Clinico-epidemiological study of snakebite: an audit of 13 years of data from a community-based treatment centre in eastern Nepal

Background: Snakebite envenomation is a global public health concern, especially in tropical and subtropical regions. We describe the demography, presentations, treatments and outcomes of snakebites from a community snakebite treatment centre in Nepal.

Methods: This was a retrospective study of snakebite cases from 2008 to 2021 presenting in a community-based treatment centre in eastern Nepal. The data were collected from predesigned forms in the centre.

Results: The median age of the victims (N=13 825) was 29 y (interquartile range 18-43) predominantly comprising farmers (39.5%). Cobras (Naja spp.) were the predominant species. Self-treatment practices like the application of tourniquets are common (74.5%) and antivenom was infused to 3.3% of victims. Motorcycles (57.9%) were the primary mode of transport, significantly reducing the time to reach healthcare centres compared with other means (p<0.001). The majority of patients visiting the community snakebite centre exhibited improvement (98.4%), with a low referral rate (0.6%) and case fatality rate (1.26%).

Conclusions: Snakebites are a common problem in rural Nepal. Neurotoxic envenomation, inflicted by the common cobra, predominates in this area. This community-based snakebite treatment centre, managed by paramedics, exemplifies the successful outcome of snakebite management in Nepal.