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Snake Envenoming: A Disease of Poverty

Author

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  • Robert A Harrison
  • Adam Hargreaves
  • Simon C Wagstaff
  • Brian Faragher
  • David G Lalloo

Abstract

Background: Most epidemiological and clinical reports on snake envenoming focus on a single country and describe rural communities as being at greatest risk. Reports linking snakebite vulnerability to socioeconomic status are usually limited to anecdotal statements. The few reports with a global perspective have identified the tropical regions of Asia and Africa as suffering the highest levels of snakebite-induced mortality. Our analysis examined the association between globally available data on snakebite-induced mortality and socioeconomic indicators of poverty. Methodology/Principal Findings: We acquired data on (i) the Human Development Index, (ii) the Per Capita Government Expenditure on Health, (iii) the Percentage Labour Force in Agriculture and (iv) Gross Domestic Product Per Capita from publicly available databases on the 138 countries for which snakebite-induced mortality rates have recently been estimated. The socioeconomic datasets were then plotted against the snakebite-induced mortality estimates (where both datasets were available) and the relationship determined. Each analysis illustrated a strong association between snakebite-induced mortality and poverty. Conclusions/Significance: This study, the first of its kind, unequivocally demonstrates that snake envenoming is a disease of the poor. The negative association between snakebite deaths and government expenditure on health confirms that the burden of mortality is highest in those countries least able to deal with the considerable financial cost of snakebite. Author Summary: Every year snake envenoming kills more people in the tropics than some of the world's recognised neglected tropical diseases (NTDs), including schistosomiasis and leishmaniasis. While lacking the epidemic potential of an infectious/vector-borne disease, snake envenoming in rural tropical communities has as great a medical mortality, if not morbidity, as the NTDs. The recent categorisation of snake envenoming as an NTD is an important advance that hopefully will result in the wider recognition and allocation of resources, particularly since death from snake envenoming is preventable; antivenom is very effective when the appropriate antivenom is correctly administered. Snake envenoming urgently requires international support to instigate the epidemiological, health education, and effective treatment initiatives that proved so potent in addressing the medical burden of NTDs such as leprosy and dracunculosis. All the global estimates of snake envenoming and deaths from snakebite indicate that mortality is highest in the world's tropical countries. Here we examined associations between the globally available data on (i) snakebite-induced mortality and (ii) socioeconomic markers of poverty. Our data unequivocally establishes that snake envenoming is globally associated with poverty, a distinctive characteristic of the neglected tropical diseases.

Suggested Citation

  • Robert A Harrison & Adam Hargreaves & Simon C Wagstaff & Brian Faragher & David G Lalloo, 2009. "Snake Envenoming: A Disease of Poverty," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(12), pages 1-6, December.
  • Handle: RePEc:plo:pntd00:0000569
    DOI: 10.1371/journal.pntd.0000569
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    Citations

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    Cited by:

    1. Carlos Yañez-Arenas & A Townsend Peterson & Pierre Mokondoko & Octavio Rojas-Soto & Enrique Martínez-Meyer, 2014. "The Use of Ecological Niche Modeling to Infer Potential Risk Areas of Snakebite in the Mexican State of Veracruz," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-9, June.
    2. Carlos A Bravo-Vega & Juan M Cordovez & Camila Renjifo-Ibáñez & Mauricio Santos-Vega & Mahmood Sasa, 2019. "Estimating snakebite incidence from mathematical models: A test in Costa Rica," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(12), pages 1-16, December.
    3. Thiago L. Jucá & Leonardo R. Oliveira Normando & Abdulrazak B. Ibrahim & Alex Chapeaurouge & Ana Cristina de Oliveira Monteiro‐Moreira & Stephen P. Mackessy, 2021. "Drought, desertification and poverty: A geospatial analysis of snakebite envenoming in the Caatinga biome of Brazil," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1685-1696, September.
    4. Sayem Ahmed & Guibehi B Koudou & Maïwenn Bagot & François Drabo & Windtaré R Bougma & Caisey Pulford & Moses Bockarie & Robert A Harrison, 2021. "Health and economic burden estimates of snakebite management upon health facilities in three regions of southern Burkina Faso," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(6), pages 1-17, June.
    5. Nicholas I Brown, 2012. "Consequences of Neglect: Analysis of the Sub-Saharan African Snake Antivenom Market and the Global Context," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(6), pages 1-7, June.
    6. Anuradhani Kasturiratne & Arunasalam Pathmeswaran & A Rajitha Wickremasinghe & Shaluka F Jayamanne & Andrew Dawson & Geoff K Isbister & Hithanadura Janaka de Silva & David G Lalloo, 2017. "The socio-economic burden of snakebite in Sri Lanka," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 11(7), pages 1-9, July.
    7. Daniel Zacarias & Rafael Loyola, 2019. "Climate change impacts on the distribution of venomous snakes and snakebite risk in Mozambique," Climatic Change, Springer, vol. 152(1), pages 195-207, January.

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