Department of Veterinary Microbiology and Parasitology, Agriculture and Forestry University, Rampur, Chitwan, Bagmati Province, Nepal.
Department of Pediatrics, Bharatpur Hospital, Bharatpur, Chitwan, Bagmati Province, Nepal.
PLoS Negl Trop Dis. 2023 Aug 28;17(8):e0011572. doi: 10.1371/journal.pntd.0011572. eCollection 2023 Aug.
Snakebite envenoming is a well-known medical emergency in the Terai of Nepal in particular. However, there is an epidemiological knowledge gap. The news media data available online provide substantial information on envenomings. Assessing this information can be a pristine approach for understanding snakebite epidemiology and conducting knowledge-based interventions. We firstly analyzed news media-reported quantitative information on conditions under which bites occur, treatment-seeking behavior of victims, and outcomes of snakebite envenomings in Nepal.
METHODOLOGY/PRINCIPAL FINDINGS: We analyzed 308 Nepalese snakebite envenomed cases reported in 199 news media articles published between 2010 and 2022 using descriptive statistics, Wilcoxon, and Chi-square tests to know why and how victims were bitten, their treatment-seeking behavior, and the outcomes. These envenomated cases known with substantial information represented 48 districts (mostly located in the Terai region) of Nepal. These envenomings mostly occurred in residential areas affecting children. Generally, envenomings among males and females were not significantly different. But, in residential areas, females were more envenomed than males. Further, victims' extremities were often exposed to venomous snakebites while their active status and these episodes often occurred at night while victims were passive during snakebites indoors and immediate surroundings of houses. Snakebite deaths were less among referred than non-referred cases, males than females, and while active than passive conditions of victims.
CONCLUSION/SIGNIFICANCE: The most of reported envenomed patients were children, and most envenomings were due to cobra bites. Consultation with traditional healers complicated snakebite management. In most cases, deaths that occur without medical interventions are a severe snakebite consequence in Nepal. Further, several deaths in urban areas and mountains and higher hills of Nepal suggest immediate need of snakebite management interventions in the most affected districts. Therefore, there is an urgent need to immediately admit Nepalese snakebite victims to nearby snakebite treatment centers without adopting non-recommended prehospital interventions. The strategies for preventing snakebite and controlling venom effects should also include hilly and mountain districts where snakebite-associated deaths are reported.
在尼泊尔的特莱地区，蛇伤中毒是一种众所周知的医疗紧急情况。然而，目前存在流行病学知识空白。在线新闻媒体数据提供了大量关于中毒事件的信息。评估这些信息可以为了解蛇伤流行病学和进行基于知识的干预提供一种全新的方法。我们首先分析了新闻媒体报道的有关咬伤发生条件、受害者寻求治疗行为以及尼泊尔蛇伤中毒结果的定量信息。
方法/主要发现：我们使用描述性统计、Wilcoxon 和卡方检验分析了 2010 年至 2022 年期间发表的 199 篇新闻媒体文章中报道的 308 例尼泊尔蛇伤中毒病例，以了解受害者为何以及如何被咬伤、他们的治疗寻求行为以及结果。这些有大量信息的中毒病例代表了尼泊尔的 48 个区（主要位于特莱地区）。这些中毒事件主要发生在住宅区，影响儿童。一般来说，男性和女性的中毒情况没有显著差异。但是，在住宅区，女性比男性更容易中毒。此外，受害者的四肢经常暴露在毒蛇咬伤中，而这些事件通常发生在夜间，受害者在室内和房屋周围处于被动状态。与未转诊病例相比，转诊病例的蛇伤死亡人数较少，男性比女性少，受害者活动状态比被动状态少。
结论/意义：报道的中毒患者大多数是儿童，大多数中毒是由眼镜蛇咬伤引起的。与传统治疗师咨询使蛇伤管理复杂化。在大多数情况下，没有医疗干预的死亡是尼泊尔蛇伤的严重后果。此外，尼泊尔城市地区和山区以及较高山区的几例死亡表明，在受影响最严重的地区急需开展蛇伤管理干预。因此，急需将尼泊尔蛇伤受害者立即送往附近的蛇伤治疗中心，而不采用非推荐的院前干预措施。预防蛇伤和控制毒液作用的策略还应包括报告有蛇伤相关死亡的丘陵和山区。
