Pediatric snakebite in Sub-Saharan Africa: Clinical predictors, outcomes, and gaps in care—A systematic review

BACKGROUND: Snakebite envenomation (SBE) remains a significant but neglected public health problem among children in sub-Saharan Africa (SSA), with clinical predictors of severity and regional disparities in outcomes still poorly characterized. METHODS: We conducted a systematic review of peer-reviewed studies published from database inception to October 2024 on pediatric snakebite envenomation (SBE) in SSA, focusing on clinical and demographic predictors of severe outcomes. Data on study characteristics, SBE symptoms, risk factors, and outcomes were synthesized descriptively. RESULTS: Eighteen studies from six SSA countries were included (totaling 2,687 pediatric patients). Children affected were predominantly under 12 years, with a male predominance. Severe outcomes including death, amputation, and permanent disability were closely associated with delayed hospital presentation (> 6-12 hours), certain traditional first aid practices, young age (