title: Estimates of disease burden due to land-snake bite in Sri Lankan hospitals.
abstract: Snake bite is a common cause of hospital admission in Sri Lanka. Despite this, there have been no countrywide studies or national estimates of disease burden due to snake bites in Sri Lankan hospitals. We assessed the disease burden due to snake bite in our hospitals and estimated the frequency of admissions due to bites by different snake species. Sri Lanka was divided into four zones based on climate and topography. Hospital morbidity and mortality data, which are available on an administrative district basis, were collated for the four zones. A survey of opinion among specialist physicians (the Delphi technique) was used to estimate the proportion of bites by different species, and requirements for anti-venom (AV) and intensive care facilities for management of snake bites in hospitals in each of the four zones. A study of hospital admissions due to snake bites in seven selected hospitals was also performed to validate the opinion survey. There was a clear difference in the incidence of hospital admissions due to snake bites in the different zones. Estimates of hospital admissions due to bites by different species also varied considerably between zones. These trends corresponded to estimates of requirements of AV and other supportive health care. Health care planning using data based on environmental information, rather than merely on political boundaries, could lead to targeted distribution of AV and intensive care requirements to manage snake bites.
authors.affiliation: Department of Community and Family Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
authors.forename: A
authors.initials: A
authors.lastname: Kasturiratne
authors.forename: A
authors.initials: A
authors.lastname: Pathmeswaran
authors.forename: M M D
authors.initials: MM
authors.lastname: Fonseka
authors.forename: D G
authors.initials: DG
authors.lastname: Lalloo
authors.forename: S
authors.initials: S
authors.lastname: Brooker
authors.forename: H J
authors.initials: HJ
authors.lastname: de Silva
mesh_terms: D000818:Animals; D000997:Antivenins / Q000191:economics / Q000627:therapeutic use; D002980:Climate; D017281:Cost of Illness; D003422:Critical Care; D003697:Delphi Technique; D005843:Geography; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D012909:Snake Bites / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D012910:Snake Venoms / Q000145:classification / Q000506:poisoning*; D013045:Species Specificity; D013188:Sri Lanka / Q000453:epidemiology; D019371:Topography, Medical; D017819:Viperidae / Q000145:classification*
chemical_list: D000997:Antivenins; D012910:Snake Venoms