Clinico-Epidemiological Profile of Snake Bite Patients in a Tertiary Healthcare Centre in South India

Abstract

Introduction: Snake bite is a common medical emergency affecting the rural poor. India has the highest rates of envenomation with 81,000 envenomation and 11,000 deaths. Such high figures in spite of availability of antivenin is a cause for concern. The availability of medical records of the victims of snake bite enabled the analysis of the factors contributing to such high mortality and morbidity associated with snake bite. Aims and Objectives:To study the prevalence of poisonous and non-poisonous snake bites in the part of Coastal Karnataka with reference to age, sex, occupation, part of body bitten, time of bite and seasonal variation. To know the systemic envenomation of various types of poisonous snakes and their effective management in reducing the mortality and morbidity rate. To have a common knowledge of the types of poisonous snakes common in this locality and their clinical manifestations. To study the socio-economic impact of snakebite cases in the region. Results: A total of 454 case records were analyzed from 2010 to 2014. 9.69% of the victims died. Male to female ratio was 2.19:1. The highest incidence was between the ages 31 and 40 which was 19.82 %( n=90). Fang marks were recorded in 45.38% of the cases. 16.9% of them reported to a hospital within an hour of the bite. 33.03% reported within 24 hours of the bite. In 65.41% of the cases, the site of snake bite was found to be the lower limb. 23.8 %( n=50) of the identified snakes were cobras. 66.66% (n=140) were vipers. 28.64% of the bites occurred between 18:00 hours and 0:00 hours. 33.92% (n= 154) of the incidents occurred outdoors. Ayurvedic medication was given in 38.23% while a tourniquet was tied in 29.41% of cases. 15.19% of the cases had haemotoxic manifestations while 18.9% had neurological manifestations. 77.5% had local reactions. Conclusion: Snake bite is an important occupational hazard that causes preventable death and disability. Delay in hospitalization, use of traditional medicine and infection are factors contributing to significant mortality and morbidity. Awareness regarding outdoor safety and early hospitalization can significantly reduce the incidence of snake bite.