Abstract
Snakebite accidents are considered category A neglected tropical diseases. Brazil stands out for snakebite accidents, mainly in the Amazon region. The best possible care after snakebite accidents is to obtain antiophidic sera on time. And the maximum ideal time to reach it is about 2 hours after an accident. Based on public health information and using a tool to analyze geographical accessibility, we evaluate the possibility of reaching Brazilian serum-providing health facilities from the relationship between population distribution and commuting time. In this exploratory descriptive study, the geographic accessibility of Brazilian population to health facilities that supply antiophidic serum is evaluated through a methodology that articulates several issues that influence the commuting time to health units (ACCESSMOD): population and facilities' distribution, transportation network and means, relief and land use, which were obtained in Brazilian and international sources. The relative importance of the population without the possibility of reaching a facility in two hours is highlighted for Macro-Regions, States and municipalities. About nine million people live in locations more than two hours away from serum-providing facilities, with relevant variations between regions, states, and municipalities. States like Mato Grosso, Pará and Maranhão had the most important participation of population with reaching time problems to those units. The most significant gaps are found in areas with a dispersed population and sometimes characterized by a high incidence of snakebites, such as in the North of the country, especially in the Northeastern Pará state. Even using a 2010 population distribution information, because of the 2020 Census postponement, the tendencies and characteristics analyzed reveal challenging situations over the country. The growing availability of serum-providing health facilities, the enhanced possibilities of transporting accident victims, and even the availability of sera in other types of establishments are actions that would allow expanding the possibilities of access to serum supply.
Highlights
In 2017, the World Health Organization classified snakebite poisoning as category A neglected tropical diseases [1], which spurred studies on appropriate prevention, implementable interventions, and resources to be allocated nationally and regionally [2].Areas such as the Western Amazon, Sub-Saharan Africa, Southeast Asia, and Eastern Australia have many snake species
The analysis of the geographical accessibility to health facilities that can provide antiophidic serum is based on the use of information about Population Distribution, Routes, Land Use, Digital Elevation Model, and Health Facilities
This study contributes with the analysis of geographical accessibility integrating several issues that influences commuting time and this can be developed for other healthcare networks
Summary
In 2017, the World Health Organization classified snakebite poisoning as category A neglected tropical diseases [1], which spurred studies on appropriate prevention, implementable interventions, and resources to be allocated nationally and regionally [2]. Areas such as the Western Amazon, Sub-Saharan Africa, Southeast Asia, and Eastern Australia have many snake species. People use traditional therapies and treatments instead of the medical network and health centers, which leads to higher mortality and amputation rates The predominance of such behavior is highlighted in African countries [2]. The profile of the population most affected by snakebite accidents has remained stable throughout the twentieth century, consisting of male rural workers aged 15–49 years [4]
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