Abstract
IntroductionSnakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper. The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. In many regions of the world, insufficient health care systems and lack of antivenom in remote and poor areas where snakebites are common, means that efficient treatment is unavailable for many snakebite victims, leading to unnecessary mortality and morbidity. In this study, geographical information systems (GIS) were used to identify populations in Costa Rica with a need of improved access to antivenom treatment: those living in areas with a high risk of snakebites and long time to reach antivenom treatment.Method/Principal FindingsPopulations living in areas with high risk of snakebites were identified using two approaches: one based on the district-level reported incidence, and another based on mapping environmental factors favoring B. asper presence. Time to reach treatment using ambulance was estimated using cost surface analysis, thereby enabling adjustment of transportation speed by road availability and quality, topography and land use. By mapping populations in high risk of snakebites and the estimated time to treatment, populations with need of improved treatment access were identified.Conclusion/SignificanceThis study demonstrates the usefulness of GIS for improving treatment of snakebites. By mapping reported incidence, risk factors, location of existing treatment resources, and the time estimated to reach these for at-risk populations, rational allocation of treatment resources is facilitated.
Highlights
Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper
The primary aim of the present study is to provide information to assist decision-making concerning for which primary health care facilities (EBAIS) it is suitable to have antivenom, i.e. those that serve a population with a high risk of snakebites and long transport times to hospitals or clinics where antivenom is available
The non-spatial descriptive statistics of major parts of our dataset correspond very closely to what has been described in detail previously [14], and only a brief summary is presented in this article
Summary
Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. Long distances to healthcare facilities and incorrect distribution of antivenoms within countries [3,5,6] means that for many of the snakebite victims worldwide, specific treatment with safe and effective antivenoms is unavailable, and traditional healers are instead often consulted [1,7,8,9] This is an unfortunate situation as antivenom treatment is highly effective at preventing morbidity and mortality caused by snakebite envenoming [3]. This is the case of Costa Rica, where antivenom is widely available throughout the public health system, as a result of domestic production and effective acquisition and distribution schemes [5]
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