Clinico-epidemiological study of snakebite: an audit of 13 years of data from a community-based treatment centre in eastern Nepal
Srista Manandhar, Sunit Chhetri, Rohan Basnet, Arun Gautam, Urza Bhattarai, Manish Uprety, Aarjav Sharma, Ujwal Gautam, Madhav Bhushal, Sanjib Kumar SharmaAbstract
Background
Snakebite envenomation is a global public health concern, especially in tropical and subtropical regions. We describe the demography, presentations, treatments and outcomes of snakebites from a community snakebite treatment centre in Nepal.
Methods
This was a retrospective study of snakebite cases from 2008 to 2021 presenting in a community-based treatment centre in eastern Nepal. The data were collected from predesigned forms in the centre.
Results
The median age of the victims (N=13 825) was 29 y (interquartile range 18–43) predominantly comprising farmers (39.5%). Cobras (Naja spp.) were the predominant species. Self-treatment practices like the application of tourniquets are common (74.5%) and antivenom was infused to 3.3% of victims. Motorcycles (57.9%) were the primary mode of transport, significantly reducing the time to reach healthcare centres compared with other means (p<0.001). The majority of patients visiting the community snakebite centre exhibited improvement (98.4%), with a low referral rate (0.6%) and case fatality rate (1.26%).
Conclusions
Snakebites are a common problem in rural Nepal. Neurotoxic envenomation, inflicted by the common cobra, predominates in this area. This community-based snakebite treatment centre, managed by paramedics, exemplifies the successful outcome of snakebite management in Nepal.