Trend of Snakebite Cases and their Management at Holy Family Hospital Rawalpindi During 2022: Trend of Snakebite Cases

Shazia  Zeb; Rizwana  Shahid; Farzana  Fatima

doi:10.54393/tt.v4i02.119

Authors

Shazia Zeb Holy Family Hospital, Rawalpindi, Pakistan
Rizwana Shahid Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
Farzana Fatima Holy Family Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/tt.v4i02.119

Keywords:

Snakebite, Vasculotoxic, Anti-snake venom ampules, Survived

Abstract

Snakebite is a neglected public health problem of tropical and subtropical regions globally. Millions of cases are reported annually worldwide and about half of them are bitten by poisonous snakes. Objectives: To determine trend of snakebite cases and their management at Holy Family Hospital during 2022. Methods: A retrospective hospital-record based study was done to identify the trend of snakebite cases reported at Holy Family Hospital Rawalpindi during 2022. The data was gathered from hospital administrators pertaining to age, gender, residential address, types of snakebite and treatment given. Data were analyzed by SPSS software version 25.0 and MS Excel 2016. Descriptive statistics were computed. Independent sample t-test was applied to measure statistically significant gender-based difference in mean age of the snake bite victims. P < 0.05 was considered significant. Results: Of the 90 snakebite cases, 64.1% were males. Mean age of the victims was 34.7 ±14.8 years. Difference in mean age of male and female victims was statistically insignificant (P > 0.67). Majority (33%) was resident of Rawalpindi, followed by 22% and 12.3% from Attock and Azad Jammu & Kashmir respectively. Peak of the cases was during July and August. As most (91.1%) of them were bitten by vasculotoxic snakes, so out of 1,117 anti-snake venom ampules about 93.1% were administered to those cases. None of the cases succumbed to snakebite. Conclusions: Snakebite has frequently been reported among residents of Rawalpindi and its neighbouring areas during summer season. The victims were promptly treated for their survival.

References

Ahmed SM, Ahmed M, Nadeem A, Mahajan J, Choudhary A, Pal J. Emergency treatment of a snake bite: Pearls from literature. Journal of Emergencies, Trauma and Shock. 2008 Jul; 1(2): 97. doi: 10.4103/0974-2700.43190

Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS medicine. 2008 Nov; 5(11): e218. doi: 10.1371/journal.pmed.0050218

Gutiérrez JM, Calvete JJ, Habib AG, Harrison RA, Williams DJ, Warrell DA. Snakebite envenoming. Nature reviews. Disease primers, 3, 17063. doi: 10.1038/nrdp.2017.63

Habib ZG, Salihu AS, Hamza M, Yakasai AM, Iliyasu G, Yola IM, et al. Posttraumatic stress disorder and psycho-social impairment following snakebite in Northeastern Nigeria. The International Journal of Psychiatry in Medicine. 2021 Mar; 56(2): 97-115. doi: 10.1177/0091217420913400

Myo-Khina TN and Nyan-Tun-Ooc YH. Prognostic indicators in patients with snakebite: analysis of two-year data from a township hospital in central Myanmar. WHO South-East Asia Journal of Public Health. 144. doi: 10.4103/2224-3151.206927

ENVPK. 11 Venomous and Non-venomous snake species found in Pakistan. 2021. [Last cited: 29th Apr 2023]. Available at: https://www.envpk.com/venomous-and-non-venomous-snake-species-found-in-pakistan/.

The Express Tribune. Treating snakebites, one snake at a time. 2019. [Last cited: 29th Apr 2023]. Available at: https://tribune.com.pk/story/1926889/treating-snakebites-one-snake-time.

Shah HBU, Khan MA, Khalid M, Akram S. Knowledge and first aid practices regarding snakebites- An experience of Southern Punjab, Pakistan. Isra Medical Journal. 2017; 9(4): 238-43.

