Clinico-Epidemiological Profile and Outcome of Snake Bite Cases Admitted at a Tertiary Hospital in Nepal

Abstract

Introduction: Snake bite among adults is an important public health and clinical problem in many tropical and subtropical countries like Nepal. There are limited studies found on snake-bite using the WHO snake-bite management guidelines. This study assessed the clinico-epidemiological profile and their outcome in snake bite cases among adults using the WHO/SEARO Guidelines for the management of snake-bites.

Materials and methods: This is a descriptive study among 128 adults admitted in Medical Department of Western Regional Hospital from July 2018 to June 2019 with the presentation of snake bite for management.

Results: Around half (51.6%) of the cases were female and the mean age was 39.3 years with standard deviation of 16.6 years. Of the 128 patients, 7% presented to hospital in first day, 32.8% in second day, 31.3% in third day, and 17.2% on fourth day and rest within ninth day of snake bite. Common site of bite were left hand (38.3%) followed by left leg (28.1%).Of the cases 81.3% developed
symptoms within first hour, 8.6% within sixth hour and rest afterwards. Local site pain and swelling was observed as most common sign/symptoms, but there was no neurotoxic manifestations. Only one (0.8%) patient needed Anti Snake Venom, two (1.6%) needed injection Vitamin K and 22(17.2%) needed Fresh Frozen Plasma (FFP) transfusion for management of complication in addition to other
supportive measures. The case fatality rate was nil.

Conclusion: Using WHO Guideline for management of snake bite in adults showed zero case fatality rate in Western Regional Hospital. However further studies need to be done by using national and WHO guidelines among larger population and area for better output and recommendation.