DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20190700

Clinicoepidemiology, clinical profile and outcome of venomous snake bite in children in Konaseema region of Andhra Pradesh, India

K. Visweswara Rao, G. Ramesh, Anand Acharya

Abstract


Background: Venomous snake bite is an acute medical emergency, and children are more quickly and severely affected than adult. Venomous snake bite is responsible for 28.5 deaths per 1000 snake bite death among 5-15years old children. Most of them used to be from rural India and is more common in school going children. But there is no study regarding clinic epidemiology and treatment outcome among pediatric age group in this part of Andhra Pradesh. This retrospective descriptive has been conducted to evaluate the clinic epidemiology, clinical presentation, complication and treatment outcome in snake bite in pediatric patients in our set up.

Methods: Present study is a retrospective, descriptive study conducted in the department of paediatrics Konaseema institute of medical science Amalapuram Andhra Pradesh, between 2006 to September 2018. This study protocol is approved by the institutional ethics committee. All the clinical parameters like, age, sex, season of bite, time of bite, socio economic statue, region, site, common clinical presentation, complications, reaction to ASV outcome of treatment were obtained from patient’s case record and was analysed.

Results: In present study total 166 snake bite patient case records were evaluated, out of this 166 snake bite cases, 28 bites were by unknown snakes. Demographic profile of patient shows that out of 70 cases, 49 cases were in male child and 21 cases were in female child. Regarding clinical profile of the children with snake bite as mentioned in Table 3, local pain was present in (n=70) 100 % patients. Local blending was presenting symptom in 64.28 %(n=45) patients.

Conclusions: From present study authors conclude that snake bite in children is more common among school going children, during monsoon and post monsoon, and in rural area. In our region vasculotoxic snake envanomation is more common and presented with cellulitis which required surgical intervention in most of circumstances. In neurotoxic envenomation some patient developed respiratory paralysis which required ventilatory support.


Keywords


Clinical profile and outcome, Paediatrics, Venomous snake bite

Full Text:

PDF

References


Snakebite envenoming, fact sheets. Available at: http://www.who.int/news-room/factsheets/detail/snakebite-envenoming.

Mohapatra B, Warrell DA, Suraweera W, Bhatia P, Dhingra N, Jotkar RM, et al. Million Death Study Collaborators. Snakebite mortality in India: a nationally representative mortality survey. PLoS neglected tropical diseases. 2011;5(4):e1018.

Whitaker R, Captain A, Ahmed F. Snakes of India. Draco Books; 2004.

Kshirsagar VY, Ahmed M, Colaco SM. Clinical profile of snake bite in children in rural India. Iran J Pediatr. 2013;23(6):632.

Kumar A, Kariyappa M, Vinutha GN. Clinico-epidemiological profile of snake bite in children in a tertiary care centre: a hospital-based study. Int J Contemporary Pediatr. 2017;5(1):124-8.

Kumaravel KS, Ganesh J. A study on the clinical profile of children with snake envenomation in a tertiary referral centre at Dharmapuri, Tamil Nadu, India. Int J Res Med Sci. 2017;4(6):2142-5.

Bhalla G, Mhaskar D, Agarwal A. A study of clinical profile of snake bite at a tertiary care centre. Toxicol Int. 2014;21(2):203-8.

Jasjit Singh, Sanjeev Bhoi, Vineet Gupta, Ashish Goel. Clinical profile of venomous snake bites in north Indian Military Hospital. J Emerg Trauma Shock. 2008;1(2):78-80.

Jayakrishnan MP, Geeta MG, Krishnakumar P, Rajesh TV, George B. Snake bite mortality in children: beyond bite to needle time. Archives Dis Childhood. 2017;102(5):445-9.

Meshram RM, Bokade CM, Merchant S, Bhongade S. Clinical profile and outcome of snake bite in children. Int J Contemporary Pediatr. 2017;4(3):910-4.

Karunanayake RK, Dissanayake DM, Karunanayake AL. A study of snake bite among children presenting to a paediatric ward in the main teaching hospital of north central province of Sri Lanka. BMC Res Notes. 2014;7:482.

Virendra C. Patil, Harsha V. Patil, Avinash Patil, Vaibhav Agrawa, et al. Clinical Profile and outcome of envenomous snake-bite at tertiary care centre, Int J. Med. Public Health. 2011;1(4).

Krishnappa R, Chandrika DG, Gowda RM, Babu P, Banala R. A study on demographical and clinical profile and the outcome of snake bite victims in a tristate tertiary care center. Int Journal Med Sci Public Health. 2016;5(09).

Saravu K, Somavarapu V, Shastry AB, Kumar R. Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An indian tertiary care hospital-based prospective study. Indian J Crit Care Med. 2012;16:187-92.

Thapar R, Darshan BB, Bhaskaran Unnikrishnan PM, Kumar N, Kulkarni V, Holla R, et al. Clinico-epidemiological profile of snakebite cases admitted in a tertiary care centre in south india: A 5 years study. Toxicol Int. 2015;22(1):66.

Menon JC, Joseph JK, Jose MP, Dhananjaya BL, Oommen OV. Clinical Profile and Laboratory Parameters in 1051 victims of snakebite from a single centre in Kerala, South India. J Assoc Physic India. 2016;63:22-9.

Kumar KS, Narayanan S, Udayabhaskaran V, Thulaseedharan NK. Clinical and epidemiologic profile and predictors of outcome of poisonous snake bites–an analysis of 1,500 cases from a tertiary care center in Malabar, North Kerala, India. Int J General Med.2018;11:209.

Patil TB, Bansod YV. Snake bite-induced acute renal failure: A study of clinical profile and predictors of poor outcome. Ann Trop Med Public Health. 2012;5:335-9.