School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Japan Snake Institute, Gunma, Japan.
PLoS Negl Trop Dis. 2023 Oct 2;17(10):e0011576. doi: 10.1371/journal.pntd.0011576. eCollection 2023 Oct.
Snakebite envenoming is a potentially life-threatening global public health issue with Bangladesh having one of the highest rates of snakebite cases. The Bede, a nomadic ethnic group in Bangladesh, traditionally engages in snake-related business such as snake charming. The Bede relies on their own ethnomedicinal practitioners for snakebite treatment while there is a lack of concrete evidence on the effectiveness of such ethnomedicinal treatment. To identify the barriers to the utilization of biomedical treatment for snakebite we conducted interviews with 38 Bede snake charmers, who have experienced snakebite, and six family members of those who died of snakebite. Our results show that four critical barriers, Accessibility, Affordability, Availability, and Acceptability (4As), prevented some of the Bede from seeking biomedical treatment. Moreover, we found that a few Bede died of a snakebite every year. There are survivors of snakebite who were able to receive biomedical treatment by overcoming all of the 4As. Our results provide insights into the current state of snakebite treatment in Bangladesh and can inform the development of more effective and accessible treatment options for those affected. Partnership between the public sector and the Bede community has the potential to make a significant impact in reducing snakebite morbidity and mortality in Bangladesh.
蛇伤中毒是一个具有潜在生命威胁的全球公共卫生问题,孟加拉国的蛇伤病例发生率位居世界前列。孟加拉国有一个名为 Bede 的游牧民族群体,他们传统上从事与蛇相关的业务,如耍蛇。Bede 依靠自己的传统医学从业者来治疗蛇伤,而这些治疗方法的有效性缺乏具体证据。为了确定在蛇伤治疗中利用生物医学治疗的障碍,我们采访了 38 名曾经历过蛇伤的 Bede 耍蛇者和 6 名因蛇伤死亡者的家属。研究结果表明,有四个关键障碍(可及性、可负担性、可获得性和可接受性)阻止了一些 Bede 人寻求生物医学治疗。此外,我们发现每年都有几名 Bede 人因蛇伤而死亡。有些蛇伤幸存者通过克服所有这 4 个障碍成功接受了生物医学治疗。我们的研究结果提供了孟加拉国目前蛇伤治疗状况的相关信息,并为那些受影响的人提供了更有效和更易获得的治疗方案的开发提供了依据。公共部门与 Bede 社区之间的合作有可能在降低孟加拉国的蛇伤发病率和死亡率方面产生重大影响。