Abstract
In Africa, Asia, Latin America, and parts of Oceania, envenoming after snakebite is a serious public health problem [1]. Conservative data suggest that between 1.2 and 5.5 million people suffer snakebites every year, resulting in 25,000 to 125,000 deaths and leaving approximately 400,000 victims with permanent sequelae [2,3]. Despite its significant impact on human health, this disease remains largely neglected by national and international health authorities, funding agencies, pharmaceutical companies, patients’ organizations, and health advocacy groups [1,2]. Most initiatives aiming to study snakes, snake venoms, and snakebite envenoming and its treatment approach the problem from a biomedical and technological perspective. Notwithstanding the substantial scientific and clinical legacy generated through this view, significant gaps remain in our understanding of other highly relevant aspects of this problem and its solutions. The emerging field of global health has brought about a more holistic approach to health issues by incorporating a “biosocial approach” to the understanding of diseases and the circumstances behind their occurrence [4]. The centrepiece of this approach is the integration of biomedical aspects—including etiology, pathophysiology, diagnosis, and therapy—with the analysis of the social, economic, psychological, cultural, and political contexts in which diseases occur. Snakebite envenoming is predominantly a disease of the poor [5], with the highest incidence and severity seen in regions facing complex and interrelated social and economic problems. Understanding how this interplay of variables influences both the circumstances leading to snakebite injury and its consequences is crucial to developing successful strategies to mitigate the problem. A comprehensive multidisciplinary approach incorporating social research into the study of snakebite envenoming is needed. Hereby, we aim to increase awareness of the following areas where reinvigorated social research would be highly beneficial.
Highlights
A key issue undermining advocacy efforts to measure the impact of snakebite envenoming worldwide is the poor level of information on incidence, mortality, sequelae, and social suffering associated with this disease
We stress the need to evaluate the degree of broader “social suffering,” i.e., the effects on people with personal and economic links to the envenomed person. Gathering this information will be possible by using community surveys and household interviews to collect data on the circumstances of the bites, whether the victim attended health facilities, the extent and type of attention provided by local traditional healers, and the consequences and sequelae of envenoming, including physical, psychological, and economical aspects. We recommend that these surveys identify socio-ethnic, occupational, biogeographic, and behavioural factors that remain undetected in conventional hospital-based or national-level public health data
Availability and accessibility of antivenoms is limited in sub-Saharan Africa, Asia, and, to a lesser extent, Latin America [2]
Summary
A key issue undermining advocacy efforts to measure the impact of snakebite envenoming worldwide is the poor level of information on incidence, mortality, sequelae, and social suffering associated with this disease. We stress the need to evaluate the degree of broader “social suffering,” i.e., the effects on people with personal and economic links to the envenomed person Gathering this information will be possible by using community surveys and household interviews to collect data on the circumstances of the bites, whether the victim attended health facilities, the extent and type of attention provided by local traditional healers, and the consequences and sequelae of envenoming, including physical, psychological, and economical aspects. We recommend that these surveys identify socio-ethnic, occupational, biogeographic, and behavioural factors that remain undetected in conventional hospital-based or national-level public health data. Few studies highlight the large impact of physical, psychological, and economic sequelae that result from snakebites [8,9]
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