title: Victims' response to snakebite and socio-epidemiological factors of 1018 snakebites in a tertiary care hospital in Sri Lanka.
abstract: BACKGROUND
  Although snake bite remains a major health problem in Sri Lanka, there is a dearth of baseline information that would be useful in education about and prevention of snakebite.
  
  
  OBJECTIVE
  The purpose of this study was to describe the socio-demographic characteristics, behavioral responses, treatment seeking, and prehospital interventions of snakebite victims in an area with high snakebite burden.
  
  
  METHODS
  This prospective study was based on a cohort of snakebite victims presented to the Anuradhapura Teaching Hospital over a 1-year period from January 2010.
  
  
  RESULTS
  Of the total of 1018 snakebite admissions, 69% were male and 65.8% were aged 21 to 50 years. Most of the victims were farmers (40%). The offending snakes were seen by 549 victims (54%); of these, only 46% (255) presented with a dead snake specimen. Only 38 of 1018 (4%) had first sought some form of indigenous treatment such as locally applied medications, herbal decoctions, nasal insufflations ("Nasna"), or applying snake stone over the bitten site. Some form of first aid had been adopted by 681 victims (67%), of whom all had washed the bitten site, and 18 victims (2%) and 4 (0.4%) had applied a dressing or incised the bitten site, respectively. A tourniquet had been applied by 353 victims (35%) for mean duration of 26 minutes (range, 5 to 120 minutes). None of the patients had immobilized the bitten limb by splinting. Oral medications had been used for pain relief in 74 cases (7%), paracetamol by all.
  
  
  CONCLUSIONS
  A proportion of patients still seek native remedies and use inappropriate first aid after snakebite in Sri Lanka.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Drs Kularatne and C. Ratnayake).
authors.forename: Abeysinghe M
authors.initials: AM
authors.lastname: Kularatne
authors.affiliation: Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka (Dr Silva). Electronic address: nkanjanasilva@gmail.com.
authors.forename: Anjana
authors.initials: A
authors.lastname: Silva
authors.affiliation: School of Medicine and Public Health, Faculty of Health, University of Newcastle, New South Wales, Australia, and Department of Biochemistry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Dr Maduwage).
authors.forename: Kalana
authors.initials: K
authors.lastname: Maduwage
authors.affiliation: Anuradhapura, Sri Lanka (Dr I. Ratnayake).
authors.forename: Ishani
authors.initials: I
authors.lastname: Ratnayake
authors.affiliation: Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka (Drs Walathara, Mendis, and Parangama).
authors.forename: Chmara
authors.initials: C
authors.lastname: Walathara
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (Drs Kularatne and C. Ratnayake).
authors.forename: Chanka
authors.initials: C
authors.lastname: Ratnayake
authors.affiliation: Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka (Drs Walathara, Mendis, and Parangama).
authors.forename: Suresh
authors.initials: S
authors.lastname: Mendis
authors.affiliation: Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka (Drs Walathara, Mendis, and Parangama).
authors.forename: Ranjith
authors.initials: R
authors.lastname: Parangama
mesh_terms: D000328:Adult; D000383:Agriculture; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012909:Snake Bites / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D012911:Snakes; D012959:Socioeconomic Factors; D013188:Sri Lanka; D063128:Tertiary Health Care; D055815:Young Adult
chemical_list: D000997:Antivenins
keywords: first aid; prevention; snakebite; sociodemography; treatment seeking