Abstract
Background: Snakebite is a major public health problem and its prevalence is high in India. Insufficient epidemiological data and global neglect of this condition prompted the World Health organization to recognize it as a ‘‘neglected tropical disease’’
 Objective: To study demographic characteristics of snakebite victims, to see clinical symptoms of bite and outcomes of snakebite.
 Methods: A prospective observational hospital-based study carried out from November 2016 to October 2017, in patients with a history of snakebite.
 Results:Total 300 patients were included in this study,170 (56.67%) were bitten by heamotoxic snakes and 130 (43.33%) were bitten by neurotoxic snakes. Majority of patients were in the age group of 20-39 years ( n=153; 51%). Men outnumbered women( n=190; 63.33%), with male to female ratio of 1.7: 1. Higher incidence of snake bite was found in July – September (n=135;45.00 %) followed by April to June( n=124; 41.33%).Majority of patients were farmers in rural areas ( n=242; 80.80%).Out of 300 patients,80required ICU care.In patients with neuroparalytic snake bites, clinical features were; ptosis (n=126; 96.92%),ophthalmoplegia (n=98; 75.38%),respiratory paralysis (n=60; 46.15%),bulbar weakness ( n=74; 56.92%) andabdomen pain(n=25; 19.23%).Clinical features in patients of haemotoxic snake bites were ; bleeding from bite site(n=110; 65.29%) , cellulitis(n=100; 58.82%), gum bleed(n=53; 31.18%), ecchymosis(n=49; 28.82%),epistaxis(n=27; 15.82%),gastrointestinal bleeding(n=25; 14.71%) andhaemoptysis(n=19; 11.18%). Complications observed were acute kidney injury ( n=62; 20.67%) , respiratory failure ( n=51; 17.00%) , DIC( n=7; 2.33%) and ARDS( n=5; 1.67%) . Out of 170 hemotoxic snake bite patients, 157 (92.35%) patients recovered and 13 (7.65%) patients died and out of 130 neurotoxic snake bites, 124 (95.39%) patients recovered and 6 (4.61%) patients died, overall mortality was 6.3%. In our study, bite to needle time was less than 1 hour in 47 patients (15.66%), less than 6 hrs in 120 patients (40%) and more than 24 hours in 45 (15%).
 Conclusion: Snakebite is common in adult males between 20 to 50 years and the commonest site is the lower limb. The majority of the victims are farmers who work in fields. A maximum number of cases presented within 1-6 hours of bite using a tourniquet on the affected limb as first aid. The complications and mortality of snakebite are high.
Highlights
Snakebite counts significant health burden in the South East Asian Region resulting in death and/ or disability of young individuals involved in agriculture work
2,000,000 snake bites are reported in India each year
Among 250 species of snakes found in the South East Asian Region, only 60 species are venomous included in three families, Elapidae, Viperidae and Colubridae[3]
Summary
Snakebite counts significant health burden in the South East Asian Region resulting in death and/ or disability of young individuals involved in agriculture work. 2,000,000 snake bites are reported in India each year. The million death study revealed 45,900 national snakebite deaths comprising 5% of all injury deaths and 0.5% of all deaths in India.[1] there is no exact figure of mortality and morbidity associated with snakebite due to poor reporting in the region[2]. Snakebite is a major public health problem and its prevalence is high in India. Conclusion: Snakebite is common in adult males between 20 to 50 years and the commonest site is the lower limb.The majority of the victims are farmers who work in fields.
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