Abstract
BackgroundMost epidemiological and clinical reports on snake envenoming focus on a single country and describe rural communities as being at greatest risk. Reports linking snakebite vulnerability to socioeconomic status are usually limited to anecdotal statements. The few reports with a global perspective have identified the tropical regions of Asia and Africa as suffering the highest levels of snakebite-induced mortality. Our analysis examined the association between globally available data on snakebite-induced mortality and socioeconomic indicators of poverty.Methodology/Principal FindingsWe acquired data on (i) the Human Development Index, (ii) the Per Capita Government Expenditure on Health, (iii) the Percentage Labour Force in Agriculture and (iv) Gross Domestic Product Per Capita from publicly available databases on the 138 countries for which snakebite-induced mortality rates have recently been estimated. The socioeconomic datasets were then plotted against the snakebite-induced mortality estimates (where both datasets were available) and the relationship determined. Each analysis illustrated a strong association between snakebite-induced mortality and poverty.Conclusions/SignificanceThis study, the first of its kind, unequivocally demonstrates that snake envenoming is a disease of the poor. The negative association between snakebite deaths and government expenditure on health confirms that the burden of mortality is highest in those countries least able to deal with the considerable financial cost of snakebite.
Highlights
Our knowledge of the global medical burden of snakebite is limited to just a few reports based primarily on either hospital records [1] or the epidemiological literature [2,3], and more recently, the latter in combination with WHO mortality data [4]
While lacking the epidemic potential of an infectious/vector-borne disease, snake envenoming in rural tropical communities has as great a medical mortality, if not morbidity, as the neglected tropical diseases (NTD)
The recent categorisation of snake envenoming as an NTD is an important advance that hopefully will result in the wider recognition and allocation of resources, since death from snake envenoming is preventable; antivenom is very effective when the appropriate antivenom is correctly administered
Summary
Our knowledge of the global medical burden of snakebite is limited to just a few reports based primarily on either hospital records [1] or the epidemiological literature [2,3], and more recently, the latter in combination with WHO mortality data [4]. The vast majority of snakebite-induced deaths (Figure 1) occur in Asia (estimates ranging from 15,400–57,600 deaths pa) and sub-saharan Africa (3,500–32,100 deaths pa) [4]. Populations in this geographic zone suffer the medical burden of the world’s neglected tropical diseases (NTD). Our analysis examined the association between globally available data on snakebite-induced mortality and socioeconomic indicators of poverty
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