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Challenges in paediatric snakebite management: physician perspectives from rural Sri Lanka
Kavinda Dayasiri1, Indika Gawarammana2, Shaluka Jayamanne1
1Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Insights
Paediatric snakebite management in Sri Lanka faces significant hurdles, including delayed care-seeking and antivenom access issues. Improving healthcare infrastructure and training is vital for better outcomes in child snakebite cases.
Area of Science:
- Pediatric Emergency Medicine
- Toxicology
- Public Health
Background:
- Snakebites pose a significant threat to children in Sri Lanka.
- Effective management of pediatric snakebites requires addressing multifaceted challenges.
Purpose of the Study:
- To explore the challenges faced by pediatric emergency care teams in managing snakebite cases in Sri Lankan children.
- Identify systemic, infrastructural, and educational barriers impacting pediatric snakebite management.
Main Methods:
- Qualitative exploratory study utilizing focus group discussions (FGDs) with physicians.
- Thematic analysis applied to identify key challenges in clinical decision-making, healthcare access, and resource availability.
Main Results:
- Key challenges include delayed medical care due to misconceptions, limited antivenom access in peripheral hospitals, and inadequate intensive care facilities.
- Variability in clinical decision-making and lack of standardized pediatric treatment guidelines complicate management.
- Gaps in clinical training and the need for interdisciplinary collaboration were emphasized.
Conclusions:
- Pediatric snakebite management in Sri Lanka is hampered by systemic, infrastructural, and educational deficits.
- Strengthening healthcare infrastructure, ensuring antivenom access, and standardizing treatment protocols are crucial.
- Policy interventions and community education are essential for improving awareness and timely care-seeking.
Purpose:
This study aims to explore the challenges encountered by paediatric emergency care teams in managing snakebite cases in children across three major referral hospitals in Sri Lanka.
Methods:
A qualitative exploratory study was conducted using focus group discussions (FGDs) with physicians who manage paediatric snakebites from Polonnaruwa and Trincomalee District General Hospitals, Kurunegala Teaching Hospital, and peripheral hospitals in the same districts. Thematic analysis was used to identify key challenges related to clinical decision-making, access to healthcare services, availability of antivenom and medical supplies, capacity building, interdisciplinary collaboration, and policy-related issues.
Results:
Several challenges were identified, including delays in seeking medical care due to community misconceptions, limited access to antivenom in peripheral hospitals, inadequate intensive care facilities, and gaps in clinical training. Variability in clinical decision-making and the absence of standardized paediatric treatment guidelines further complicated management. Participants emphasized the need for interdisciplinary collaboration, improved referral networks, and targeted educational interventions to address these gaps.
Conclusions:
Paediatric snakebite management in Sri Lanka is hindered by systemic, infrastructural, and educational challenges. Strengthening healthcare infrastructure, ensuring equitable access to antivenom, implementing standardized treatment protocols, and enhancing training programs for healthcare providers are crucial steps in improving patient outcomes. Policy-level interventions and community education initiatives are necessary to mitigate delays in care-seeking and enhance awareness.
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