Snakebite Envenoming: A Public Health Perspective

Epidemiological study of snakebite cases in Brazilian Western Amazonia

“…Approximately 88% of the patients were literate and 63% of them were rural workers. The number of snakebite cases increased during the brightest period of the day, although most venomous snakes have nocturnal habits, which corroborates the results of previous studies 11,[18][19][20] . This study showed that the incidence of snakebites was higher among rural workers aged 20-49 years, affecting especially the lower limbs (Table 2) 1,2,9,25 , and 44 (47.8%) patients used alternative medicine ( Table 3).…”

“…The occurrence of leukocytosis with neutrophilia in patients is related to the endocrine-metabolic response to trauma, where the inoculated venom induces neutrophils, due to the action of metalloproteinases and disintegrins, the protein components present in the venom of Bothrops atrox snakes (the main Bothrops snake involved in the envenomations in the Amazon region), which has been shown in experimental studies 11 . Local and systemic effects identified in Bothrops envenomations are due to the proteolytic, hemorrhagic, and nephrotoxic effects of the venom 20 .…”

“…Among the Brazilian regions, the Midwest and North have the highest number of bitten cases per 100,000 people 9 . It is noteworthy that the Northern region has the highest proportion of snakebite cases in relation to the population (520 snakebites/ million inhabitants), which may have aggravated the difficulties in both mobility and communication 10,11 . According to the data from the Brazil's Information System for Notifiable Diseases [Sistema de Informação de Agravos de Notificação (SINAN)], Secretary of Health Surveillance, and Ministry of Health (MH) from 2000 to 2007, Rondônia is one of the states in the North that has the highest number of snakebite cases, with a total of 4,455 cases during this period.…”