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 Research Notes

Aranjan Lionel Karunanayake¹  Dissanayake Mohottalage Randima Dissanayake³  Roshini Kilanthi Karunanayake² 

[1] College of Medicine, Nursing & Health Sciences, National University of Fiji, Suva, Fiji;Teaching Hospital, Sri Jayawardenapura, Sri Lanka;Teaching Hospital, Chilaw, Sri Lanka

关键词: Sri Lanka;    Venomous;    Pediatrics;    Snake bite;   

Others  :  1131787
DOI  :  10.1186/1756-0500-7-482

 received in 2014-02-12, accepted in 2014-07-21,  发布年份 2014

【 摘 要 】

Background

Snake bite is a common problem in the North Central province of Sri Lanka. Common krait (Bungarus careuleus), Ceylon krait (Bungarus ceylonicus), Cobra (Naja naja), Russell’s viper (Daboia russelii), Saw-scaled viper (Echis carinatus) and Hump-nosed pit viper (Hypnale hypnale) are the six species of venomous land snakes in Sri Lanka. A significant number of adults and children are bitten by snakes every year. However, the majority of research studies done in Sri Lanka and other countries show adults bitten by snakes and studies describing children bitten by snakes are very sparse.

Methods

A descriptive cross sectional study was performed in the Teaching Hospital Anuradhapura in the North Central Province of Sri Lanka from May 2010 to 2011 May to describe the characteristics associated with cases of snake bite.

Results

There were 24 males and 20 females. The highest numbers of bites (48%) were in the range of ages 6-12 years. The majority of the bites occurred between 6 pm to 6 am (59%).The foot was the most common bitten site (48%). Out of all the venomous bites, the Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number (44%) and Russell’s viper (Daboia ruselii) accounted for the second highest number (27%). A significant number of venomous bites occurred indoors while sleeping (22%). Antivenom serum was given to (39%) of venomous bites. Deaths occurred in (11%) of the venomous bites.

Conclusions

Hump-nosed pit viper (Hypnale hypnale) accounted for the highest number of venomous bites. Majority of the bites occurred between 6 pm and 6 am. Foot was the most common bitten site. A significant number of venomous bites occurred indoor while sleeping. Antivenom serum was given to a significant number of venomous bites. Educating the public on making their houses snake proof and using a torch when going out during night time will help in the prevention of getting bitten by snakes.

【 授权许可】

   
2014 Karunanayake et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: World Health Statistics 2007. Geneva: WHO; 2007. http://www.who.int/whosis/whostat2007en/ webcite. Accessed 29 September 2008
• [2]Wagstaff SS, Laing GD, Theakston RGD, Papaspyridis C, Harrison RA: Bioinformatics and multiepitope DNA immunization to design rational snake antivenin. PLoS Med 2006, 3:e184.
• [3]Kasturiratne A, Wickremasinghe R, de Silva N, Gunawardena K, Pathmeswaran A, Premaratne R, Salvioloi L, Lalloo DG, de Silva HJ: The global burden of snakebite: a literature analysis and modeling based on regional estimates of envenoming. PLoS Med 2008, 5:e218.
• [4]Emilie A, Sanjib KS, Himmatrao SB, Ulrich K, Francois C: Snake bite in South Asia: a review. PLoS Negl Trop Dis 2010, 4:e603.
• [5]Robert AH, Adam H, Simson C, Wagstaff BF, David GL: Snake envenoming: a disease of poverty. PLoS Negl Trop Dis 2009, 3:e569.
• [6]Alirol E, Sharma SK, Bawaska HS, Kuch U, Chappius F: Snake bite in South Asia. PLoS Negl Trop Dis 2010, 4:e603.
• [7]Rahman R, Faiz MA, Selims S, Rahman B, Basher A, Jones A, d Estie C, Hossain M, Islam Z, Ahmed H, Milton AH: Annual incidence of snake bite in rural Bangladesh. PLoS Negl Trop Dis 2010, 4:e860.
• [8]Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S: Snake envenomation in a North Indian hospital. EMJ 2005, 22:118-120.
• [9]Jamaiah I, Rohela M, Roshalina R, Undan RC: Prevalence of snake bites in Kangar district hospital, Perlis West Malaysia: a retrospective study (January 1999-December 2000). South East Asian J Trop Med Public Health 2004, 35:962-965.
• [10]De Silva HJ, Pathmeswaran A, Ranasinghe C, Jayamanna S, Samarakoon SB, Hitharage A, Kalupahana R, Ratnatilaka GA, Uluwaththage W, Aronson JK, Armitage JM, Lalloo DJ, de Silva HJ: Low dose adrenaline, promethazine and hydrocortisone in the prevention of acute adverse reactions to anti venom following snake bite. Arandomized double blind placebo controlled trial. PLoS Med 2011, 8:e1000-e1435.
• [11]Silva de : Snake bites in Anuradhapura District. Snake 1981, 13:117-130.
• [12]Sellahewa KH: Lessons from four studies on management of snake bite in Sri Lanka. CMJ 1997, 42:8-15.
• [13]Fernando R: Management of acute poisoning. Colombo: National poisons information centre; 2002:144-150.
• [14]Silva A, Pilapitiya S, Siribaddana S: Acute myocardial infarction following a possible direct intravenous bite of Russel’s viper (Daboia russelii). BMC Res Notes 2012, 12:5-500.
• [15]Sheiff MHR: Renal disease due to snake bite and its management. CMJ 1983, 28:190-198.
• [16]Karunarathna S, Udaya Kumara Y, Govindapala D, Fernando H: Type IV renal tubular acidosis following resolution of acute kidney injury and disseminated intravascular coagulation due to hump-nosedpit viper (Hypnalehypnale) bite. Indian J Nephrol 2013, 23:294-296.
• [17]Maduwage K, Kularatne K, Wazil A, Gawarammana L: Coagulopathy, acute kidney injury, and death following Hypnalezara envenoming: the first case report from Sri Lanka. Toxicon 2011, 58:641-643.
• [18]Fonseka CL, Jeevagan V, Gnanathasan CA: Life threatening intracerebralhaemorrhage following saw scaled viper (Echiscarinatus) envenoming – authenticated case report from Sri Lanka. BMC Emerg Med 2013, 8:5. doi:10,1186/1471-227x
• [19]Gnanathasan A, Rodrigo CX, Parantharaja T, Coonghe A: Saw-scaled viper (Echiscarinatus) bites in Sri Lanka: is it a different sub species? Clinical evidence from an authenticated case series. Am J Trop Med Hyg 2012, 86:254-257.
• [20]Kularatne SA, Sivansathan S, Medagedara SC, Maduwage K, de Silva A: Revisiting saw-scaled viper (Echiscarinatus) bites in the Jaffna peninsula of Sri Lanka: distribution, epidemiology and clinical manifestations. Trans R Soc Trop Med Hyg 2011, 105:591-597.
• [21]Kuch U, Sharma SK, Alirol E, Chappuis F: Fatal neurotoxic envenoming from the bite of a lesser black krait (Bangaruslividus) in Nepal. South East Asian J Trop Med Public Health 2011, 42:960-964.
• [22]Hasan SM, Basher A, Molla AA, Sultana NK, Faiz MA: The impact of snake bite on house hold economy in Bangladesh. Trop Doct 2012, 42:41-43.
• [23]Maduwage K, Isbister GK, Silva A, Bowatta S, Mendis S, Gawarammana I: Epidemiology and clinical effects of hump – nosed pit viper (Hypnalehypnale) envenoming in Sri Lanka. Toxicon 2013, 61:11-15.