Armstrong Lois J, Cynthia Sharon, George Miriam, Zachariah Anand
Consultant, Epidemiology and Research Department, Duncan Hospital, Raxaul, East Champaran District, Bihar, India.
Consultant, Community Health Department, Duncan Hospital, Raxaul, East Champaran District, Bihar, India.
Trop Doct. 2019 Oct;49(4):285-292. doi: 10.1177/0049475519865036. Epub 2019 Jul 27.
In Bihar, an estimated 4500 snakebite deaths occur per year, but community data are scarce. Using a multi-stage cluster design, 4159 households were interviewed across six Community Development (CD) blocks in North Bihar, identifying 206 snakebites and 254 deaths between the Chhaat festivals of 2014 and 2015. Concurrently, 357 snakebite victims presented to Duncan Hospital from this area. None of the 254 verbal autopsies were attributed to snakebite envenoming. The annual community snakebite incidence was 643/100,000 person-years (95% confidence interval [CI] = 556-730) with peak incidence in women aged 30-39 years at 1323/100,000 person-years (95% CI = 837-1809). Two-thirds of snakebite victims attended traditional healers first for help (95% CI = 59.9-73.2). The community envenomation rate was 24.9/100,000 person-years (95% CI = 7.6-42.2). The hospital envenomation rate was 4.6% (95% CI = 3.5-5.7). Of the hospital snakebite deaths, 91% (10/11) were aged <16 years. Only 4.6% (95% CI = 4.1-5.1) of snakebite victims from this area presented at the local hospital.
在比哈尔邦，据估计每年有4500人死于蛇咬，但社区数据匮乏。采用多阶段整群设计，对北比哈尔邦六个社区发展（CD）街区的4159户家庭进行了访谈，确定在2014年和2015年的洒红节期间有206起蛇咬事件和254例死亡。同时，有357名蛇咬受害者被送往该地区的邓肯医院。在这254例死因推断中，没有一例归因于蛇咬中毒。社区蛇咬年发病率为643/10万人口年（95%置信区间[CI]=556 - 730），30 - 39岁女性的发病率最高，为1323/10万人口年（95%CI = 837 - 1809）。三分之二的蛇咬受害者首先求助于传统治疗师（95%CI = 59.9 - 73.2）。社区中毒率为24.9/10万人口年（95%CI = 7.6 - 42.2）。医院中毒率为4.6%（95%CI = 3.5 - 5.7）。在医院蛇咬死亡病例中，91%（10/11）年龄小于16岁。该地区只有4.6%（95%CI = 4.1 - 5.1）的蛇咬受害者前往当地医院就诊。
