The socio-economic burden of snakebite in Sri Lanka

Kasturiratne, Anuradhani; Pathmeswaran, A.; Wickremasinghe, Rajitha; Jayamanne, Shaluka; Dawson, Andrew; Isbister, Geoffrey K.; Silva, Hithanadura Janaka de; Lalloo, David G.

doi:10.1371/journal.pntd.0005647

Cited by 57 publications

(62 citation statements)

References 13 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…I could not work, I could not provide anything to my people." (TA-ENT03) This agrees with studies carried out in several Asian countries, where the cost of treatment forced people to acquire loans and sell family assets [5,6,33]. In the case of Costa Rica, the social public health system (CCSS) provides antivenom and medical care free of charge to most of the people affected, but nevertheless, there are other consequences leading to expenses that have to be taken care of by the patients and their families.…”

Section: Long-term Socioeconomic Consequencessupporting

confidence: 73%

Circumstances and Consequences of Snakebite Envenomings: A Qualitative Study in South-Eastern Costa Rica

Arias-Rodríguez

Gutiérrez

2020

Toxins

View full text Add to dashboard Cite

A qualitative study was carried out in south-eastern Costa Rica on the circumstances and consequences of snakebite envenomings. This region has the highest incidence of snakebites and the lowest per capita and per family income in the country. There is a high degree of destitution and an unstable labor situation in the region. This study was based on semistructured interviews with 15 people who had suffered snakebite envenomings. This sample size was established on the basis of data saturation. Bites occurred mostly while doing agricultural work, either as salaried workers, as occasional workers, or working on their own. Although all people were attended in health centers of the public health system, and received antivenom free of charge, the majority of them did not receive compensation or rehabilitation upon discharge from the health facilities as a result of not being regular salaried workers. People described many difficulties as a consequence of these envenomings, such as permanent physical sequelae, including two amputations, psychological consequences, economic hardships, and difficulties for reinsertion into agricultural work. In spite of the significant advances that Costa Rica has made for reducing the impact of these envenomings, results reveal issues that require urgent attention by government and civil society organizations, to compensate for the physical, psychological, social, and economic consequences of these envenomings.

show abstract

Section: Long-term Socioeconomic Consequencessupporting

confidence: 73%

Circumstances and Consequences of Snakebite Envenomings: A Qualitative Study in South-Eastern Costa Rica

Arias-Rodríguez

Gutiérrez

2020

Toxins

View full text Add to dashboard Cite

show abstract

“…Geographically, the greatest impact of snakebite is in the tropical and subtropical regions (with India considered as having the highest rates of incidence and mortality), due to a combination of factors ranging from snake density to developing world status resulting in many local people not having access to footwear, flashlights or adequate medical care [ 8 , 10 , 11 , 12 , 13 ]. Estimates for snakebite incidence vary widely, ranging from 1.8 million to 5.4 million bites globally per year with tremendous socio-economic impacts [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. However, the lack of robust record keeping in the most affected regions, combined with many victims not presenting to hospital due to logistical or cultural reasons, lead to estimates widely-recognized as likely being gross underestimations.…”

Section: Epidemiologymentioning

confidence: 99%

“…This is despite snakebite being a socially destabilizing force that has a very high medical and social value-for-money in regards to the economy of treatment relative to the more expensive treatment for chronic diseases [ 3 ]. Thus, the limited understanding of snakebite epidemiology has relegated snakebite to an neglected tropical disease status despite the social and economic catastrophic impact it may have [ 19 ]. Entire family groups may be plunged into poverty if the person killed or suffering permanent disability is the primary source of income.…”

Section: Epidemiologymentioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

View full text Add to dashboard Cite

Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood. Tens of thousands of lives are lost to snakebites each year and hundreds of thousands of people will survive with some form of permanent damage and reduced work capacity. These numbers are well recognized as being gross underestimations due to poor to non-existent record keeping in some of the most affected areas. These underestimations complicate achieving the proper recognition of snakebite’s socioeconomic impact and thus securing foreign aid to help alleviate this global crisis. Antivenoms are expensive and hospitals are few and far between, leaving people to seek help from traditional healers or use other forms of ineffective treatment. In some cases, cheaper, inappropriately manufactured antivenom from other regions is used despite no evidence for their efficacy, with often robust data demonstrating they are woefully ineffective in neutralizing many venoms for which they are marketed for. Inappropriate first-aid and treatments include cutting the wound, tourniquets, electrical shock, immersion in ice water, and use of ineffective herbal remedies by traditional healers. Even in the developed world, there are fundamental controversies including fasciotomy, pressure bandages, antivenom dosage, premedication such as adrenalin, and lack of antivenom for exotic snakebites in the pet trade. This review explores the myriad of human-origin factors that influence the trajectory of global snakebite causes and treatment failures and illustrate that snakebite is as much a sociological and economic problem as it is a medical one. Reducing the incidence and frequency of such controllable factors are therefore realistic targets to help alleviate the global snakebite burden as incremental improvements across several areas will have a strong cumulative effect.

show abstract

“… 12 In the study by Kasturiratne et al, high economic losses were evidenced because of out-of-pocket expenditures, losses of income attributable to the event, and expenses by relatives because of patient care. 16 In the study by Magalhães et al, prehospitalization ambulatory care, outpatient care for those who were not hospitalized, postdischarge consultation, treatment (antivenom therapy), hospitalization, costs from the patient’s perspective, and costs from society’s perspective (loss of productivity due to premature death and morbidity) were analyzed. 18…”

Section: Resultsmentioning

confidence: 99%

<p>Economic Evaluations of Interventions for Snakebites: A Systematic Review</p>

Castillo¹,

Estrada-Gómez²,

Cardona‐Arias³

2020

CEOR

View full text Add to dashboard Cite

Background Snakebite is an often-neglected event with a high rate of mortality and is concentrated in poor areas. We aimed to assess the economic impact and health effects of the implementation of interventions for snakebites through a systematic review of the scientific literature. Methods Thirty search strategies were conducted in seven databases, applying PRISMA’s identification, screening, selection, and inclusion phases. The reproducibility of the selection of studies and the extraction of information were guaranteed. The methodological quality was evaluated using the Consolidated Health Economic Evaluation Reporting Standards. Qualitative synthesis and meta-analysis were performed for determining the average cost-effectiveness (ACE) for each death and disability-adjusted life years (DALY) avoided. Results Six cost-effectiveness studies were included for the supply of antivenom (AV), taken as outcomes on days of hospitalization or in ICU, death and DALYs avoided. All studies only included institutional costs, and majority of them did not specify the analytical model or economic evaluation parameters and did not perform uncertainty analyses. The management protocol standardization with interdisciplinary attention improves ACE of AV. Cost-effectiveness ratio (CER) of treatment with AV was USD 1253 (constant value for the year 2017, adjusted by purchasing power parity) for each death avoided and USD 51 per DALY avoided. Conclusion High cost-effectiveness of the AV treatment for snakebites was evidenced, which shows that the allocation of resources for this event should be a healthcare priority in addition to implementation of strategies that improve the access to, opportunity, and quality of hospital and pre-hospital care and reduce the cost of AV.

show abstract

The socio-economic burden of snakebite in Sri Lanka

Cited by 57 publications

References 13 publications

Circumstances and Consequences of Snakebite Envenomings: A Qualitative Study in South-Eastern Costa Rica

Circumstances and Consequences of Snakebite Envenomings: A Qualitative Study in South-Eastern Costa Rica

Snakebite: When the Human Touch Becomes a Bad Touch

<p>Economic Evaluations of Interventions for Snakebites: A Systematic Review</p>

Contact Info

Product

Resources

About