- Title
- A Prospective Study of Snakebite in a Tertiary Care Hospital in South-Western Nepal
- Creator
- Pandey, Deb Prasad; Shrestha, Bhola Ram; Acharya, Krishna Prasad; Shah, Khagendra Jang; Thapa-Magar, Chhabilal; Dhakal, Ishwari Prasad; Mohamed, Fahim; Isbister, Geoffrey K.
- Relation
- NHMRC.APP1110343 http://purl.org/au-research/grants/nhmrc/1110343
- Relation
- Transactions of the Royal Society of Tropical Medicine & Hygiene Vol. 117, Issue 6, p. 435-443
- Publisher Link
- http://dx.doi.org/10.1093/trstmh/trac127
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Snakebite is a neglected public health issue in Nepal. We aimed to characterize patients with snake envenoming admitted to hospital in south-western Nepal. Methods: This was a prospective cohort study of 476 snakebite patients admitted to Bheri Hospital from May to December 2017. Data were collected on patient demographics, bite circumstances, snake type, treatment-seeking behavior, clinical effects, complications and treatment. Results: There were 139/476 (29%) patients with clinical features of envenomation and 10 deaths (8%), of which six were prehospital deaths; 325/476 (68%) patients used non-recommended prehospital first aid, including 278 (58%) who applied a tourniquet and 43 (9%) consulting traditional healers. Median time to hospital arrival was 1.5 (IQR: 0.8–4) h. Also, 127 envenomated patients (91%) developed neurotoxicity and 12 (9%) hemotoxicity, while 124 patients (89%) received antivenom, with a median dose of 10 (4–30) vials. Three patients developed anaphylaxis following antivenom administration; 111 of 139 (80%) cases were admitted to the ICU and 48 (35%) were intubated. Median length of hospital stay for all cases was 0.5 (IQR: 0.5–1.2) d, but it was 2.2 (IQR: 1.5–3.8) d for envenomated cases. Conclusions: The majority of snakebite patients used non-recommended first aid or attended traditional healers. Almost one-third of patients developed systemic envenomation and required antivenom. The case fatality rate was high, but many died prior to arriving in hospital.
- Subject
- antivenom; envenomation; hemotxicity; neurotoxcitiy; snakebit incidence; traditional healer
- Identifier
- http://hdl.handle.net/1959.13/1480250
- Identifier
- uon:50468
- Identifier
- ISSN:0035-9203
- Language
- eng
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