Outcome determinants of snakebites in North Bihar, India: a prospective hospital based study

Research Report

J Venom Res 
(2017), Vol 8, in press

Published online: 28 June 2017

Full Text (PDF ~195kb)

Takanungsang Longkumer, Lois J Armstrong, Philip Finny

Duncan Hospital, A Unit of Emmanuel Hospital Association, Raxaul, East Champaran District, Bihar, India

*Correspondence to: Correspondence to: Lois Armstrong, Email: loisjarmstong@gmail.com

Received: 06 March 2017 | Revised: 26 June 2017 | Accepted: 28 June 2017

©Copyright The Author(s). First published by Library Publishing Media. This is an open access article, published under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0). This license permits non-commercial use, distribution and reproduction of this article, provided the original work is appropriately acknowledged, with correct citation details.


Bihar is the state with the third largest number of snakebite deaths per year in India. This prospective, one-year study of 608 snakebites provides the first data from Bihar on determinants of unfavourable outcomes in snakebites. Any delay in reaching hospital raised the risk of a snakebite patient for an unfavourable outcome [OR 8.88, CI 2.04-38.8]. Attending a traditional practitioner prior to presenting to the hospital was the only specific, significant delay [OR 3.52, CI 1.26-9.7]. Prevention of unfavourable outcomes occurred by presenting to hospital in less than 1.5 hours [OR 0.23, CI 0.052-1.0]. Motorbike was the best mode of transport [OR 0.37, CI 0.12-1.1]. Other risk factors were patients aged under 15 years [OR 3.79, CI 1.57–9.12] and bites to the upper limb [OR 2.47, CI 1.01-6.04]. Patients who were envenomated had a higher risk of unfavourable outcome, if referred due to antivenom being unavailable [OR 12.2, CI 1.49-100]. To save lives, it is imperative that measures to reduce delays in getting patients to hospital must be included in snakebite management, alongside continued availability of antivenom and assisted ventilation.

KEYWORDS: Snakebite, unfavourable outcomes, risk factors, delays, traditional practitioners, motorbikes