Snakebite mortality in India: a nationally representative mortality survey.

PLoS Negl Trop Dis 2011 Apr 12;5(4):e1018. Epub 2011 Apr 12.

Shri Ramachandra Bhanj Medical College, Cuttack, Orissa, India.

Background: India has long been thought to have more snakebites than any other country. However, inadequate hospital-based reporting has resulted in estimates of total annual snakebite mortality ranging widely from about 1,300 to 50,000. We calculated direct estimates of snakebite mortality from a national mortality survey.

Methods And Findings: We conducted a nationally representative study of 123,000 deaths from 6,671 randomly selected areas in 2001-03. Full-time, non-medical field workers interviewed living respondents about all deaths. The underlying causes were independently coded by two of 130 trained physicians. Discrepancies were resolved by anonymous reconciliation or, failing that, by adjudication. A total of 562 deaths (0.47% of total deaths) were assigned to snakebites. Snakebite deaths occurred mostly in rural areas (97%), were more common in males (59%) than females (41%), and peaked at ages 15-29 years (25%) and during the monsoon months of June to September. This proportion represents about 45,900 annual snakebite deaths nationally (99% CI 40,900 to 50,900) or an annual age-standardised rate of 4.1/100,000 (99% CI 3.6-4.5), with higher rates in rural areas (5.4/100,000; 99% CI 4.8-6.0), and with the highest state rate in Andhra Pradesh (6.2). Annual snakebite deaths were greatest in the states of Uttar Pradesh (8,700), Andhra Pradesh (5,200), and Bihar (4,500).

Conclusions: Snakebite remains an underestimated cause of accidental death in modern India. Because a large proportion of global totals of snakebites arise from India, global snakebite totals might also be underestimated. Community education, appropriate training of medical staff and better distribution of antivenom, especially to the 13 states with the highest prevalence, could reduce snakebite deaths in India.

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0001018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075236PMC
April 2011
23 Reads

Publication Analysis

Top Keywords

snakebite deaths
16
snakebite mortality
12
annual snakebite
12
snakebite
9
nationally representative
8
andhra pradesh
8
deaths
8
rural areas
8
india
5
total 562
4
reconciliation failing
4
accidental death
4
adjudication total
4
41/100000 99%
4
failing adjudication
4
562 deaths
4
snakebites snakebite
4
total deaths
4
underestimated accidental
4
deaths assigned
4

References

(Supplied by CrossRef)
Medicine in India: Modern Period (History of Science, Philosophy and Culture in Indian Civilization, Vol. IX: Part 1)
OP Jaggi et al.
2000
Snakes of India: The Field Guide
R Whitaker et al.
2004
Snake bites.
BMJ 1892
Indian sanitary reports.
BMJ 1927
Snakebite mortality in the world.
S Swaroop et al.
Bull World Health Organ 1954
Health Status Indicators, National Health Profile 2007 and 2008 (Provisional): 3.1.2.9 State/UT wise Cases and Deaths Due to Snake Bite in India. 107–108.
Epidemiology of snake bite in the district of Burdwan, West Bengal.
AK Hati et al.
J Indian Med Assoc 1992
Snake-bites: appraisal of the global situation.
JP Chippaux et al.
Bull World Health Organ 1998

Similar Publications