Snakebite-associated audiological sequelae: Rethinking care pathways in African health systems

Abstract

Snakebite envenomation remains one of the most neglected tropical diseases (NTDs), with clinical management primarily focused on survival and acute complications. While mortality and limb-related disability have been well documented, potential auditory and vestibular sequelae remain underexplored, particularly within African health systems. Emerging evidence, primarily from non-African settings, suggests that snakebite survivors may experience hearing loss and vestibular dysfunction; however, these outcomes are not routinely recognised or integrated into rehabilitation pathways. This article provides a conceptual public health perspective informed by existing literature and implementation considerations for hearing healthcare in snakebite management. It examines potential mechanisms of snakebite-associated audiological dysfunction and identifies gaps in surveillance, research and post-acute care within sub-Saharan Africa. We propose the integration of task-shifted and technology-supported audiological screening, referral pathways and rehabilitation services into snakebite care frameworks. Strengthening surveillance and incorporating functional outcomes into national NTD strategies may improve post-snakebite disability prevention and rehabilitation outcomes across African health systems.