Das Suman, Banerjee Sitikantha, Naskar Somnath, Das Dilip K
Resident (Community Medicine), Burdwan Medical College, West Bengal, India.
Resident (Community Medicine), All India Institute of Medical Sciences, Nagpur, India.
Med J Armed Forces India. 2021 Jan;77(1):58-62. doi: 10.1016/j.mjafi.2019.11.003. Epub 2020 Apr 29.
Snakebite is a time decisive medical emergency requiring contact with health facility at the earliest. Many snakebite victims yet seek care from traditional healers (THs) or village quacks (VQs) before reaching an appropriate facility, which leads to adverse consequences. This study was conducted to assess care-seeking behaviour and pathways followed in reaching appropriate facilities among suspected snakebite cases and to identify associated factors.
A hospital-based cross-sectional study was conducted at a medical college in West Bengal. All suspected snakebite cases admitted during a reference period of two months were studied. Study subjects and/or accompanying persons were interviewed for care-seeking behaviours and pathways followed.
Among the 393 study participants, most were ≤30 years of age, men, agricultural workers, of lower middle and lower socioeconomic class and only 69.5% had formal schooling. The commonest place of occurrence was the agricultural field (40.7%), and the commonest biting site was the lower extremity (77.6%). Only half of participants (55.2%) used immediate correct measures at the biting site. Incorrect practices included tourniquet application (29.5%), use of herbal preparation (7.1%), blade shaving at site (2.8%) etc. As first care-seeking points, 15% and 24.9% of cases visited THs and VQs, respectively. Pathway analysis revealed that unfavourable pathway was followed by 39.9% participants. Two unfavourable points were consulted by 3.8% of participants. The care-seeking pathway was significantly associated with religion, caste, education and socioeconomic class.
Findings of this study highlight the urgent need for behaviour change interventions addressing the myths and misconceptions of people regarding snakebite.
蛇咬伤是一种时间紧迫的医疗紧急情况，需要尽早与医疗机构取得联系。许多蛇咬伤受害者在前往合适的医疗机构之前，会先寻求传统治疗师（THs）或乡村庸医（VQs）的治疗，这会导致不良后果。本研究旨在评估疑似蛇咬伤病例寻求治疗的行为和前往合适医疗机构所采取的途径，并确定相关因素。
在西孟加拉邦的一所医学院进行了一项基于医院的横断面研究。对在两个月参考期内收治的所有疑似蛇咬伤病例进行了研究。对研究对象和/或陪同人员就寻求治疗的行为和途径进行了访谈。
在393名研究参与者中，大多数年龄≤30岁，为男性，从事农业工作，社会经济阶层为中下层，只有69.5%接受过正规教育。最常见的发生地点是农田（40.7%），最常见的咬伤部位是下肢（77.6%）。只有一半的参与者（55.2%）在咬伤部位采取了立即正确的措施。不正确的做法包括使用止血带（29.5%）、使用草药制剂（7.1%）、在咬伤部位用刀片刮（2.8%）等。作为首个寻求治疗的地点，分别有15%和24.9%的病例去看了传统治疗师和乡村庸医。途径分析显示，39.9%的参与者采取了不利的途径。3.8%的参与者咨询了两个不利的地点。寻求治疗的途径与宗教、种姓、教育和社会经济阶层显著相关。
本研究结果突出表明，迫切需要开展行为改变干预措施，以消除人们对蛇咬伤的误解和错误观念。
