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Snakebite Envenoming: A High-Priority Neglected Tropical Disease
A recent study by the Indian Council of Medical Research (ICMR) has found that India leads in the global number of snakebite cases, contributing to almost half of the world’s snakebite deaths. The World Health Organization (WHO) classifies Snakebite Envenoming (SE) as a High-Priority Neglected Tropical Disease (NTD).
SE is a potentially fatal condition resulting from the injection of venom into the body after a bite from a venomous snake or exposure to venom squirted into the eyes by certain snake species as a defense mechanism. SE poses a significant public health risk, especially in rural areas of tropical and subtropical countries in Africa, the Middle-East, Asia, Oceania, and Latin America. For millions of people living in these regions who rely on agriculture or subsistence hunting and gathering, the threat of snakebite is a daily reality.
Impact of Snakebite Envenoming
Snakebite victims, primarily in developing nations, often suffer from long-term complications such as deformities, contractures, amputations, visual impairments, kidney problems, and psychological distress. Globally, about 5.4 million snake bites occur each year, leading to 1.8 to 2.7 million cases of envenoming. Furthermore, between 81,410 and 1,37,880 individuals die annually, and approximately three times this number undergo amputations or encounter other permanent disabilities due to snakebites.
India, in particular, has recorded approximately 1.2 million snakebite deaths between 2000 and 2019, averaging 58,000 per year.
The WHO’s Roadmap for SE Management
The WHO has launched a roadmap to reduce snakebite-induced death and disability by half by 2030. This roadmap includes the creation of a sustainable antivenom market, requiring a 25% increase in competent manufacturers by 2030. It also includes plans for a pilot project to create a global antivenom stockpile. As part of this initiative, snakebite treatment strategies and response mechanisms are being integrated into national health plans in affected countries.
Indian Initiatives on Snakebite Management
Before the WHO’s roadmap, researchers from ICMR had initiated community awareness and health system capacity building from 2013. The National Task Force on snakebite, funded by ICMR, continues these efforts through a national study.
Challenges in Managing Snakebite Envenoming
The high number of snakebite deaths can be attributed to several factors, including inadequate community awareness and lack of first aid knowledge, delay in accessing life-saving treatment, and unavailability of trained medical officers for snakebite management. Certain superstitions, such as belief in a snake god or the ability of tamarind seeds or magnets to reduce venom effect, also contribute to delays in seeking timely medical care.
Moreover, no Information, Education, and Communication (IEC) materials on identifying venomous and non-venomous snakes are available in government healthcare facilities.
Recommendations for Better Snakebite Management
The ICMR study recommends incorporating snakebite management into the curriculum of state public health department training institutions in India. Mandatory short-term training of medical graduates during their internships and inclusion in the induction training upon joining state health services are also suggested.
A multi-sectoral approach can also help reduce mortality and morbidity due to SE in India. This approach includes enhancing community awareness and boosting the capacity of healthcare facilities to address snakebite cases effectively.
