|Year : 2013 | Volume
| Issue : 1 | Page : 53-55
Epidemiology of snakebite reported in a Medical College Hospital in Tamil Nadu
Muthunarayanan Logaraj1, Rajavelu Thirumavalavan2, Sekharan Gopalakrishnan1
1 Department of Community Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai, Tamil Nadu, India
2 Critical Care and Clinical Toxicology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai, Tamil Nadu, India
|Date of Web Publication||17-Apr-2013|
Department of Community Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai - 603 203, Tamilnadu
Source of Support: None, Conflict of Interest: None
Snakebite is one of the serious medical problems in India; however reliable data on epidemiological and treatment seeking behavior related to snakebite are very few. Hence a cross-sectional study was carried out at a tertiary care hospital among patients admitted with history of snakebite with a pretested structured questionnaire. Analysis of 106 reported cases of snakebite showed that 87.7% of the victims were in the age group of 15-59 years. Snakebite was twice common among males compared to females. Among the snakebite victims 46.2% were agricultural workers. Out of 84.9% snakebite victims who had seen the snake, only 24.5% killed the snake and brought for identification. Nearly two fifth of the cases were reported during the months of July to September. More than three fourth of the bites occurred in the lower limbs and nearly 69% of them occurred at night.
Keywords: Epidemiology, snakebite, Tamil Nadu
|How to cite this article:|
Logaraj M, Thirumavalavan R, Gopalakrishnan S. Epidemiology of snakebite reported in a Medical College Hospital in Tamil Nadu. Int J Health Allied Sci 2013;2:53-5
|How to cite this URL:|
Logaraj M, Thirumavalavan R, Gopalakrishnan S. Epidemiology of snakebite reported in a Medical College Hospital in Tamil Nadu. Int J Health Allied Sci [serial online] 2013 [cited 2019 May 27];2:53-5. Available from: http://www.ijhas.in/text.asp?2013/2/1/53/110566
| Introduction|| |
It is estimated that on average, nearly 200,000 are bitten by snakes every year in India out of which 35,000-50,000 die annually.  There are about 3000 species of snakes distributed throughout the world. In India, about 500 of the species are venomous and about 52 species are poisonous.  Snakebite is one of the serious medical problems in India; however, reliable data on morbidity and mortality on snakebite are not available since there are no proper reporting systems and a large number of cases seek traditional methods of treatment.  The present study was conducted with the objective of documenting, the socio-demographic profile of the victims, types of snake, seasonal variations, and clinical symptoms of patients admitted with history of snakebite.
| Materials and Methods|| |
A cross-sectional study was carried out at SRM Medical College Hospital and Research Centre, a tertiary care hospital in the Kancheepuram district of Tamil Nadu. The study included 106 cases who were admitted with history of snakebite between January 2007 and December 2009. The data on the variables such as age, sex, occupation, place of bite, site of bite, type of snake, time of bite, first aid taken were collected using a pretested structured questionnaire from the patient at the time of their admission. The data were analyzed with the help of Microsoft Excel and SPSS version 17 and were presented as simple proportions.
| Results|| |
About 106 cases of snakebite were reported during the study period of 3 years from 2007 to 2009. In this study majority (87.7%) of the victims were in the age group of 15-59 years. Snakebite was twice common among males compared to females. Among the snakebite victims 46.2% were agricultural workers, 31.1% were nonagricultural workers, 14.2% were housewives, and 8.5% were students. Out of 84.9% of the victims who had seen the snake, only 24.5% killed the snake and brought for identification. Reported types of snake were Cobra 12.3%, Krait 9.4%, Saw scale viper 4.7%, and Russel viper 2.8% [Table 1].
More number of cases of snakebite (40.6%) was reported during the months of July to September. The lower limb was found to be the most common site of bites (78.3%) and they occurred mostly at night (68.9%). Persons with barefoot were the most common victims of the snakebite and most of the bites occurred in the outdoor. Nearly half of the victims of the snake bite were in agricultural field and 36.8% of the bites occurred around their places of living [Table 2].
The common symptoms of snakebite reported during the time of admission to the hospital include local pain 67%, bleeding from the site 12.3%, inability to open the eyes 3.8%, giddiness 2.8%, and difficulty in breathing 2.8%. Only 4.7% of the victims of snakebite visited local traditional healers and 14.2% of the victims visited local doctors before they approached the hospital, while 81.1% of them came directly to hospital. The interval between time of snakebite and seeking medical care was less than 1 hour in 47.2% of cases. First aid was not provided in 51% of cases and the habit of tying a knot above the site of bite was seen in 39.6% [Table 3].
| Discussion|| |
Out of 106 cases of snakebite reported in the hospital two third of the victims were males and one third were females. Similar findings were reported by Pannalal et al. and Inamdar.  More males were victims of snakebite may be due to the fact that males were found to be available more in outdoors and thus more risk of exposure to the snakebite. In our study, snakebite had affected mainly the lower limbs (78.3%); similar findings were reported by other investigators. ,, In our study, 78% of the bites occurred in outdoor and 68.9% during night and majority of them were agricultural workers. Similar findings have been previously reported by Sharma et al.  In the present study, nearly three fourth of the bites have occurred over the bare foot. The above findings denote that risk of bitten by a snake increases with type of occupation and lack of preventive measures during occupation.
