Viper bite and its complications at a tertiary care centre in southern part of West Bengal: A prospective, clinical, socioeconomic and epidemiological study.

Abstract

Viper snake bite is a threat to the Indian health system with 83 000 deaths annually. There is a paucity of literature regarding independent risk factors for renal damage due to viper bite. We present the scenario in a rural part of West Bengal and highlight some vital factors to prevent the complications. We screened all patients with snake bite from January 2012 to December 2015 in Midnapore Medical College and chose definite viper bites according to our inclusion criteria, treated them as per the Indian government protocol, followed them for any acute kidney injury, managed them with haemodialysis (HD) if needed and compared some socioeconomic and clinical factors between HD and non-HD groups to predict the outcome. A total of 1220 snake bites were screened, 660 were viper bites, and 1 80 needed HD at least once. The HD group mostly consists of tribal population (75% v. 45% in non-HD group) who used unscientific first-aid measures. Bite timing was characteristically between 4 a.m. and 8 a.m., especially during defecation in fields, without any considerable seasonal variation. The average bite-to-needle time was 24.6 hours in the HD group and 5.1 hours in the non-HD group, with the average economic burden of ₹3345 in the HD group and ₹730 in the non-HD group. Along with formal education, there is a need to create awareness among the relatively poor tribal population about snake bite to reduce the bite-to-needle time.