Clinico-epidemiological features of snakebite: a study from Eastern Nepal

Area of Science:

• * Clinical Tropical Medicine
• * Epidemiology of Venomous Bites

Background:

• * Snakebite is a significant public health issue in rural and agricultural areas of Nepal.
• * Understanding the epidemiology of snakebite envenomation is crucial for effective prevention and treatment strategies.

Purpose of the Study:

• * To analyze the clinical characteristics and outcomes of suspected snakebite cases in Eastern Nepal.
• * To identify risk factors, common envenomation symptoms, and treatment responses.

Main Methods:

• * Retrospective study of 604 suspected snakebite cases from January to December 2000.
• * Data collected using pre-designed proformas at a peripheral snakebite treatment center.
• * Analysis of patient demographics, bite circumstances, clinical presentation, first aid, and treatment outcomes.

Main Results:

• * The majority of patients (75%) were aged 11-40 years, with farmers and housewives being the most affected groups.
• * Most bites occurred outdoors during agricultural activities (65%), with lower limbs being the most common site (62%).
• * Neurotoxicity was observed in 11% of cases, while coagulopathy was absent. Anti-snake venom reactions occurred in 28.16% of patients, with a 3% mortality rate among neurotoxic cases.

Conclusions:

• * Snakebite envenomation in this region disproportionately affects young adults involved in agricultural work.
• * Timely arrival at treatment centers is critical, as delayed presentation was associated with mortality.
• * Effective management requires addressing common misconceptions about first aid and prompt administration of appropriate antivenom therapy.