Fatal snake bites – sociodemography, latency pattern of injuries

Abstract

BackgroundIndia is a thickly populated country; apart from having biodiversity among people, climate does change from place to place. Western Ghats of South India harbors variety of plantations and diverse creatures. Agriculture is the primary occupation of the people and some tribes living in these regions. Here majority are callous/ ignorant in employing neither advanced farming techniques nor safety precautions, hence are exposed to bites and stings by animals. Of these, snake bites cause significant mortality and morbidity. Proper care for some of these individuals is out of reach. Identification of offending snake, snake bite injury or findings of envenomation is a key not only for the administration of antisnake venom but also for the victim to realize that he needs an expert care. Unless he believes it to be a critical snake bite and not a thorn prick, scorpion sting or a spider bite he will not approach a health care provider. To know about these dangerous signs that may help the victim to realize it as a case of snake bite, current study is employed on fatal cases in this region.Methods60 fatal snakebite cases were studied retrospectively for 5 years with an objective to know the socio-demography, latency and pattern of injuries in rural Southern India.ResultsMost of the victims were males, in the age group of 31-50 years and were at risk of snake bites while farming. Large sample of subjects approached traditional therapists and were deprived of essential care in the critical first few hours after snake bite. Fang marks (90%), local ecchymoses (50%) and internal hemorrhage (28.3%), were the frequent demonstrable signs appreciated at autopsy.ConclusionSnakebite is a neglected, endemic, occupational (farming) disease of the poor and there is need for National Snakebite Prevention Programme for curtailing this menace.

The timing is right to end snakebite deaths in South Asia

“…With poor access to health facilities, they often resort to traditional faith healers, who indulge in practices such as chanting, incisions, attempts to suck venom from the bite site, tying tourniquets, or local application of herbs, cow dung, or snakestones. 10 13 30 These measures can delay treatment 20 31 and result in increased mortality. 13 25…”

“…Snakebites are more common among the poor. 8 20 Poor housing conditions and inadequate lighting provide easy access to snakes into living spaces and they are not easily spotted. 18 Open houses, sleeping on the floor, and open defecation are other factors increasing the risk of snake encounters 8 …”

Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem

“…Most of the bites happened during the rainy season from May to October, when most villagers are working in the fields for rice cultivation. The age, sex and seasonal distribution are similar in other regions of the world [ 13 , 26 , 27 ]. In Phin district the seasonal difference is less distinct with a considerable number of snakebites during the dry season, most likely because many villagers in this area are working in the forest during that time with a high risk of snakebite.…”

“…He acquired data on human development index (HDI), per capita expenditure on health, the percentage labour force in agriculture and gross domestic product (GDP) from databases on 138 countries for which snakebite-induced mortality rates have been estimated and each analysis illustrated a strong association between snakebite-induced mortality and poverty [ 25 ]. Rao et al found that approximately 87% of snakebite victims with fatal outcome in Southern India lived below poverty line [ 26 ].…”

Epidemiological study of snakebites in Ardabil Province (Iran)

“…Most snakebite victims are men and people aged 15–54 years which is related to the fact that men spend more time in nature and outdoors ( 14 , 15 ). Studies also show that most of the bite sites are on lower limbs and the least bite sites are related to head and neck ( 16 , 17 ). The average incidence of snakebite in Iran was estimated to be 6.9 per 100000 and Ardabil province, with incidence of 4.1 per 100000, is the country’s 19th rank of snakebite incidence ( 1 , 2 ) and according to hospital evidence, snakebite in Ardabil province is relatively high.…”