Nearly 36.8% of the bites had occurred in and around houses. This may be due to the reason that most of the rural population rear poultry and they spray the grains outside the houses to feed them. The rats are attracted to eat the spillover grains and take shelter in the crevices and holes in mud walls of the rural houses; these in turn attract snakes to such houses and they often enter them in search of food (rats). Common kraits are known to enter houses at night in search of food and bite their human victims sleeping on the floor, a common sleeping habit among Hindus in the rural Indian subcontinent. , The highest number of snakebites were reported (40.6%) from July to September. Similar findings were reported by other investigators. , In contrast Lal et al. reported more cases of snakebite from September to November. ,, The most common symptom reported was local pain followed by bleeding and similar findings were reported by other studies. , Even though 51.9% of the snakebite victims did not attempted any first aid measures, 31.6% have applied tourniquets above the site of bite.
| Conclusion|| |
It was evident from our study that most of the snakebites were preventable as they were associated with occupation and absence of footwear. Health education measures should be intensified about the use of gumboots to protect rural farmers from snakebite. The community should be educated about the risks of domestic bites, especially those occurring at night. Measures should be taken to prevent sheltering of rats either by closure of crevices and holes or use of mesh to cover the outlets in rural houses. Most experts currently discourage the use of tourniquets above the site of bite which could increase local complications by increasing tissue anoxia and triggering severe systematic envenoming right after their removal. , Imparting health education to traditional healers, community leaders and self-help groups in the villages on the do's and don'ts on the prevention of snakebite will go a long way in the prevention of death from snakebite among rural communities in India.
| References|| |
|1.||David AW. Guidelines for the clinical management of snake-bites in the south-east Asia region. New Delhi: World Health Organization, Regional Office for South East Asia; 2005. p. 1-67. |
|2.||Grover JK, Gindhar Adiga U, Radhi SS. Snakebites. J Forensic Med Toxicol 1996; 12:20-4. |
|3.||Lal P, Dutta S, Rotti SB, Danabalan M, Kumar A. Epidemiology profile of snakebite cases admitted in JIPMER; Indian j Community Med 2001;26:36-38 |
|4.||Inamdar IF, Aswar NR, Ubaidulla M, Dalvi SD. Snakebite: Admissions at a tertiary health care centre in Maharashtra, India. S Afr Med J 2010;100:456-8. |
|5.||Sellahewa K. Lessons from four studies on the management of snakebite in Sri Lanka. Ceylon Med J 1997;42:8-15. |
|6.||Lalloo DG, Trevett AJ, Saweri A, Naraqi S, Theakston RD, Warrell DA. The epidemiology of Snake bites in Popua New Guinea. Trans R Soc Trop Med Hyg 1995;89:178-82. |
|7.||Nhachi CF, Kasilo OM. Snake poisoning in Rural Zimbabwe. J Appl Toxicol 1994;14:191-3. |
|8.||Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S. Snake envenomation in a north Indian hospital. Emerg Med J 2005; 22:118-20. |
|9.||Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Trans R Soc Trop Med Hyg 2002;96:79-84. |
|10.||Saini RK, Singh S, Sharma S, Rampal V, Manhas AS, Gupta VK. Snake bite poisoning presenting as early morning neuroparalytic syndrome in Jhuggi dwellers. J Assoc Physicians India 1986; 34:415-7. |
|11.||Brunda G, Sashidhar RB. Epidemiological profile of snake-bite cases from Andhra Pradesh using immune analytical approach. Indian J Med Res 2007;125:661-8. |
|12.||Buranasin P. Snake bites at Maharat Nakhon Ratchasima regional Hospital. Souteast Asian J Trop Med Public Health 1993;24:186-92. |
|13.||Rano Mal. A study of snakebite cases J Pakistan Med Assoc 1994;44:289. |
|14.||Hisham M, Mahaba MD. Snakebite: Epidemiology, prevention, clinical presentation and management. Ann Saudi Med 2000;20:66-8. |
|15.||Al-Lawatia A, Al-Abri SS, Lalloo DG. Epidemiology and outcome of snake bite cases evaluated at a Tertiary Care Hospital in Oman. J Infect Public Health 2009;2:167-70. |
|16.||Warrell DA. WHO/SEARO Guidelines for the clinical management of snake bites in the Southeast Asian region. Southeast Asian J Trop Med Public Health 1999;30:1-85. |
|17.||Gold BS, Dart RC, Barish RA. Bites of venomous snakes. N Eng J Med 2002;347:347-56. |
[Table 1], [Table 2], [Table 3]