess the situation of management system of snakebite, antivenom market and access to antivenoms in seven ASEAN countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR and Myanmar. Data were analysed by a framework method.ResultsASEAN have developed various strategies to improve outcomes of snakebite victims. Five domestic antivenom manufacturers in the region produce up to 288 375 vials of antivenoms annually with the value of US$13 058 053 million which could treat 42 213 snakebite victims. However, there remain challenges to be addressed especially the lack of snakebite-related informatics system, inadequate antivenoms at the healthcare facilities and when the majority of snakebite victims seek traditional healers instead of conventional treatment.ConclusionImproving the situation of snakebite and antivenom is not only about the availability of antivenom, but the whole landscape of surrounding management and supporting system. The assessment of the situation of snakebite and antivenom is crucial for countries or regions where snakebites are prevalent to recognise their current standpoint to inform the development of strategies to achieve the goal set by the WHO of halving the global burden of snakebite by 2030.

Understanding the burden of snakebite is crucial for developing evidence-based strategies to pursue the goal set by the World Health Organization to halve morbidity and mortality of snakebite by 2030. Therefore, this study aimed to estimate economic and disease burden of snakebite in South East Asia. A decision analytic model was developed to estimate burden of snakebite in 2019 in seven countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR, and Myanmar. Country-specific input parameters were sought from published literature, data from the country’s Ministry of Health, unpublished local data, and expert opinion. Economic burden was estimated from the societal perspective. Costs were expressed in 2019 US Dollars (USD). Disease burden of snakebite was estimated as disability-adjusted life years (DALYs). Probabilistic sensitivity analysis was performed for 1,000 iterations to estimate a 95% credibility interval (CrI) of burden of snakebite. There are five antivenom manufacturers in South East Asia, including Thailand, Indonesia, Philippines, Vietnam, and Myanmar. However, antivenoms were not enough to treat all snakebite victims. We estimated that there were 242,648 snakebite victims (95%CrI 209,810-291,023) of which 15,909 victims (95%CrI 7,592-33,949) were dead and 954 victims (95%CrI 383-1,797) were amputated. Annual disease burden of snakebite was estimated at 391,979 DALYs (95%CrI 187,261-836,559 DALYs). Total costs of snakebite were estimated at 2.5 billion USD (95%CrI 1.2-5.4 billion USD) which were equivalent to 0.09% (95%CrI 0.04-0.20%) of the region’s gross domestic product. More than 95% of the estimated burden was attributed to premature deaths. Our estimates highlighted the high burden of snakebite in South East Asia despite the availability of domestically produced antivenoms. Almost all of the estimated economic and disease burdens were attributed to premature deaths from snakebite envenoming which suggested that the remarkably high burden of snakebite could be averted by increasing access to antivenom.

Background Understanding the burden of snakebite is crucial for developing evidence-informed strategies to pursue the goal set by the World Health Organization to halve morbidity and mortality of snakebite by 2030. However, there was no such information in the Association of Southeast Asian Nations (ASEAN) countries. Methodology A decision analytic model was developed to estimate annual burden of snakebite in seven countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR, and Myanmar. Country-specific input parameters were sought from published literature, country's Ministry of Health, local data, and expert opinion. Economic burden was estimated from the societal perspective. Costs were expressed in 2019 US Dollars (USD). Disease burden was estimated as disability-adjusted life years (DALYs). Probabilistic sensitivity analysis was performed to estimate a 95% credible interval (CrI). Principal findings We estimated that annually there were 242,648 snakebite victims (95%CrI 209,810-291,023) of which 15,909 (95%CrI 7,592-33,949) were dead and 954 (95%CrI 383-1,797) were amputated. We estimated that 161,835 snakebite victims (69% of victims who were indicated for antivenom treatment) were not treated with antivenom. Annual disease burden of snakebite was estimated at 391,979 DALYs (95%CrI 187,261-836,559 DALYs) with total costs of 2.5 billion USD (95%CrI 1.2-5.4 billion USD) that were equivalent to 0.09% (95% CrI 0.04-0.20%) of the region's gross domestic product. >95% of the estimated burdens were attributed to premature deaths. Conclusion/Significance The estimated high burden of snakebite in ASEAN was demonstrated despite the availability of domestically produced antivenoms. Most burdens were attributed to premature deaths from snakebite envenoming which suggested that the remarkably high burden of snakebite could be averted. We emphasized the importance of funding research to perform a comprehensive data collection on epidemiological and economic burden of snakebite to eventually reveal the true burden of snakebite in ASEAN and inform development of strategies to tackle the problem of snakebite.

With an estimated 81 000-138 000 deaths each year, snakebite envenomat ion is the deadliest disease on the WHO list of neglected tropical diseases. Most snakebite envenomations occur in Asia and Africa, particularly in rural areas. The toxic effect is predominantly haematotoxic or neurotoxic. In addition, cytotoxins cause swelling and tissue necrosis. For specific therapy, antivenoms are used, which are usually obtained from equine serum. Access to antivenom is often not guaranteed, especially in low-and middle-income countries. In addition to education and practical recommendations, poverty re- duction is the best form of prevention. To achieve the WHO goal of reducing mortality by 50 % by 2030, free treatment with antivenom and education of the population on prevention are essential.

