Snakebite incidents, prevention and care during COVID-19: Global key-informant experiences

Abstract

Snakebite envenoming is a long-neglected disease causing significant morbidity and mortality in snakebite endemic low- and middle-income countries (LMICs). Global awareness on snakebite was increasing steadily up to 2020, and an increasing number of countries began to acknowledge the issue, when coronavirus disease 2019 (COVID-19) started to have an unprecedented impact on societies and health systems. To better understand how snakebite incidents, prevention and care are being affected during this global emergency, we collected perspectives of snakebite community- and health system stakeholders in a qualitative key-informant study. An open-ended survey and semi-structured interviews were conducted to gather information on changes in snakebite occurrence and circumstances, community responses, access to care and health outcomes in LMICs since the COVID-19 pandemic. Forty-three informants from 21 countries participated in the study. Based on informants' experiences, in spite of COVID-19 lockdowns, exposure to snakes did not change in many rural agrarian communities, where incidences are usually highest. However, we did find several access to care issues relating to avoidance of formal care, transport barriers, overburdened healthcare systems and -providers, and antivenom manufacturing and supply disruptions, which were unique per context. On a brighter note, ventilator availability had increased in several countries, although not automatically benefitting snakebite patients directly. In conclusion, we found apparent effects of the COVID-19 pandemic on snakebite prevention and care, although its severity was highly context- and time-dependent. Interactions between the pandemic effects and snakebite incidents most severely impact remote rural communities, showing the need to invest in community-based prevention and care.

Situation of snakebite, antivenom market and access to antivenoms in ASEAN countries

“…Fourth, impact of the coronavirus disease 2019 (COVID-19) pandemic on snakebite and antivenom situation in ASEAN countries was not included during the interviews. However, the overall economic burden of COVID-19 pandemic on ASEAN countries would most likely worsen access to antivenom due to financial constraints at least for some countries, as previously investigated by van Oirschot and colleagues 36. Lastly, most findings were based on interviews because the included studies were mostly limited to epidemiological aspects of snakebite rather than access to antivenoms.…”

Snakebite envenoming in humanitarian crises and migration: A scoping review and the Médecins Sans Frontières experience

“…Regarding natural disasters and snakebite, other informants surveyed in the study, Van Oirschot et al reported that they had seen an increase in snakebite cases but did not directly relate this to COVID-19 ( van Oirschot et al, 2021 ). Instead they associated it to” increased rainfall or flood” (Bangladesh, Malaysia, Nepal, Brazil).…”

“…Our search was completed by non-peer reviewed publications suggested by key-informants or found outside the systematic search. Firstly, we included a large peer-reviewed study published in Toxicon-X recently that expressed the views of experts and key-informants about the impact of the global COVID-19 pandemic and crisis on the burden of snakebite ( van Oirschot et al, 2021 ).…”

Traditional remedies for snakebite in Sudan

“…The strategy was tasked by the Snakebite Envenoming Working Group (SBE-WG) concentrating on the achievement of a 50% reduction in mortality and disability caused by snakebite envenoming by 2030. This aim will be accomplished through four objectives in terms of engagement of the communities, provision of safe effective treatment, strengthening of the health systems and establishment of an effective partnership [9].…”