National programme for prevention &amp; control of snakebite in India: Key challenges &amp; recommendations

Bawaskar, HimmatraoS; Gajbhiye, RahulK; Munshi, Hrishikesh

doi:10.4103/ijmr.ijmr_2424_22

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…The venoms of Big Four venomous snakes-that is, Indian cobra (Naja naja), Indian krait (Bungarus caeruleus), Russell's viper (Daboia russelii), and saw-scaled viper (Echis carinatus)-are used in the development of polyvalent ASV. 38 Our hospital uses polyvalent anti-snake venom (ASV) supplied under the name of BENOM TM . Each ml of this polyvalent ASV neutralizes 0.6. mg cobra venom, 0.45 mg krait venom, 0.60 mg Russell's viper venom, and 0.45 mg saw-scaled viper venom.…”

Section: Discussionmentioning

confidence: 99%

Clinico-Epidemiological Profile, Trends, and Health-Related Outcomes of Snakebite Victims: A One-Year Prospective Study from Eastern India

Stephen,

Mohanty,

Radhakrishnan

et al. 2024

Wilderness & Environmental Medicine

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Introduction Snakebite envenomation is a significant life-threatening public health problem in Southeast Asia (SEA). In this region, India reported the largest number of snakebite deaths from 2000 to 2019 (1.2 million), with an average of 58,000 deaths yearly. Methods This prospective observational study was carried out among snakebite victims at the emergency department (ED) of a tertiary care public sector hospital in eastern India. Results A total of 145 cases of venomous snakebite were investigated. More than half ( n = 81, 56%) of the snakebite victims were between 17 to 45 years. Most of the snakebite victims were male (68%) and were farmers (53%) by occupation. The majority of snakebites occurred during the daytime (76%) and while outdoors (67%). Most victims sustained a bite on the lower extremity (71%). The peak incidence of snakebites occurred from June to September (69%). Three-quarters of all patients were unaware of the required first aid measures following a snakebite. Among the 145 venomous snakebites, 48 were presumptively identified as the Indian cobra, 32 by the Indian krait, 56 by the Russel's viper, and 9 by saw-scaled viper. The mean duration from the snakebite to the onset of systemic effects in the Indian cobra was 52 ± 14.28 min, 66 ± 18.35 min in the Indian krait, 42 ± 13.47 min in Russel's viper, and 48 ± 16.38 min in saw-scaled viper. Respiratory failure was the commonly observed complication following an elapid envenomation. The mortality rate was 2.1% among the patients treated with antivenom. Conclusions Snakebite is considered an occupational hazard in India, commonly affecting the young population in their productive period. The peak incidence was during monsoon season, and the majority had neurotoxic envenomation following an elapid bite (55%) that contributed to the increased mortality and morbidity among young adults. Of the 145 patients, the majority (84%) recovered fully with treatment; 16% of the victims developed morbidity viz cellulitis, respiratory failure, acute renal failure, compartment syndrome, local tissue necrosis, intracerebral hemorrhage, and disseminated intravascular coagulation. Appropriate first aid measures and timely medical intervention can significantly improve the treatment outcome following snakebites.

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Section: Discussionmentioning

confidence: 99%

Clinico-Epidemiological Profile, Trends, and Health-Related Outcomes of Snakebite Victims: A One-Year Prospective Study from Eastern India

Stephen,

Mohanty,

Radhakrishnan

et al. 2024

Wilderness & Environmental Medicine

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Section: Introductionmentioning

confidence: 99%

“…2 Snakebite in India is not uniformly distributed but is concentrated in regions that are heavily forested, harbor agrarian population, and are economically disadvantaged. 3 Incidents of SBE recur annually in rural regions of India, especially during the monsoon season, often leading to transient and reactive responses from authorities. Nevertheless, the underlying issues of strengthening health care system capacity, ensuring resource availability, and fostering community awareness have persistently remained unaddressed.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the underlying issues of strengthening health care system capacity, ensuring resource availability, and fostering community awareness have persistently remained unaddressed. 3 Over the past decade, India has witnessed commendable but limited efforts to combat the SBE burden, spearheaded primarily by the Indian Council of Medical Research (ICMR). 4 The ICMR embarked on this mission in 2013, way before the World Health Organization recognized SBE as a high-priority neglected tropical disease in 2017.…”

Section: Introductionmentioning

confidence: 99%

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Empowering Health care Systems and Communities for Snakebite Envenoming Control in India

Munshi,

Gajbhiye

2023

Asia Pac J Public Health

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Snakebite envenoming (SBE) is a global health challenge, predominantly affecting economically disadvantaged regions. India contributes significantly to global snakebite mortality. Since 2013, the Indian Council of Medical Research (ICMR) has spearheaded efforts to combat SBE. A multi-sectoral engagement in the snakebite research projects and inputs from communities, traditional healers, and the health system have led to the creation of an Information Education and Communication (IEC) material suite, including management flowchart, information booklets, posters, and brochures, all available in local languages. These resources were broadly disseminated in high-burden regions in Maharashtra and Odisha, resulting in an approximately 10% increase in case reporting within a year. This holistic approach, engaging diverse stakeholders and addressing multiple facets of SBE, offers promise for alleviating the snakebite burden, not only in India but also in other low- and middle-income countries across South Asia, Africa, and South America, holding potential for broader positive global impact.

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Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden

Kumar,

Rathore

2024

J Epidemiol Glob Health

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The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.

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National programme for prevention & control of snakebite in India: Key challenges & recommendations

Cited by 4 publications

References 16 publications

Clinico-Epidemiological Profile, Trends, and Health-Related Outcomes of Snakebite Victims: A One-Year Prospective Study from Eastern India

Clinico-Epidemiological Profile, Trends, and Health-Related Outcomes of Snakebite Victims: A One-Year Prospective Study from Eastern India

Empowering Health care Systems and Communities for Snakebite Envenoming Control in India

Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden

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