Clinical, laboratory profile and outcomes in children with snakebite from Eastern India
Biswajit Pattanaik1, Chinmaya Mahapatra1, I K Karthika1
1Departments of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Insights
Snakebite is a major health issue for children in India. Early treatment with anti-snake venom (ASV) significantly reduces complications and hospital stays, improving outcomes for pediatric snakebite victims.
Area of Science:
- Pediatric Medicine
- Toxicology
- Public Health
Background:
- Snakebite envenoming is a critical global health concern, causing substantial morbidity and mortality, especially in underserved rural populations.
- Children in Eastern India are disproportionately affected by snakebites, necessitating a detailed understanding of their clinical profiles and outcomes.
Purpose of the Study:
- To evaluate the clinical characteristics, laboratory findings, and treatment outcomes of snakebite cases in pediatric patients from Eastern India.
- To identify factors influencing complications and recovery in children following snake envenomation.
Main Methods:
- A retrospective case record analysis was conducted for children admitted with snakebites between January 2017 and December 2021.
- Clinical features, laboratory data, management interventions, complications, and patient outcomes were systematically reviewed and analyzed.
Main Results:
- Thirty pediatric snakebite cases were analyzed, with a male predominance (2.3:1) and a mean age of 10.4 years. Most bites (96%) occurred on lower limbs, presenting with vasculotoxic (53%) and neurotoxic features.
- Early arrival (before 6 hours) was associated with fewer complications like acute kidney injury (AKI) and shorter hospital stays (4.7 days) compared to late arrivals (7.2 days).
- 86.7% of children were discharged without sequelae, while 10% left against medical advice, and one fatality occurred.
Conclusions:
- Snakebite poses a significant threat to children, highlighting their vulnerability due to outdoor activities.
- Prompt administration of anti-snake venom (ASV) and avoidance of traditional first aid are crucial for mitigating complications, reducing hospital stays, and improving outcomes in pediatric snakebite cases.
Background:
Snakebite remains a significant public health problem worldwide, particularly in rural areas with unexpected morbidity and mortality. This study evaluated the clinical, laboratory profile and outcomes in children with snake bites from Eastern India.
Methods:
This was a retrospective case record-based study between January 2017 and December 2021. The clinical features, complications, laboratory profiles and outcomes were analysed.
Results:
Thirty children with snake bites were admitted during this study period. There was a male predominance with a ratio of 2.3:1. The mean age of presentation was 10.4 years. About 60% of bites occurred during the rainy season between July and September. Most bites (96%) were on lower limbs, predominantly showing vasculotoxic features followed by neurotoxic and a combined presentation. In this study, around 53% received anti-snake venom (ASV) before reaching our centre; the median time to reach our centre was 13 h. Complications such as acute kidney injury (AKI), cellulitis, shock and coagulation abnormalities were common in those who arrived early (before 6 h) than in those who reached late (after 6 h). Similarly, the mean duration of hospital stay was less for those seeking medical attention early as compared to those reaching late for treatment (4.7 days vs. 7.2 days). Twenty-six out of 30 (86.7%) were discharged without any sequelae, 3 (10%) children were left against medical advice and one died.
Conclusions:
Snakebite remains a major health problem in children causing significant morbidity and mortality. Children, in general, especially males, are particularly vulnerable because of their playful and explorative nature and considerable time spent in outdoor activities. Preventive measures, education about avoiding traditional first aid methods and early administration of ASV reduce complications, duration of hospital stay and avoid the use of antibiotics.
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