Bibliographic Details
| Title: |
A prospective study of snakebite in a tertiary care hospital in south-western Nepal. |
| Authors: |
Pandey, Deb Prasad, Shrestha, Bhola Ram, Acharya, Krishna Prasad, Shah, Khagendra Jang, Thapa-Magar, Chhabilal, Dhakal, Ishwari Prasad, Mohamed, Fahim, Isbister, Geoffrey K |
| Source: |
Transactions of the Royal Society of Tropical Medicine & Hygiene; Jun2023, Vol. 117 Issue 6, p435-443, 9p |
| Subject Terms: |
SNAKEBITES, TERTIARY care, LONGITUDINAL method, LENGTH of stay in hospitals, ANTIVENINS, HEALERS |
| Geographic Terms: |
NEPAL |
| Abstract: |
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. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
