title: Appraisal of snakebite incidence and mortality in Bolivia.
abstract: No information has been yet published on snakebite in Bolivia. The country includes very different ecological situations leading to various epidemiological risks. A study has been carried out to evaluate the incidence and location of snakebite, particularly in relation with altitude, in order to improve management. Investigations on snakebite epidemiology were based on a) cases treated in health facilities as reported by health authorities and b) household surveys carried out in areas with high variations of altitude, in various regions of Bolivia. An average of 700 bites was treated each year in Bolivia (national annual incidence = 8 bites per 100,000 people) with a great disparity between districts. Household surveys showed annual incidences ranged from 30 to 110 bites per 100,000 inhabitants depending on location. Annual mortality ranged 0.1-3.9 per 100,000 people. A significant and constant inverse correlation was shown between snakebite incidence and altitude, which may be explained by both snake and human distributions and activities. Notification of snakebite is useful for improving patient management and informing antivenom distribution. It should also involve the report of deaths and clinical details of envenomation.
authors.affiliation: UMR 216, Mother and Child Facing Tropical Diseases, Institut de Recherche pour le Développement (IRD), La Paz, Bolivia; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Pharmacie, France; Laboratorio de Parasitología, Instituto Nacional de Laboratorios de Salud (INLASA), Ministerio de Salud y Deportes, La Paz, Bolivia. Electronic address: jean-philippe.chippaux@ird.fr.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Chippaux
authors.affiliation: UMR 216, Mother and Child Facing Tropical Diseases, Institut de Recherche pour le Développement (IRD), La Paz, Bolivia.
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Postigo
mesh_terms: D000328:Adult; D000531:Altitude; D001838:Bolivia / Q000453:epidemiology; D005260:Female; D005843:Geography; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population; D012621:Seasons; D012909:Snake Bites / Q000453:epidemiology* / Q000401:mortality*; D014505:Urban Population
keywords: Bolivia; Envenomation; Epidemiology; Snakebite; South America