Annual Incidence of Snake Bite in Rural Bangladesh

Abstract

BackgroundSnake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia.Methodology/Principal FindingsWe undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4–789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital.Conclusions/SignificanceIncidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted.

Procurement and Supply of Anti Snake Venom as a Determinant of Snake Bite Management Outcome at a Government Medical College Hospital in Karnataka

“…5 As evident in our study 189 patients (50.26%, n=376) were administered anti snake venom but later found that there was no envenoming. This is due to the fact that snake bite being a life threatening event the treating physician would prefer to err on the safer side rather than not taking the chance at all.…”

Knowledge, attitude and practice regarding snakes and snake bite among rural adult of Belagavi, Karnataka

“…16,19 It was encouraging to know that in the present study 364 (91%) of the participants did not consider going to a faith healer or quack as a treatment option after snake bite, this finding was similar to the study done by Pandey et al 4 While in other similar studies 86% of snakebite victims in Bangladesh, 75% in Pakistan, and 61% in Maharashtra, India still visit traditional healers. [20][21][22] In the present study it was found that 305 (76.25%) of the total participants offer milk to snakes brought by local Snake charmers on Nag Panchami festival which proves detrimental to the snake's health. Therefore awareness camps in laying emphasis on imparting basic knowledge about snake identification, snakebite prevention and clearing misconceptions should be held in schools, proper first aid methods for snakebites should be demonstrated through various outreach activities and increased awareness about snake and snakebite identification among heath care workers and general population should also be done.…”

A multicomponent strategy to improve the availability of antivenom for treating snakebite envenoming

“…Community-based surveys are especially valuable in that they lack the statistical biases inherent in hospital-based surveys. 8,9 ii) increasing access to antivenoms, particularly in rural areas, through mechanisms geared towards facilitating antivenom deployment, such as maintaining the cold chain (in the case of liquid antivenoms), sharing it with vaccination programmes, or improving coordination between rural health posts and central governmental offices. The clinical management of envenomings in primary-health-care facilities should be promoted.…”

“…Of those who are bitten, approximately 125 000 die and around 400 000 are left with permanent sequelae. 2,3,6,7 However, more recent nationwide community-based surveys in Bangladesh and India have shown that the scale of this problem is far greater than suggested by hospital-based statistics 8,9 and that these global figures greatly underestimate the actual incidence of snakebite envenoming and the resulting mortality and disability.…”