Snakebites at Maharat Nakhon Ratchasima Regional Hospital.

One hundred and ninety-nine victims of snakebite hospitalized at Maharat Nakhon Ratchasima Hospital between 1898 and 1991 were studied. The male:female ratio was 1.9:1 and their mean age (+/- SD) was 30.0 +/- 18.6 years. The most common of victims were farmers and laborers. Dead snakes were identified as follows: 72 were Trimeresurus sp. (36.2%), 36 were Naja kaouthia (17.6%), 4 were Bungarus fasciatus (2.0%), 1 were Colloselasma rhodostoma (0.5%) and 1 was Vipera russelli (0.5%). No death was noted among the victims bitten by Trimeresurus sp, C. rhodostoma and V. russelli. Fifty-eight victims exhibited complications, constituting 29.1%. Four cases died from the bite of N. kaouthia, 2 from B. fasciatus and 1 from unidentified snake. A total death rate was 3.5% (7 in 199 cases). The mean duration in the hospital for patients bitten by Trimeresurus sp. and N. kaouthia were 2.3 days and 2.0 days, respectively. In order to decrease the morbidity and mortality of snakebite victims in Nakhon Ratchasima Province, prevention and control of this entity should be emphasized in health education of local people, training programs on appropriate management of snakebites for the medical and paramedical personnel working in the remote rural district hospitals and health centers. In addition, antivenoms and other necessary medical supplies should be adequately provided.