Abeysinghe M Kularatne1, Anjana Silva2, Kalana Maduwage3, Ishani Ratnayake4, Chmara Walathara5, Chanka Ratnayake1, Suresh Mendis5, Ranjith Parangama5. 1. Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Drs Kularatne and C. Ratnayake). 2. Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka (Dr Silva). Electronic address: nkanjanasilva@gmail.com. 3. School of Medicine and Public Health, Faculty of Health, University of Newcastle, New South Wales, Australia, and Department of Biochemistry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Dr Maduwage). 4. Anuradhapura, Sri Lanka (Dr I. Ratnayake). 5. Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka (Drs Walathara, Mendis, and Parangama).
Abstract
BACKGROUND: Although snake bite remains a major health problem in Sri Lanka, there is a dearth of baseline information that would be useful in education about and prevention of snakebite. OBJECTIVES: The purpose of this study was to describe the socio-demographic characteristics, behavioral responses, treatment seeking, and prehospital interventions of snakebite victims in an area with high snakebite burden. METHODS: This prospective study was based on a cohort of snakebite victims presented to the Anuradhapura Teaching Hospital over a 1-year period from January 2010. RESULTS: Of the total of 1018 snakebite admissions, 69% were male and 65.8% were aged 21 to 50 years. Most of the victims were farmers (40%). The offending snakes were seen by 549 victims (54%); of these, only 46% (255) presented with a dead snake specimen. Only 38 of 1018 (4%) had first sought some form of indigenous treatment such as locally applied medications, herbal decoctions, nasal insufflations ("Nasna"), or applying snake stone over the bitten site. Some form of first aid had been adopted by 681 victims (67%), of whom all had washed the bitten site, and 18 victims (2%) and 4 (0.4%) had applied a dressing or incised the bitten site, respectively. A tourniquet had been applied by 353 victims (35%) for mean duration of 26 minutes (range, 5 to 120 minutes). None of the patients had immobilized the bitten limb by splinting. Oral medications had been used for pain relief in 74 cases (7%), paracetamol by all. CONCLUSIONS: A proportion of patients still seek native remedies and use inappropriate first aid after snakebite in Sri Lanka.
BACKGROUND: Although snake bite remains a major health problem in Sri Lanka, there is a dearth of baseline information that would be useful in education about and prevention of snakebite. OBJECTIVES: The purpose of this study was to describe the socio-demographic characteristics, behavioral responses, treatment seeking, and prehospital interventions of snakebite victims in an area with high snakebite burden. METHODS: This prospective study was based on a cohort of snakebite victims presented to the Anuradhapura Teaching Hospital over a 1-year period from January 2010. RESULTS: Of the total of 1018 snakebite admissions, 69% were male and 65.8% were aged 21 to 50 years. Most of the victims were farmers (40%). The offending snakes were seen by 549 victims (54%); of these, only 46% (255) presented with a dead snake specimen. Only 38 of 1018 (4%) had first sought some form of indigenous treatment such as locally applied medications, herbal decoctions, nasal insufflations ("Nasna"), or applying snake stone over the bitten site. Some form of first aid had been adopted by 681 victims (67%), of whom all had washed the bitten site, and 18 victims (2%) and 4 (0.4%) had applied a dressing or incised the bitten site, respectively. A tourniquet had been applied by 353 victims (35%) for mean duration of 26 minutes (range, 5 to 120 minutes). None of the patients had immobilized the bitten limb by splinting. Oral medications had been used for pain relief in 74 cases (7%), paracetamol by all. CONCLUSIONS: A proportion of patients still seek native remedies and use inappropriate first aid after snakebite in Sri Lanka.
Authors: Isabelle Bolon; Andrew M Durso; Sara Botero Mesa; Nicolas Ray; Gabriel Alcoba; François Chappuis; Rafael Ruiz de Castañeda Journal: PLoS One Date: 2020-03-05 Impact factor: 3.240