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A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.

Carlos Bravo-Vega1, Camila Renjifo-Ibañez2, Mauricio Santos-Vega1,3

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Snakebite envenoming is underestimated due to underreporting. A new framework estimates total snakebite incidence, identifying at-risk populations and improving disease management strategies for this neglected tropical disease.

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Area of Science:

  • Epidemiology
  • Public Health
  • Tropical Medicine

Background:

  • Snakebite envenoming is a neglected tropical disease with underestimated disease burden.
  • Underreporting is prevalent due to factors like traditional medicine use, deficient reporting systems, and healthcare inaccessibility.
  • Optimizing disease management strategies for snakebite envenoming presents a significant challenge.

Purpose of the Study:

  • To propose a novel framework for estimating total snakebite incidence at a fine political scale.
  • To identify populations and regions most at-risk for snakebite envenoming.
  • To improve disease management strategies for snakebite envenoming.

Main Methods:

  • Generated fine-scale snakebite risk maps based on venomous snake distribution in Colombia.
  • Employed a generalized mixed-effect model incorporating risk maps, poverty, and travel time to medical centers.
  • Calibrated the model using Colombian snakebite data (2010-2019) with the Markov-chain-Monte-Carlo algorithm.

Main Results:

  • Estimated that 10.19% of total snakebite cases (532.26 yearly envenomings) go unreported.
  • Identified populations in the Orinoco and Amazonian regions as most at-risk with the highest underreporting percentages.
  • Found that precipitation and temperature influence venomous snake habitat suitability.

Conclusions:

  • The developed framework enables estimation of snakebite underreporting using diverse data sources.
  • This algorithm can be adapted for use in other countries to enhance snakebite incidence estimation and management.
  • The framework complements, but does not replace, the critical need for robust surveillance systems.