Snakebite: Admissions at a tertiary health care centre in Maharashtra, India

Abstract

Snakes are found all over the world except in the Arctic, New Zealand and Ireland, and are more commonly distributed in temperate and tropical countries.1 Snakes are most likely to bite human beings when they feel threatened, startled or provoked, and/or have no means of escape when cornered. Snakes are likely to approach residential areas when attracted by prey, such as mice and frogs. The Deccan plateau, with its agricultural land and hot, dry climate, provides an ideal environment for cobras, kraits and vipers.2 Snakebite is generally considered to be a rural problem and has been linked with environmental and occupational conditions.3 Most houses in the rural areas of India are made of mud and have many crevices where rodents flourish. Snakes have easy ingress to such houses and often enter them in search of food. Firewood and dried cow dung, stored in or near the house, provide ready shelter for snakes and rodents. 4 Morbidity and mortality from snakebite envenomation depends on the species of snake, since the estimated fatal dose of venom varies among species. In India, almost two-thirds of the bites are attributed to the saw-scaled viper (as high as 95% in some areas such as Jammu 5 ), about a quarter to Russell's viper, and smaller proportions to cobras and kraits. 6 Snakebite is an important and serious medical problem in many parts of India. However, reliable data for morbidity and mortality are not available since there is no proper reporting system. Moreover, many cases are not recorded in official statistics, as people seek traditional treatment methods. Most snakebite studies in India deal with clinical and management aspects, and there are few epidemiological studies. 7 We studied the epidemiology of snakebite cases over a period of 10 years. Aim and objectivesWe aimed to study the epidemiology of snakebite cases admitted to hospital; trends of snakebite and death from snakebite; seasonal variations; and the outcomes of snakebite cases. MethodsIn a record-based retrospective descriptive study, we evaluated snakebite cases admitted to the hospital from 1999 to 2008. Data were collected from the Medical Records Department of the Dr Shankarrao Chavan Government Medical College. Recorded information was entered in a pre-coded pro forma and included age, sex, residence, site of bite, type of snake poison, whether cases had been directly admitted to this hospital or referred from other health centres, time interval between snakebite and initiation of treatment, and the outcomes of snakebite cases. The total number of hospital admissions for different illnesses during 1999 -2008 was 488 344. As required by the government of Maharashtra, all snakebites are classified as medico-legal cases, whose records are kept separately in the medical records department. The total number of cases registered during the above period was 5 718. We evaluated only the records of snakebite cases where outcomes were recorded as recovered and discharged from hospital, or died while in hospital. Excluded were snakebite patients ...

Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India

“…The predominance of male victims suggests a special risk of outdoor activity. This is comparable to the studies done by other authors [4,[11][12][13][14].…”

“…Rural inhabitants form the biggest chunk of casualties (67.5%) attributed to the labour they are generally engaged in and this collaborates with inference drawn from other studies [4,[9][10][11][12][13].…”

Knowledge, attitude and practice regarding snakes and snake bite among rural adult of Belagavi, Karnataka

“…16,19 It was encouraging to know that in the present study 364 (91%) of the participants did not consider going to a faith healer or quack as a treatment option after snake bite, this finding was similar to the study done by Pandey et al 4 While in other similar studies 86% of snakebite victims in Bangladesh, 75% in Pakistan, and 61% in Maharashtra, India still visit traditional healers. [20][21][22] In the present study it was found that 305 (76.25%) of the total participants offer milk to snakes brought by local Snake charmers on Nag Panchami festival which proves detrimental to the snake's health. Therefore awareness camps in laying emphasis on imparting basic knowledge about snake identification, snakebite prevention and clearing misconceptions should be held in schools, proper first aid methods for snakebites should be demonstrated through various outreach activities and increased awareness about snake and snakebite identification among heath care workers and general population should also be done.…”

‘A life threatening scratch on little toe’ – at most clinical suspicion the essential key in management of snake bite

“…Inamdar et al [17] from Central India studied the outcome, seasonal variation, and death pattern of snakebite cases over 10 years. They concluded snake bite as a life-threatening emergency; early appropriate use of antivenom and close monitoring will reduce complications and mortality.…”