Geographical accessibility to the supply of antiophidic sera in Brazil: Timely access possibilities

Abstract

Snakebite accidents are considered category A neglected tropical diseases. Brazil stands out for snakebite accidents, mainly in the Amazon region. The best possible care after snakebite accidents is to obtain antiophidic sera on time. And the maximum ideal time to reach it is about 2 hours after an accident. Based on public health information and using a tool to analyze geographical accessibility, we evaluate the possibility of reaching Brazilian serum-providing health facilities from the relationship between population distribution and commuting time. In this exploratory descriptive study, the geographic accessibility of Brazilian population to health facilities that supply antiophidic serum is evaluated through a methodology that articulates several issues that influence the commuting time to health units (ACCESSMOD): population and facilities’ distribution, transportation network and means, relief and land use, which were obtained in Brazilian and international sources. The relative importance of the population without the possibility of reaching a facility in two hours is highlighted for Macro-Regions, States and municipalities. About nine million people live in locations more than two hours away from serum-providing facilities, with relevant variations between regions, states, and municipalities. States like Mato Grosso, Pará and Maranhão had the most important participation of population with reaching time problems to those units. The most significant gaps are found in areas with a dispersed population and sometimes characterized by a high incidence of snakebites, such as in the North of the country, especially in the Northeastern Pará state. Even using a 2010 population distribution information, because of the 2020 Census postponement, the tendencies and characteristics analyzed reveal challenging situations over the country. The growing availability of serum-providing health facilities, the enhanced possibilities of transporting accident victims, and even the availability of sera in other types of establishments are actions that would allow expanding the possibilities of access to serum supply.

Preliminary assessment of antivenom availability and management in the public health system of Costa Rica: An analysis based on a survey to pharmacists in public health facilities

“…These, in turn, are intimately related to the coverage, organization, and quality of the public health system. There is great heterogeneity in this scenario on a global basis ( Fan and Monteiro, 2018 ; Gutiérrez, 2012 ; Habib and Warrell, 2013 ; Oliveira et al, 2022 ; Potet et al, 2021 ), and therefore, analysis of antivenom availability and accessibility in specific regional and national contexts is a relevant task.…”

Acessibilidade Geográfica a Serviços de Saúde

“…As soluções consideradas estão relacionadas a distintas funcionalidades: A aplicação online desenvolvida foi testada com a realização de análises da acessibilidade geográfica a serviços de saúde. Foram refeitas a título de teste análises anteriormente publicadas a respeito da acessibilidade geográfica a serviços de atenção a traumas complexos (Oliveira et al, 2018), a municípios que dispunham de capacidade de atenção à saúde de alta complexidade no âmbito da COVID-19 (FIOCRUZ, 2020) e a estabelecimentos com oferta de soros antiofídicos (Oliveira et al, 2022). Nas repetições de análises realizadas anteriormente, foi possível através da instalação online, obter os mesmos resultados com menor tempo de processamento e sem impacto local (Figuras 3, 5 e 6).…”

“…Há na literatura diversos exemplos de estudos a respeito da acessibilidade geográfica a diversos serviços de saúde e baseados em diversas metodologias (Oliveira et al, 2004, Rocha et al, 2017, Ouma et al, 2018, Oliveira et al, 2022. A Organização Mundial da Saúde (OMS) disponibiliza em parceria com universidades europeias um software livre denominado ACCESSMOD (WHO, 2018), que permite a análise do tempo de deslocamento até unidades de saúde a partir das diversas questões que influenciam esse tempo como: distribuição da população, localização dos estabelecimentos, vias e meios de transporte (incluindo velocidades de deslocamento), relevo e uso da terra.…”

“…Ambas possibilitam uma aproximação mais real da acessibilidade geográfica aos serviços de saúde (Oliveira et al, 2022).…”

Vulnerability to snakebite envenoming and access to healthcare in the Terai region of Nepal: a geospatial analysis

“…Analyses of accessibility to healthcare are being conducted in many LMICs countries, including Nepal. 19 , 20 However, to our knowledge, only two studies have combined snakebite (risk or cases) and accessibility to healthcare in the population, 21 , 22 and none have done it continuously or taken uncertainty intervals (UI, a measure representing dispersion from an estimate) into account when calculating travel times. Similarly, when calculating snakebite vulnerability, previous studies have used surrogate values for risk (eg, species habitat suitability), and have also not considered UI.…”