Snakebite envenomations and access to treatment in communities of two indigenous areas of the Western Brazilian Amazon: A cross-sectional study

Abstract

Background The indigenous populations of Brazil present poor health indicators and a disproportionate prevalence and case-fatality rate of neglected tropical diseases, including snakebite envenomations (SBEs). This study aims to estimate access to medical care for SBEs and analyze the barriers that prevent victims from accessing healthcare in indigenous communities in two health districts located in the Western Brazilian Amazon. Methodology/Principal findings This cross-sectional study used semi-structured interviews to collect data from individuals who experienced SBEs in the Upper Rio Solimões and Upper Rio Negro indigenous health districts. Of the 187 participants, 164 (87.7%) reported that they had access to healthcare and received assistance in a hospital in the urban area of the municipalities. Frequency was 95.4% in the Upper Rio Solimões SIHD, and 69.6% in the Upper Rio Negro SIHD (P<0.0001). The study found that the availability of indigenous medicine as the only choice in the village was the main reason for not accessing healthcare (75%), followed by a lack of financial resources and means of transportation (28.1%). Four deaths were reported from SBEs, resulting in a case-fatality rate of 2.1%. Conclusions/Significance In the study areas, there are records of SBE patients who did not receive medical attention. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in the region of the Upper Solimões River. The implementation of cross-cultural hospital care needs to be considered in order to reduce the resistance of indigenous populations in relation to seeking treatment for SBEs.

Children Growing Up with Severe Disabilities as a Result of Snakebite Envenomations in Indigenous Villages of the Brazilian Amazon: Three Cases and Narratives

“…Snakebite incidence is five-fold higher in the Brazilian Amazon compared to the rest of the country [ 11 ]. Furthermore, in the Amazon region of Brazil, children are proportionally more affected than in the other regions of the country [ 13 ]. In Brazil, living in rural areas and time to care of >3 h are risk factors for severity following snakebites in children [ 14 ].…”

“…In general, previous studies carried out in the Amazon on disabilities caused by snakebites have described only the clinical aspects of the problem [ 19 , 25 , 26 , 27 ], without stressing the repercussions of the problem on the social life of patients. In this study, which seeks to address this problem, we report the clinical characteristics and narratives obtained from interviews with the parents and with three children presenting severe physical disabilities from snakebite envenomations in indigenous villages of the Brazilian Amazon, which were identified in previous surveys carried out in these areas [ 13 ].…”