Jayawardana Subashini, Chang Thashi, Gnanathasan Ariaranee, Arambepola Carukshi
Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka.
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka.
Trans R Soc Trop Med Hyg. 2025 May 1;119(5):550-559. doi: 10.1093/trstmh/trae071.
Despite the availability of antivenom, not all snakebite victims choose to seek allopathic care. This choice of care is likely to be determined by unexplored personal and external factors. We studied the factors influencing the choice of treatment and first aid measures among snakebite victims.
We conducted a population-based study integrating quantitative and qualitative research methods among snakebite victims in the preceding 12 months, selected from 8707 residents in Ampara District, representing typical rural Sri Lanka with a high snakebite burden. Interviewers collected data using questionnaires and in-depth interviews. Logistic regression and thematic analysis were performed.
Among the 153 victims, 57.5% were farmers. As first aid, 19.6% practiced the application of tourniquets. The treatment choices were allopathic medicine (65.4%), ayurvedic/traditional (26.1%), faith healing (3.3%), self-medication (2.0%) and none (3.3%). Visible ambient light at the time of bite (adjusted odds ratio [aOR] 2.3 [95% confidence interval {CI} 1.1 to 4.7]), absence of local swelling (aOR 2.5 [95% CI 1.1 to 5.3]) and prolonged bleeding (aOR 8.6 [95% CI 1.9 to 33.3]) determined failure to seek allopathic treatment, while personal characteristics showed no influence. Qualitative inquiry revealed that the treatment choice was influenced by the ability of the victim or others to recognize envenoming features and the snake as venomous and awareness of the facilities available in hospitals.
The time of snakebite, recognition of the snake/envenoming and awareness of accessible medical services determined the treatment choice following snakebite.
尽管有抗蛇毒血清，但并非所有蛇咬伤受害者都选择寻求现代医学治疗。这种治疗选择可能由尚未探究的个人和外部因素决定。我们研究了影响蛇咬伤受害者治疗选择和急救措施的因素。
我们在前12个月对蛇咬伤受害者进行了一项基于人群的研究，整合了定量和定性研究方法，研究对象从安帕拉区的8707名居民中选取，该地区代表了蛇咬伤负担高的典型斯里兰卡农村地区。访谈者通过问卷调查和深入访谈收集数据。进行了逻辑回归和主题分析。
在153名受害者中，57.5%是农民。作为急救措施，19.6%的人使用了止血带。治疗选择为现代医学（65.4%）、阿育吠陀/传统医学（26.1%）、信仰疗法（3.3%）、自我用药（2.0%）和不治疗（3.3%）。咬伤时可见周围环境光（调整比值比[aOR]2.3[95%置信区间{CI}1.1至4.7]）、无局部肿胀（aOR 2.5[95%CI 1.1至5.3]）和出血时间延长（aOR 8.6[95%CI 1.9至33.3]）决定了未寻求现代医学治疗，而个人特征未显示出影响。定性调查显示，治疗选择受受害者或其他人识别中毒特征和蛇为有毒的能力以及对医院可用设施的知晓程度影响。
蛇咬伤时间、对蛇/中毒的识别以及对可获得医疗服务的知晓程度决定了蛇咬伤后的治疗选择。
