Mapping the Risk of Snakebite in Sri Lanka - A National Survey with Geospatial Analysis

Ediriweera, Dileepa Senajith; Kasturiratne, A.; Pathmeswaran, A.; Gunawardena, N.K.; Wijayawickrama, B.A.; Jayamanne, Shaluka; Dawson, Andrew; Giorgi, Emanuele; Diggle, Peter J.; Lalloo, David G.; Silva, Hithanadura Janaka de

doi:10.1371/journal.pntd.0004813

Cited by 112 publications

(178 citation statements)

References 15 publications

(19 reference statements)

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“…ceylonicus ), Russell’s viper ( Daboia russelii ), Saw-scaled viper ( Echis carinatus ) and Hump-nosed pit viper ( Hypnale hypnale ) [2]. Sri Lanka is one of the highest envenoming reporting countries in the region with an estimated incidence of over 80000 bites, 30000 envenomings and 400 deaths per year, predominantly among rural residents engaged in agriculture related occupations [3]. …”

Section: Introductionmentioning

confidence: 99%

Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study

et al. 2016

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BackgroundSnakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.Methodology/Principal FindingsA sample representative of residents of a single district in a region of high incidence of snake envenoming was recruited to identify ever snakebite victims. They were evaluated for chronic musculoskeletal disabilities that had developed immediately or within four weeks after the snakebite and persisted over three months. In-depth interviews, validated musculoskeletal functional assessment criteria and specialists’ examinations were utilised. Among the 816 victims, 26 (3.2%, 95% confidence interval: 2.2–4.6%) had musculoskeletal disabilities, persisting on average for 13.4 years (SD = 14.4). The disabilities were mostly in lower limbs (61.5%) and ranged from swelling (34.6%), muscle wasting (46.1%), reduced motion (61.5%), reduced muscle power (50%), impaired balance (26.9%), chronic non-healing ulcers (3.85%), abnormal gait (3.85%), fixed deformities (19.2%) to amputations (15.4%). Based on disability patterns, six snakebite-related musculoskeletal syndromes were recognised. The offending snakes causing disabilities were cobra (30.8%), Russell’s viper (26.9%) and hump-nosed viper (7.7%). Cobra bites manifested muscle wasting (87.5%), reduced muscle power (87.5%), joint stiffness (62.5%) and deformities (37.5%) while viper bites manifested impaired balance (42.8%), pain (71.4%) and swelling (71.4%).Conclusions/SignificanceSnakebite envenoming is associated with considerable long-term musculoskeletal disabilities. Facilities for specialized care and rehabilitation need to be established in high risk areas.

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Section: Introductionmentioning

confidence: 99%

Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study

et al. 2016

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“…Data from studies conducted in India [11,14], Bangladesh [15], Sri Lanka [16,17], Nigeria [12,18], Burkina Faso [19], Kenya [20] and Senegal [21], amongst others, provide evidence of an increasing capability of acquiring snakebite epidemiology data that need to be adopted and promoted more widely. The workshop was informed of hospital-based and community survey projects being undertaken or planned in several countries represented by the recently established African Society of Venimology and in Southeast Asia.…”

Section: Priority Actions Identified and Progress To Meet The Retrmentioning

confidence: 99%

Priority Actions and Progress to Substantially and Sustainably Reduce the Mortality, Morbidity and Socioeconomic Burden of Tropical Snakebite

Harrison

Gutiérrez

2016

Toxins

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The deliberations and conclusions of a Hinxton Retreat convened in September 2015, entitled “Mechanisms to reverse the public health neglect of snakebite victims” are reported. The participants recommended that the following priority actions be included in strategies to reduce the global impact of snake envenoming: (a) collection of accurate global snakebite incidence, mortality and morbidity data to underpin advocacy efforts and help design public health campaigns; (b) promotion of (i) public education prevention campaigns; (ii) transport systems to improve access to hospitals and (iii) establishment of regional antivenom-efficacy testing facilities to ensure antivenoms’ effectiveness and safety; (c) exploration of funding models for investment in the production of antivenoms to address deficiencies in some regions; (d) establishment of (i) programs for training in effective first aid, hospital management and post-treatment care of victims; (ii) a clinical network to generate treatment guidelines and (iii) a clinical trials system to improve the clinical management of snakebite; (e) development of (i) novel treatments of the systemic and local tissue-destructive effects of envenoming and (ii) affordable, simple, point-of-care snakebite diagnostic kits to improve the accuracy and rapidity of treatment; (f) devising and implementation of interventions to help the people and communities affected by physical and psychological sequelae of snakebite.

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“…Of the total envenoming events, more than 100,000 occur in South and Southeast Asia [1]. In Sri Lanka, an estimated 398 (95% confidence interval: 356–441) snakebites per 100,000 population occur annually and approximately 38% of them result in envenoming [2]. The estimated deaths due to snakebite in Sri Lanka are 2.3 (95% CI: 0.2–4.4) per 100,000 population [2].…”

Section: Introductionmentioning

confidence: 99%

“…In Sri Lanka, an estimated 398 (95% confidence interval: 356–441) snakebites per 100,000 population occur annually and approximately 38% of them result in envenoming [2]. The estimated deaths due to snakebite in Sri Lanka are 2.3 (95% CI: 0.2–4.4) per 100,000 population [2]. Most of these envenoming events are due to cobra, Russell’s viper, saw scaled viper and krait bites.…”

Section: Introductionmentioning

confidence: 99%

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Prevention of krait bites by sleeping above ground: preliminary results from an observational pilot study

Rodrigo

Kirushanthan

Gnanathasan

2017

J Occup Med Toxicol

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IntroductionNeurotoxic envenoming following the bites of kraits (Bungarus spp.) is a common cause of death in the dry zone of Sri Lanka and elsewhere in South Asia. Most of these bites occur at night and are inflicted on people sleeping on the ground. Thus we hypothesized that the simple measure of sleeping above ground would help to reduce the number of observed krait bites.MethodsThis study was conducted in two villages of the Kilinochchi district of Sri Lanka which had reported a high number of krait bites in the two years preceding the study. Most of the residents in these two villages slept on the ground. Residents in one area were given beds free of charge, using funds available from the study. Both villages received health education on the prevention of krait bites.ResultsForty five beds were distributed to 45 families in one village. This enabled 115 individuals to sleep above ground level. 6 monthly follow up visits were conducted ensuring the proper utilization of beds. Follow up was continued for 30 months (September 2013–March 2016); during this time period no krait bites were reported in either area.ConclusionsWe observed a dramatic decline of krait bites in both villages. Better awareness with effective health education and clearing of vegetation could have led to the decline in the number of krait bites in both villages.

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Mapping the Risk of Snakebite in Sri Lanka - A National Survey with Geospatial Analysis

Cited by 112 publications

References 15 publications

Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study

Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study

Priority Actions and Progress to Substantially and Sustainably Reduce the Mortality, Morbidity and Socioeconomic Burden of Tropical Snakebite

Prevention of krait bites by sleeping above ground: preliminary results from an observational pilot study

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