Snakebites cause considerable death and injury worldwide and pose an
important yet neglected threat to public health, says new research published
in this week’s PLoS Medicine. The study used the most comprehensive methods
yet to estimate that at least 421,000 envenomings and 20,000 deaths from
snakebites occur each year, especially in South and South East Asia and
sub-Saharan Africa.
To estimate death and injury from snakebite, Janaka de Silva (University of
Kelaniya, Sri Lanka) and colleagues conducted a systematic review of the
scientific literature, reviewed county-specific mortality data from
databases maintained by United Nations organizations, and identified
unpublished information from Ministries of Health, National Poison Centres,
and snakebite experts on snakebites in countries that do not have reliable
data on snakebite incidence and mortality.
This data retrieval produced information for many of the world’s 227
countries, which were grouped into 21 geographical regions. The researchers
estimate that 421,000 envenomings and 20,000 deaths occur worldwide from
snakebite each year, but warn that these figures may be as high as 1,841,000
envenomings and 94,000 deaths, especially in areas of sub-Saharan Africa and
South Asia where antivenoms are hard to obtain. India has the highest
estimated annual envenomings and deaths: 81,000, and 11,000 respectively.
In a related Perspective article, Jean-Philippe Chippaux from the the
Institut de Recherche pour le DГ©veloppement in La Paz, Bolivia and
uninvolved in the research, argues that this study is a “preliminary but
essential step in improving accessibility of anitvenoms and the treatment of
snakebite.” Dr. Chippaux notes the dire situation of antivenom availability
and cost in Africa – a situation that could be worsened by the current
global economic crisis-where the price of a vial of antivenom is the
equivalent of several months of income for most rural families. Better
information on the global burden of snakebite would help understand how much
antivenom needs to be produced and in what areas it needs to be distributed,
he says. As de Silva and colleagues conclude, despite their careful
methodology, more population-based studies of incidence and mortality from
snakebite are urgently needed.
Citation: Estimation of the global burden of snakebite.
Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK,
Pathmeswaran A, et al. (2008)
PLoS Med 5(11): e218. doi:10.1371/journal.pmed.0050218
Click here to view article online
Citation: Chippaux J-P (2008) Estimating the global burden of snakebite can
help to improve management. PLoS Med 5(11): e221.
doi:10.1371/journal.pmed.0050221
Click here to view article online
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