SNAKE BITE IN CHILDREN – A HOSPITAL-BASED CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Abstract

Background– Snake bite is a neglected issue in our country. It is a potentially life-threatening condition with its incidence being underestimated. Many poisonous snakes are found in this part of the country, most of them being neurotoxic in nature. Despite a large number of morbidities and mortalities every year, very little attention is paid by clinicians in this area. Objectives – a) To study the prevalence, epidemiological, demographic and clinical prole of non-poisonous and poisonous snake bites. b) To study the various complications of snake bite and their response to standard treatment in these patients. It is an institutional-basedMethodology- cross-sectional descriptive study carried out in the Department of Pediatrics, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India. All children under 12 years of age admitted in our pediatric ward with a alleged history of snake bite between June 2021 to May 2022 were included in the study after taking informed consent from the guardians of these children. Total 94 patients were included in our study. Results- Most of the patients were more than 5 years of age with the mean age being 7.74 years. The incidence of snake bite was more in males (61.70%) as compared to females(38.29%). Cases were more reported from rural areas (84.04%) as compared to urban areas(15.96%) .Bites were more common in the lower extremities (74.47%) as compared to upper extremities (25.53%) and between the months of June to August (38.3%). Most patients reported to the hospital within 6 hours of bite (71.3%). Most of them hadn't used any rst aid, while rest of them had used a tourniquet or application of herbs or had cut the affected part proximal to the bite before reaching the hospital. 42.55% were non-poisonous bites and 57.45% were poisonous snake bites. Out of the poisonous bites majority (34.05%) were neurotoxic snake bites and 23.40% were vasculotoxic in nature. Among neurotoxic snake bites, ptosis was the predominant symptom and among vasculotoxic snakebites, cellulitis and oliguria were the predominant symptoms. ASV was administered in 57.45% patients. Around 18.08% patients required invasive ventilation and 23.4% required non-invasive ventilatory support. Eventually 94.68% patients were discharged successfully and the remaining patients were discharged with complications or were referred to a higher centre. There was no mortality due to snake bite during the study period. Conclusion- Snake bite victims who were brought to our hospital early had an excellent prognosis in our study. Awareness about the necessity of early medical attention needed in cases of snake bites can reduce the complications and mortality arising out of them.