Snakebites in Rural Areas of Brazil by Race: Indigenous the Most Exposed Group.

Maria Cristina Schneider,Kyung-Duk Min,Myriam Vuckovic,Ronir Raggio Luiz,Quincy Huang,Volney Camara,Deise I Galan,Caroline Sarpy,Lucia Montebello

doi:10.3390/ijerph18179365

Abstract

Animal stings are environmental hazards that threaten millions annually and cause a significant socioeconomic impact. Snakebite envenoming affects 2.7 million people globally every year, mostly the poorest and rural communities, with approximately 27,000 annual cases in Brazil. This study’s objective is to identify the most exposed racial group for snakebites in rural areas of Brazil and analyze possible differences in the outcome of an accident. A retrospective epidemiological study was conducted using a database of rural snakebite cases from Brazil’s Ministry of Health (2017). Descriptive analysis and a regression model were performed to examine the association of bad outcomes after a snakebite with several covariables. While mixed-race individuals presented the highest number of cases (61.79%), indigenous and white populations were the racial groups with the highest and lowest exposure rates (194.3 and 34.1 per 100,000 population, respectively). The fatality rate was 3.5 times higher in the indigenous population compared to the white population. In the multivariable model, the number of hours between the accident and health care received and the case classification suggested an association with a bad outcome. Snakebite is prominent in Brazil, particularly among indigenous groups. Antivenom is available in the Brazilian Health System; however, efforts need to be made for decentralization.

Highlights

Animal bites and stings are important environmental hazards that threaten millions of people annually and cause a significant socioeconomic impact at the individual and country level
Indigenous people are the most exposed racial group to snakebites in rural areas of Brazil and present higher fatality rates as compared to the white population, which is the racial group less exposed to snakebites
Even though the antivenom is available free of charge in the Brazilian Health system in all states, in 2017 there were still 55 (52 with race information) deaths recorded in rural areas among the roughly 16,000 cases of snakebites officially reported

Summary

Introduction

Animal bites and stings are important environmental hazards that threaten millions of people annually and cause a significant socioeconomic impact at the individual and country level. Snakebite envenoming is one of these examples that affects close to 2.7 million people globally every year and has an estimated mortality close to 100,000 deaths [1,2]. Treated, envenomation poses a large threat to public health in terms of suffering, morbidity, mortality, and long-term disability [2]. In response to the large global burden of disease due to snakebite and the global crisis in antivenom production that has left millions of vulnerable people with no or difficult access to the antivenom, the World Health Organization (WHO)’s Strategic and Technical.

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