Retrospective Study of Snakebites in Nawalpur Snakebite Treatment Center, South-central Nepal

Snakebite is a pronounced health problem in the rural tropics and the subtropics of Nepal. However, only fragmentary hospital-based epidemiological data are available. We aimed to determine the incidence of snakebites and describe demographic characteristics, circumstances, seasonal patterns, and outcomes of snakebite treatment in the south-central region of Nepal. We retrospectively studied snakebite records maintained for the seven-month interval between July 2013 and January 2014 in the Nawalpur Snakebite Treatment Center, Netragunj, Sarlahi District. Records were reviewed and data collected during the interval from 01 February through 31 July 2017. Data were analyzed using descriptive statistics. A total of 396 snakebite case records were identified during the seven-month interval. 386 (97%) were nonenvenomed cases, and 10 (3%) were envenomed cases, which included three deaths (30% case fatality rate). We estimated annual incidence of 26 snakebites, 1 envenomation, and 0.2 death per 100,000 people. An average of 16 vials (range = 6-29) of Indian polyvalent antivenom (VINS Bioproducts Limited, India) were administered in envenomed cases. None of the patients performed the WHO recommended first aid measures. Patients were transported to the center via motorcycle (n = 319, 81%) most often. Snakebite is a significant problem for farmers suggesting it to be an important occupational health hazard in Sarlahi District and vicinity. No use of WHO recommended first aid measures suggests a limited scope of snakebite education in this region. Further, a prospective study of snakebites is needed to understand pre-hospital care practices, and circumstances and details of confirmed snakebite cases.