ZUSAMMENFASSUNG Mit jährlich geschätzten 81 000–138 000 Todesfällen sind Schlangenbissvergiftungen die tödlichste Erkrankung auf der WHO-Liste der vernachlässigten Tropenkrankheiten. Die meisten Schlangenbissvergiftungen treten in Asien und Afrika auf, vor allem in ländlichen Gebieten. Die Giftwirkung ist überwiegend hämatotoxisch oder neurotoxisch. Zudem verursachen Zytotoxine Schwellungen und Gewebsnekrosen. Zur spezifischen Therapie werden Antivenine eingesetzt, die meist aus Pferdeserum gewonnen werden. Der Zugang zu Antiveninen ist häufig nicht gewährleistet, vor allem in Ländern mit niedrigen und mittleren Einkommen. Neben der Aufklärung und praktischen Empfehlungen ist Armutsbekämpfung die beste Prävention. Um das WHO-Ziel einer Mortalitätsreduktion um 50 % bis 2030 zu erreichen, ist eine kostenlose Behandlung mit Antiveninen und eine Gesundheitsaufklärung der Bevölkerung zur Prävention essenziell.

Mục tiêu của nghiên cứu nhằm mô tả đặc điểm dịch tễ học rắn độc cắn, kiến thức, thái độ, thực hành và một số yếu tố liên quan về xử trí ban đầu của người dân khi bị rắn cắn tại tỉnh Thừa Thiên Huế năm 2017. Nghiên cứu mô tả cắt ngang một số yếu tố dịch tễ học với 36.182 đối tượng và đánh giá kiến thức, thái độ, hành vi của 400 người dân tại ba khu vực đồi núi; vùng trũng, ven biển và đầm phá; thành thị trên địa bàn Thừa Thiên Huế. Kết quả cho thấy: Ước tính tỷ lệ rắn cắn trên 100.000 người/năm lần lượt là 172 (95%-CI: 105–266), 69 (95%-CI: 33–117) và 10 (95%-CI: 1–56) tại 3 khu vực đồi núi; vùng trũng, ven biển và đầm phá; thành thị. Tỷ lệ bị rắn độc cắn trên toàn địa bàn tỉnh Thừa Thiên Huế là 62 (95%-CI: 17–199) trên 100.000 người/năm. Thái độ được đánh giá là “Tốt” ở 81% người dân tham gia, kiến thức và thực hành “Đạt” tương ứng là 36% và 8%. Trong phân tích hồi quy đa biến, có 2 yếu tố liên quan đến kiến thức xử trí ban đầu của người dân khi bị rắn độc cắn: Giới tính, nghề nghiệp; Có 2 yếu tố liên quan đến thái độ: Trình độ học vấn, khu vực sống; Có 3 yếu tố liên quan đến thực hành: Dân tộc, trình độ học vấn và khu vực sống (p <0,05).

Objectives Dengue virus (DENV) detection by polymerase chain reaction (PCR) facilitates diagnosis of dengue fever, which is the most frequent arboviral disease globally. Two studies were performed in countries with high dengue incidence, to assess the diagnostic performance of different PCR techniques. Methods/Results Two hundred and seventy-nine acute phase blood samples from febrile patients were analyzed for DENV by the RealStar Dengue RT-PCR kit (Altona Diagnostics) as gold standard in comparison with the Tropical Fever Core multiplex PCR (Fast Track Diagnostics). In total, 102 samples collected in Savannakhet Province (Lao PDR, Southeast Asia) in 2013 and 35 samples from Valledupar (Colombia, South America) tested positive for DENV by RealStar RT-PCR. In comparison, the Tropical Fever Core multiplex PCR detected 65.0% (65/102) and 68.6% (24/35) of these samples as positive for DENV in Savannakhet and Valledupar, respectively. Diagnostic sensitivity of the multiplex PCR strongly correlated with viral load. A subset of DENV PCR-confirmed samples was additionally tested by BNITM in house Dengue Type RT-PCR in comparison with two commercial test kits (RealStar Dengue Type RT-PCR [Altona Diagnostics], Dengue differentiation PCR [Fast Track Diagnostics]). The leading dengue serotype in Savannakhet was DENV-3 (58% [29/50]), while DENV-1 (53.8% [14/26]) was the predominant serotype found in samples collected in Valledupar by BNITM-type PCR. However, three DENV serotypes were circulating in Valledupar and in Savannakhet. In 2015, additional studies found predominantly DENV-4 (71% [12/17]) in Savannakhet. Conclusions Both studies emphasized that routine diagnostics in both regions will benefit from an expanded use of highly sensitive pan-dengue PCRs.

Background Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare. Method The study was approached from the interpretive paradigm with phenomenology as a methodology. Semi-structured interviews were conducted with 19 traditional healers who treat snakebite patients in two rural settings in Ghana. From the Ashanti and Upper West regions respectively, 11 and 8 healers were purposively sampled. Interview data was coded, collated and analysed thematically using ATLAS.ti 8 software. Demographic statistics were analysed using IBM SPSS Statistics version 26. Findings Snakebite was reportedly a frequent occurrence, perceived as dangerous and often deadly by healers. Healers felt optimistic in establishing a diagnosis of snakebite using a multitude of methods, ranging from herbal applications to spiritual consultations. They were equally confident about their therapies; encompassing the administration of plant and animal-based concoctions and manipulations of bite wounds. Traditional healers were consulted for both physical and spiritual manifestations of snakebite or after insufficient pain control and lack of antivenom at hospitals; referrals by healers to hospitals were primarily done to receive antivenom and care for wound complications. Most healers welcomed opportunities to engage more productively with hospitals and clinical staff. Conclusions The fact that traditional healers did sometimes refer victims to hospitals indicates that improvement of antivenom stocks, pain management and wound care can potentially improve health seeking at hospitals. Our results emphasize the need to explore future avenues for communication and collaboration with traditional healers to improve health seeking behaviour and the delivery of much-needed healthcare to snakebite victims.