Pandey Deb Prasad, Adhikari Bhojraj, Pandey Parash, Sapkota Kalyan, Bhusal Mina Kumari, Kandel Priti, Shrestha Durga Laxmi, Shrestha Bhola Ram
Department of Veterinary Microbiology and Parasitology, Agriculture and Forestry University, Bharatpur Metropolitan City, Nepal.
Institute for Social and Environmental Research-Nepal, Bharatpur Metropolitan City, Nepal.
Am J Trop Med Hyg. 2024 Nov 19;112(2):431-440. doi: 10.4269/ajtmh.24-0399. Print 2025 Feb 5.
We aimed to estimate the cost of snakebite and its impact on the economy of snakebite-affected households in southern Nepal. We conducted cross-sectional and prospective studies of confirmed snakebite cases at two hospitals in south central and southwestern Nepal during May to October 2020. We estimated the economic impact of snakebite on affected households by evaluating direct and indirect costs for treatments and opportunity costs of patients and attendants (household members or relatives). We included 553 snakebites that caused 185 envenomings (34%), resulting in 15 deaths (case fatality rate, 8%). These occurred across 87 subdistricts, 21 districts, and six provinces (25% rural, 75% urban overall). Median direct, indirect, and opportunity costs of snakebite were US$95.30, US$65.80, and US$4,995.20 for envenomings and US$14.50, US$13.50, and US$10.10 for nonenvenomed snakebites, respectively. The impact of snakebite envenomings on household economy included not only the remarkable out-of-pocket expenditure but also the loss of patients' and visitors' productivity (i.e., daily income/wages while seeking snakebite care in hospitals). Lack of insurance for snakebite treatment increased the psychosocial and economic burden. Deterioration in family economy and psychology was particularly severe when death from snakebite affected breadwinners. Therefore, taking action to minimize the impact of snakebite envenoming becomes a priority for all.
我们旨在估算尼泊尔南部蛇咬伤的成本及其对受蛇咬伤影响家庭经济的影响。2020年5月至10月期间，我们在尼泊尔中南部和西南部的两家医院对确诊的蛇咬伤病例进行了横断面研究和前瞻性研究。我们通过评估治疗的直接和间接成本以及患者和陪护人员（家庭成员或亲属）的机会成本，估算了蛇咬伤对受影响家庭的经济影响。我们纳入了553例蛇咬伤病例，其中185例出现了中毒症状（34%），导致15人死亡（病死率为8%）。这些病例分布在87个分区、21个县和六个省（总体上25%为农村地区，75%为城市地区）。对于中毒症状的蛇咬伤，其直接、间接和机会成本中位数分别为95.30美元、65.80美元和4995.20美元；对于未中毒的蛇咬伤，其直接、间接和机会成本中位数分别为14.50美元、13.50美元和10.10美元。蛇咬伤中毒对家庭经济的影响不仅包括显著的自付费用，还包括患者和陪护人员生产力的损失（即在医院寻求蛇咬伤治疗期间的日收入/工资）。缺乏蛇咬伤治疗保险增加了心理社会和经济负担。当蛇咬伤导致养家糊口者死亡时，家庭经济和心理状况的恶化尤为严重。因此，采取行动尽量减少蛇咬伤中毒的影响成为所有人的首要任务。
