Ralph Ravikar, Ramesh Rohan Michael, Jambugulam Mohan, Deborah Arpitha Anbu, Aruldas Kumudha, Moorthy Neal A, John Sushil Mathew, Walson Judd L, Zachariah Anand, Ajjampur Sitara Swarna Rao
Poison Control Center, Department of Medicine Unit-1, Christian Medical College, Vellore 632004, Tamil Nadu, India.
The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, Tamil Nadu, India.
Trans R Soc Trop Med Hyg. 2025 Mar 7;119(3):317-326. doi: 10.1093/trstmh/trae083.
Nearly 60 000 Indians die of snakebite envenoming each year. Most deaths occur in rural communities and remote tribal settlements. We describe snakebite-related epidemiology and health-seeking behaviours in a rural (Timiri) and remote tribal block (Jawadhu Hills) in Tamil Nadu, India.
This cross-sectional survey used structured questionnaires for information pertaining to snakebites and their treatment in the preceding year. Treatment-seeking behaviour from the moment reported until recovery was mapped. Traditional healers residing in the two blocks were also surveyed.
Snakebite incidence and mortality were 174/100 000 population and 2.7/100 000 population in Jawadhu Hills and 194/100 000 population and 2.6/100 000 population in Timiri, respectively. More snakebite victims applied tourniquets in Jawadhu Hills (90%) than in Timiri (69%). Traditional healers were the first contact for 64% in Jawadhu Hills. Ambulances and buses were reported as unavailable in Jawadhu Hills. Traditional healers in Jawadhu Hills did not refer snakebite victims to hospitals.
Three challenges to snakebite mitigation in Indian rural and tribal communities highlighted in this study are potentially harmful first aid, a disconnect between traditional healers and the public health system and a lack of emergency transport to health facilities. Addressing these challenges would necessitate community awareness, traditional healer engagement and improved means of public transportation.
每年有近6万印度人死于蛇咬伤中毒。大多数死亡发生在农村社区和偏远的部落定居点。我们描述了印度泰米尔纳德邦一个农村地区（蒂米里）和一个偏远部落地区（贾瓦德胡山）与蛇咬伤相关的流行病学情况及就医行为。
这项横断面调查使用结构化问卷收集前一年与蛇咬伤及其治疗相关的信息。绘制了从报告蛇咬伤到康复期间的就医行为。还对居住在这两个地区的传统治疗师进行了调查。
贾瓦德胡山的蛇咬伤发病率和死亡率分别为每10万人174例和每10万人2.7例，蒂米里的蛇咬伤发病率和死亡率分别为每10万人194例和每10万人2.6例。贾瓦德胡山使用止血带的蛇咬伤受害者（90%）比蒂米里（69%）更多。在贾瓦德胡山，64%的蛇咬伤受害者首先联系传统治疗师。据报告，贾瓦德胡山没有救护车和公共汽车。贾瓦德胡山的传统治疗师没有将蛇咬伤受害者转诊到医院。
本研究强调的印度农村和部落社区减轻蛇咬伤危害面临的三个挑战是潜在有害的急救、传统治疗师与公共卫生系统之间的脱节以及缺乏前往医疗机构的紧急交通工具。应对这些挑战需要提高社区意识、让传统治疗师参与以及改善公共交通方式。
