Clinical, laboratory profile and outcomes in children with snakebite from Eastern India

Biswajit Pattanaik; Chinmaya Mahapatra; I K Karthika; Amit K Satapathy; Joseph John; Rashmi R Das; Bhagirathi Dwibedi; Samarendra Mahapatro; Krishna M Gulla

doi:10.4103/jfmpc.jfmpc_1965_22

Clinical, laboratory profile and outcomes in children with snakebite from Eastern India

J Family Med Prim Care. 2023 Aug;12(8):1588-1592. doi: 10.4103/jfmpc.jfmpc_1965_22. Epub 2023 Aug 29.

Authors

Biswajit Pattanaik¹, Chinmaya Mahapatra¹, I K Karthika¹, Amit K Satapathy¹, Joseph John¹, Rashmi R Das¹, Bhagirathi Dwibedi¹, Samarendra Mahapatro¹, Krishna M Gulla¹

Affiliation

¹ Departments of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Abstract

Background: Snakebite remains a significant public health problem worldwide, particularly in rural areas with unexpected morbidity and mortality. This study evaluated the clinical, laboratory profile and outcomes in children with snake bites from Eastern India.

Methods: This was a retrospective case record-based study between January 2017 and December 2021. The clinical features, complications, laboratory profiles and outcomes were analysed.

Results: Thirty children with snake bites were admitted during this study period. There was a male predominance with a ratio of 2.3:1. The mean age of presentation was 10.4 years. About 60% of bites occurred during the rainy season between July and September. Most bites (96%) were on lower limbs, predominantly showing vasculotoxic features followed by neurotoxic and a combined presentation. In this study, around 53% received anti-snake venom (ASV) before reaching our centre; the median time to reach our centre was 13 h. Complications such as acute kidney injury (AKI), cellulitis, shock and coagulation abnormalities were common in those who arrived early (before 6 h) than in those who reached late (after 6 h). Similarly, the mean duration of hospital stay was less for those seeking medical attention early as compared to those reaching late for treatment (4.7 days vs. 7.2 days). Twenty-six out of 30 (86.7%) were discharged without any sequelae, 3 (10%) children were left against medical advice and one died.

Conclusions: Snakebite remains a major health problem in children causing significant morbidity and mortality. Children, in general, especially males, are particularly vulnerable because of their playful and explorative nature and considerable time spent in outdoor activities. Preventive measures, education about avoiding traditional first aid methods and early administration of ASV reduce complications, duration of hospital stay and avoid the use of antibiotics.

Keywords: Anti-snake venom; children; outcome; snake bite.