A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central Province of Sri Lanka

Karunanayake, Roshini Kilanthi; Dissanayake, Dissanayake Mohottalage Randima; Karunanayake, A.L.

doi:10.1186/1756-0500-7-482

Cited by 23 publications

(30 citation statements)

References 15 publications

(44 reference statements)

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“…The most frequently bitten site in our study was the lower extremity (85.2%). Similar observations have been made in other studies [12,14]. But the study done by Aktar F [15] on snake bite envenomation in 151 children, most common location of bite was right forearm in 61.6% of children.…”

Section: Discussionsupporting

confidence: 89%

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Clinico-epidemiological profile of snake bite in children in a tertiary care hospital, South India

V.¹,

2018

Int J Pediatr Res

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Introduction: A high incidence of snake bite envenomation is observed in India, due to rapid urbanization and deforestation. Snake bite is a life-threatening conditionand remains a significant cause for hospital admissions in paediatric age group. Because of their smaller body mass, they have rapid systemic envenomation and high mortality rate. Methods: This is a descriptive type of study about clinical and epidemiological profile of snake bite cases in pediatric age group and also included unknown bites with features of snake bite envenomation. This was done for the period of one year from July 2015 to June 2016. Data about age, sex, bitesite, clinical features, complications, management and outcome were collected and analysed. Results: The study included 54 cases of snake bite victim. Majority were boys (64.8%). The common age group affected was 5-10 years (59%). Lower extremities were the most common site of bites (85%). 42.6% of cases had clinical features within 2 to 6 hours of snake bite. Bite admission interval was 6 hours. Prehospital treatment was employed in 10.3% of patients. In our study, 38.9 % of victimspresented with snake bite of unknown species, 39% known species of snakes and 22.1% were cases of envenomation, where the snake was not visualized. The commonest identified species were viper bite (n=11, 20.4%), followed by rat snake (n=7, 13%) and krait (n=3,5.6%). 23(42.6%) cases had dry bite. About 12 (22%) children had local cellulitis; 12 (22%) had combined cellulitis and hemotoxicity; 7 (13%) had neurotoxicity. In our study polyvalent Anti snake venom (ASV) was used in 55.6% of cases and 18.5% of victims developed hypersensitivity reactions to ASV. The case fatality was 11.1% and Krait was the main cause of mortality. Conclusions: Of the children presented with snake bite envenomation, the snake was visualized in majority of cases. Most of them developed clinical features in 2 to 6 hours ofbite. Cellulitis was the commonest presentation and polyvalent ASV was used for treatment. Neurotoxic Krait bite was the commonest cause of mortality.

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Section: Discussionsupporting

confidence: 89%

“…The epidemiological character in our study showed that more common victims in children were males when compared to females. Similar observation was made by Karunanayake RK [14] in a study on 54 children with snake bite envenomation.…”

Section: Discussionsupporting

confidence: 84%

Clinico-epidemiological profile of snake bite in children in a tertiary care hospital, South India

V.¹,

2018

Int J Pediatr Res

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“…Studies on pediatric snake bite victims were limited, however similar observation was seen by Kshirsagar et al and Karunanayakeet al with 89% and 48% children more than 5 yearsrespectively 5,6 . The mean age of 10.7 years is reported by Schulte et al 6 .Larger proportion of the victims were males (61.4%) and the male to female ratio was 1.6:1. This correlates with various studies with higher incidence in males.…”

Section: Discussionmentioning

confidence: 76%

Snake bite in Children: A retrospective study in a tertiary care centre in Southern India

Sivagami¹

2017

JMSCR

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“…In a study conducted by Karunanayake et al in Sri Lanka highest numbers of bites (48%) were in the range of ages 6-12 years. 5 Maximum number of snake bite occurred during the months of June (24%) and July (16%), together constituting 40% of the total. Another peak was observed during October (12%).…”

Section: Discussionmentioning

confidence: 99%

A clinical profile of poisonous snake bite in children of North Kerala, India

Shyna

K²,

Mohammed³

2018

Int J Contemp Pediatr

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Background: Snake bite is a common medical emergency and underestimated public health problem causing significant morbidity and mortality worldwide. Poisonous snake bite is a common problem in north Kerala and a significant number of children are bitten by snakes every year. Majority of studies in this respect have been done on adult snake bite victims and only limited studies are available based on poisonous envenomation in children in our region. The clinical profile of snake bite in children can differ significantly from adult snake bite victims so study was conducted to find the clinical profile of poisonous snake bite in children less than fifteen years. Methods: This was a descriptive cross-sectional study conducted in a tertiary care academic institution located in the northern part of Kerala from December 2009 to November 2010. All children less than 15 years with poisonous snake bite were included in this study. Patients with non-poisonous bite, without signs of envenomation and with preexisting bleeding and renal disorders were excluded. Results: There were fifty cases of poisonous snake bite and among them 76% were males and 24% were females. The highest numbers of bites (50%) occurred in the age group between 11-15 years. Maximum number of snake bite occurred during the months of June and July. The majority of the bites occurred during night between 6 pm to 9 pm (42 %). Among the identified venomous bite Viper accounted for the highest number (48%), followed by Krait (12 %) and Cobra (4%). Lower extremities were the most observed bitten part of the body (82%) and the commonest site was foot. Eighty-four percentage of victims reached hospital within 6 hours of snake bite. The most common clinical manifestation was local pain (94%) followed by swelling (90%) and regional lymphadenopathy (82%). Majority had hemotoxicity (94%) and neurotoxicity (6%) was comparatively lesser in our study. Most common complication was overt bleeding manifestations (14%) followed by gangrene of bite site (8%), acute kidney injury (6%) and respiratory paralysis (2%). Thirty eight percent of cases required more than 10 vials of ASV and reaction to ASV occurred in 40% of cases. No mortality occurred during this study period. Conclusions: Poisonous snake bite is a common life threatening medical emergency in our region. Morbidity and mortality due to this can be reduced by early administration of anti-snake venom and prompt recognition and management of complications. So, prompt referral of children with poisonous snake bite to centres where facilities in managing snake bite is crucial in preventing mortality.

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A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central Province of Sri Lanka

Cited by 23 publications

References 15 publications

Clinico-epidemiological profile of snake bite in children in a tertiary care hospital, South India

Clinico-epidemiological profile of snake bite in children in a tertiary care hospital, South India

Snake bite in Children: A retrospective study in a tertiary care centre in Southern India

A clinical profile of poisonous snake bite in children of North Kerala, India

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