Luiselli L, Sale L, Akani GC, Amori G. Venomous snake abundance within snake species’ assemblages worldwide. Diversity. 2020 Feb; 12(2): 69. doi: 10.3390/d12020069

Alirol E, Sharma SK, Bawaskar HS, Kuch U, Chappuis F. Snake bite in South Asia: a review. PLoS neglected tropical diseases. 2010 Jan; 4(1): e603. doi: 10.1371/journal.pntd.0000603

Asif N, Akhtar F, Kamal K. A study of ninety snake bite cases at Pakistan Air Force (PAF) Hospital, Shorkot, Pakistan. Pakistan Armed Forces Medical Journal. 2015 Jun; 65(3): 333-8.

Khan MS. The snakebite problem in Pakistan. Bulletins Chicago Herpetological Society. 2014 Jan; 49(12): 165-7.

Silva KM, Silva KB, Sueiro LR, Oliveira ME, Almeida-Santos SM. Reproductive biology of Bothrops atrox (serpentes, viperidae, crotalinae) from the brazilian Amazon. Herpetologica. 2019 Sep; 75(3): 198-207. doi: 10.1655/D-18-00023

Bravo-Vega C, Santos-Vega M, Cordovez JM. Disentangling snakebite dynamics in Colombia: How does rainfall and temperature drive snakebite temporal patterns?. PLOS Neglected Tropical Diseases. 2022 Mar; 16(3): e0010270. doi: 10.1371/journal.pntd.0010270

Thapar R, Darshan BB, Unnikrishnan B, Mithra P, Kumar N, Kulkarni V, et al. Clinico-epidemiological profile of snakebite cases admitted in a tertiary care centre in South India: a 5 years study. Toxicology International. 2015 Jan; 22(1): 66. doi: 10.4103/0971-6580.172260

Lancet T. Snake-bite envenoming: a priority neglected tropical disease. Lancet (London, England). 2017 Jul; 390(10089): 2. doi: 10.1016/S0140-6736(17)31751-8

Jarwani B, Jadav P, Madaiya M. Demographic, epidemiologic and clinical profile of snake bite cases, presented to Emergency Medicine department, Ahmedabad, Gujarat. Journal of emergencies, trauma, and shock. 2013 Jul; 6(3): 199. doi: 10.4103/0974-2700.115343

Satyanarayan B, Panda SK, Sunder A, Kumari S. Clinical and epidemiological profile of snakebite cases–A study from an industrial teaching hospital at Jamshedpur, Jharkhand, India. Journal of family medicine and primary care. 2022 Dec; 11(12): 7652. doi: 10.4103/jfmpc.jfmpc_890_22

Tchoffo D, Kamgno J, Kekeunou S, Yadufashije C, Nana Djeunga HC, Nkwescheu AS. High snakebite underreporting rate in the Centre Region of Cameroon: an observational study. BMC Public Health. 2019 Dec; 19: 1-7. doi: 10.1186/s12889-019-7363-3

Jayawardana S, Arambepola C, Chang T, Gnanathasan A. Prevalence, vulnerability and epidemiological characteristics of snakebite in agricultural settings in rural Sri Lanka: a population-based study from South Asia. PLoS One. 2020 Dec; 15(12): e0243991. doi: 10.1371/journal.pone.0243991

Shahid R, Umar M, Zeb S, Mahmood T, Fatima F. Trend of OPD, Emergency, Diagnostic & Operative Statistics 2020 of Holy Family Hospital Rawalpindi Pakistan in Relation to COVID-19. British Journal of Medical & Health Sciences (BJMHS). 2022 Feb; 4(2). doi: 10.26717/BJSTR.2022.42.006737

Agha S, Shahani R, Kazi SA. Pattern of snake bite cases visiting at rural health centre of Sindh, Pakistan. Pakistan Armed Forces Medical Journal. 2010 Sep; 60(3): 360-2.

World Health Organization. Guidelines for the management of snakebites. 2016. 2nd Edition. Available at: https://www.who.int/docs/default-source/searo/india/health-topic-pdf/who-guidance-on-management-of-snakebites.pdf?sfvrsn=5528d0cf_2

World Health Organization. Regional Office for South East Asia. Regional Action Plan for prevention and control of snakebite envenoming in the South-East Asia. 2022-2030. Available at: https://www.who.int/news/item/23-05-2019-who-launches-global-strategy-for-prevention-and-control-of-snanebite-envenoming.