Snakebite epidemiology in humans and domestic animals across the Terai region in Nepal: a multicluster random survey

Alcoba, Gabriel; Sharma, Sanjib Kumar; Bolon, Isabelle; Ochôa, Carlos; Martins, Sara Babo; Subedi, Manish; Shah, Bhupendra; Ghimire, Anup; Gignoux, Etienne; Luquero, Francisco J.; Castañeda, Rafael Ruiz de; Ray, Nicolas; Chappuis, François

doi:10.1016/s2214-109x(22)00028-6

Cited by 17 publications

(25 citation statements)

References 24 publications

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“…Another limitation in our analysis was that we were only able to present results for each country, while recent verbal autopsy surveys have shown granular geographical and seasonal variation in the risk of snakebite envenomation within countries, with the greatest risk in rural areas 12 , 13 . One recent study in the Terai region of Nepal, which is a low-altitude zone with a monsoon climate where agriculture is the primary occupation, found that the mortality rate of snakebite envenomation was 22.4 per 100,000, over five times our estimate for India 13 . According to mortality estimates from GBD 2019, these results would make snakebite envenomation the ninth greatest cause of death in Nepal and the greatest cause of death among injuries, ahead of the mortality rate due to falls, self-harm, and road injuries 15 .…”

Section: Discussionmentioning

confidence: 99%

“…More large-scale community-based surveys are required to accurately determine the burden of snakebite envenoming in rural areas and better understand the geographic and temporal trends that could lead to more impactful interventions. For example, in South Asia, snakebite envenomation is closely tied to monsoon season, which should guide health system infrastructure planning and antivenom distribution, among other interventions 13 .…”

Section: Discussionmentioning

confidence: 99%

“…At the regional level, meta-analyses have analyzed national health reporting systems, hospital records, and household surveys to estimate the regional burden in sub-Saharan Africa and the Americas, and found the annual mortality to be 7331 and 370 deaths, resepectively 7,8 . Recent community-based household surveys have demonstrated the capacity of targeted data collection to assess the burden of snakebite envenomation in areas of high snakebite vulnerability, such as India, Sri Lanka, and the Terai Region of Nepal [9][10][11][12][13] . Updated estimates of the global situation, including the use of large global health data repositories and more advanced spatiotemporal modeling, are lacking 14 .…”

Section: Gbd 2019 Snakebite Envenomation Collaborators*mentioning

confidence: 99%

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Global mortality of snakebite envenoming between 1990 and 2019

Roberts¹,

Johnson²,

Zeng³

et al. 2022

Nat Commun

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Snakebite envenoming is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900–78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5–1.0) per 100,000 and represents a 36% (2–49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3—5.0). We forecast mortality will continue to decline, but not sufficiently to meet WHO’s goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Gbd 2019 Snakebite Envenomation Collaborators*mentioning

confidence: 99%

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Global mortality of snakebite envenoming between 1990 and 2019

Roberts¹,

Johnson²,

Zeng³

et al. 2022

Nat Commun

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“…7 With more than half of the population living in Terai and people mostly engaged in agricultural activities (65%), this region has the greatest human and animal snakebite incidence, with an estimated 261 incidences per 100,000 people each year. 3 The hilly region is the part at an altitude above 610 meters that comprises the largest land area of the country, and it has 43.1 per cent of the total population. 7 The mountainous region is the northernmost part, with an altitude above 4877 meters, and is the least populated ecological division.…”

Section: Topographic Variations Of Snakebitementioning

confidence: 99%

Snakebite in the Hills and Mountains of Nepal

Bogati¹,

Bhatt

Nepal

et al. 2022

J Nepal Med Assoc

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Snakebite is an important public health issue around the world. In Nepal, it affects a huge number of people mostly belonging to low-income households who are involved in agriculture. Although snakebite has a serious impact on the Terai population, a few studies suggest that snakebite also occurs frequently in hills and mountains. In the absence of sufficient studies related to snakebites in these geographical regions, it is tough to sketch a true picture and estimate the magnitude of snakebites in those areas. Because of this, the healthcare system is probably not prepared enough to handle the victims of snakebites. This demands a proper study of the burden of the issue in these regions and appropriate initiatives for addressing it.

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“…Snakebite, with an estimated incidence of 251 per 100 000 snakebites yearly, is a serious public health concern in Nepal [ 1 ]. Green pit vipers and mountain pit vipers are commonly found poisonous snake species in Nepal’s hills and highlands.…”

Section: Introductionmentioning

confidence: 99%

Management of snake bite during third trimester of pregnancy with coagulopathy and delivery of a live baby in resource-limited setting in Nepal: a case report

Gupta

Bhandari

Anand

et al. 2022

Oxford Medical Case Reports

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We reported a case of snakebite in an 18-year-old woman, Gravida 2 Para 1+0 in the third trimester of pregnancy who presented with pain and swelling over the left hand and forearm and vaginal spotting. The laboratory investigations revealed coagulopathy attributed to green pit viper envenomation. On the fourth day of admission, the patient developed sudden abdominal pain and massive per vaginal bleeding with haemorrhagic shock, most likely abruptio placentae. In Nepal, no anti-snake venom has been developed for green pit-viper. So, she was managed conservatively, including blood transfusion, and delivered a single live female baby without any foetal complications. The patient was discharged along with the baby after 8 days of hospitalization. This case demonstrated that vigilant observation and appropriate resuscitation with fluids and blood products could save mother and baby in pit viper envenomation cases in settings where specific anti-snake venom is unavailable.

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Snakebite epidemiology in humans and domestic animals across the Terai region in Nepal: a multicluster random survey

Cited by 17 publications

References 24 publications

Global mortality of snakebite envenoming between 1990 and 2019

Global mortality of snakebite envenoming between 1990 and 2019

Snakebite in the Hills and Mountains of Nepal

Management of snake bite during third trimester of pregnancy with coagulopathy and delivery of a live baby in resource-limited setting in Nepal: a case report

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