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Publication date: 
July 12, 2018

Access to health services and availability of anti-venom medications are key to surviving

SEATTLE – A new scientific study finds 93 million people live in remote areas with venomous snakes and, if bitten, face a greater likelihood of dying than those in urban settings because of poor access to anti-venom medications. 

The study, conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, was published today in the international medical journal, The Lancet.

“One’s vulnerability to snakebites represents a nexus of ecological contexts and public health weaknesses,” said Dr. David Pigott, one of the study’s authors and assistant professor at IHME.  “Understanding where venomous snakes live and people’s proximity to effective treatments are the two most important steps toward reducing deaths. Our analysis identifies communities in greatest need.” 

According to Pigott, nations whose people are most vulnerable include: Benin, Congo (Brazzaville), Ethiopia, Myanmar, Nigeria, Papua New Guinea and South Sudan. 

He and the other researchers identified the regions and nations where it is hard to access treatment. In addition, they generated range maps of 278 species of venomous snakes listed by the World Health Organization (WHO). 

The study cross-referenced this data using criteria such as transport time to care facilities with anti-venom medications and quality of care based a health care access and quality index, which examines 32 causes from which death should not occur in the presence of effective health care. 

In May, the WHO mandated that a comprehensive plan be developed supporting countries in implementing measures for greater access to treatment to people bitten by venomous snakes. This followed a declaration last year that poisoning from snakebites is a neglected tropical disease.

"In conflict zones like South Sudan and Central African Republic, MSF treats more people affected by snakebite than landmine injuries," said Dr. Gabriel Alcoba, one of the study's authors and a doctor with Doctors Without Borders/Médecins Sans Frontières (MSF) and Geneva University Hospitals (HUG). "While the disease has been classified by WHO as a Neglected Tropical Disease and is among the top 10 causes of hospital admissions in MSF’s hospitals in South Sudan and CAR, treatment options are still extremely insufficient. We are grateful that this study can bring attention to the vulnerability of people to snakebite and highlight the lack of data in African snakebite-prone and conflict-affected areas. We hope this data can help improve clinical training and increase access to safer and cheaper anti-venoms for people in need."

Other research concludes that an estimated 5 million people are bitten every year by poisonous snakes, and about 125,000 of them die. As a result, it is one of the most burdensome neglected tropical diseases. 

“In spite of the numbers, snakebites received relatively limited global attention,” said Professor Simon Hay, Director of Geospatial Science at IHME. “We hope this analysis can broaden the discussion about snakes.” 

Researchers from the Geneva-based Université de Genève and the Hôpitaux Universitaires de Genève participated in the study.

“Thanks to this model, we were able to construct three maps that allowed us to uncover the three hot spots in terms of these three criteria, focusing most heavily on the zones where the individuals are most vulnerable,” said Nicolas Ray, researcher at the Institute of Environmental Sciences and at the Institute of Global Health at Université de Genève.

 

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About the Institute for Health Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME makes this information widely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to improve population health.