Abstract
Snakebite Poisoning is a common paediatric emergency especially during the monsoonseason in the terai and inner terai regions of Nepal. There is hardly any study conductedso far in Nepal to highlight different aspects of snakebite poisoning in children. Thisretrospective study was therefore conducted basically to find out the clinicoepidemiologicalfeatures, case fatality rate and risk factors for death in childrenadmitted in Lumbini Zonal Hospital (LZH) with features of snakebite poisoning.The study showed the highest incidence of snakebite poisoning among children agedabove 10 years. The peak incidence of poisoning was seen during July-August. Thesemonths correspond with the monsoon season in Nepal. Most of the victims had bitesby unidentified snakes (75%), mostly on the fingers & hands (nearly 50%). Nearly47% of the children had respiratory distress, and a large majority of them requiredrespiratory support therapy. Case fatality rate (CFR) was nearly 29%. The relativerisk factors for death due to snakebite poisoning were: age above 5 years, male sex,bites on the finger & hand and bites by Kraits. Mortality and morbidity due to snakebitecan be reduced by early & judicious use of anti-snake venom (ASV).Key Words: Snakebite, Poisoning, Children, Case fatality rate, Nepal
Highlights
Of the more than 3,000 known species of snakes, only 200 are poisonous to humans.[1]
This retrospective study was conducted in those 73 children, who had clinical features of snakebite poisoning and were brought in the emergency of Lumbini Zonal Hospital during the 24 months period from April, 2000 to April, 2002
Incidence of snakebite poisoning was highest among children aged above 10 years (51%), and lowest among children below 5 years (14%)
Summary
Of the more than 3,000 known species of snakes, only 200 are poisonous to humans.[1]. Address for correspondence : Dr Binod M. Venom from the Elapids is neurotoxic as it blocks the transmission of nerve impulse from the neuromuscular junction.[1] More than 80 % of bites have been reported to be by non-poisonous snakes.[1] Incidence of snakebite with or without features of systemic envenomation has been reported to be 4.3 per 1000 population in Nepal.[3] Even after bites by the poisonous snakes only 50 % of the victims were reported to show the features of systemic envenomation in a study done earlier.[4] Symptoms of poisoning can rapidly progress in a few hours from mild drowsiness to cranial nerve palsies, weakness and death, which occurs usually from respiratory failure.[1] Death can, occur in some cases from shock due to fright before the poisonous symptoms commence.[5]
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