ArticlePLoS neglected tropical diseases2020
Time delays in treatment of snakebite patients in rural Sri Lanka and the need for rapid diagnostic tests.
Article in PLoS neglected tropical diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 41 citations in OpenAlex.
- Compliance with national snakebite treatment guidelines in rural Sri Lankan hospitals: a cluster randomized controlled trial of a brief educational intervention.BMC medical education · 2023Trial
- Evaluation of long-term consequences among snakebite survivors in rural Kenya including validation of a functional limitations assessment tool.PLoS neglected tropical diseases · 2026Article
- Snakebite patterns in rural Sri Lanka and their implications for preventive measures.PLoS neglected tropical diseases · 2026Article
- Early Clinical Approach Prevents Severe Neurotoxicity Following Cobra Envenoming: An Integrated Experimental and Multi-Center Clinical Study in Thailand.Biomedicines · 2026Article
- Analysis of factors influencing skin sensitivity test results of antivenom and its potential correlation with allergic reactions: a retrospective cohort study.Frontiers in allergy · 2026Article
- Unveiling the burden of snakebite injuries: an EQ-5D-5 L-based evaluation of health-related quality of life.BMC public health · 2025Article
- Community beliefs, risk factors, and preventive practices of snakebite: a local study with global perspectives.BMC research notes · 2025Observational
- Using a Machine Learning Approach to Predict Snakebite Envenoming Outcomes Among Patients Attending the Snakebite Treatment and Research Hospital in Kaltungo, Northeastern Nigeria.Tropical medicine and infectious disease · 2025Article
- Effectiveness of late and very late antivenom administration on recovery from snakebite-induced coagulopathy in French Guiana: a population-based study.Lancet regional health. Americas · 2025Article
- Total CroFab and Anavip Antivenom Vial Administration in US Rattlesnake Envenomations: 2019-2021.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2023Article
- Antivenom availability, delays and use in Australia.Toxicon: X · 2023Article
- Vulnerability to snakebite envenoming and access to healthcare in the Terai region of Nepal: a geospatial analysis.The Lancet regional health. Southeast Asia · 2023Article
- Towards better antivenoms: navigating the road to new types of snakebite envenoming therapies.The journal of venomous animals and toxins including tropical diseases · 2023Article
- Current Status and Influencing Factors of Snakebite Diagnosis and Treatment Knowledge Among Medical Staff in China: A Cross-Sectional Study.International journal of public health · 2023Article
- Long-term health effects perceived by snakebite patients in rural Sri Lanka: A cohort study.PLoS neglected tropical diseases · 2022Article
- Snakebite victim profiles and treatment-seeking behaviors in two regions of Kenya: results from a health demographic surveillance system.Tropical medicine and health · 2022Article
- Indian Polyvalent Antivenom Accelerates Recovery From Venom-Induced Consumption Coagulopathy (VICC) in Sri Lankan Russell's Viper (Frontiers in medicine · 2022Article
- Clinical management of snakebite envenoming: Future perspectives.Toxicon: X · 2021Article
- Snakebite envenoming in different national contexts: Costa Rica, Sri Lanka, and Nigeria.Toxicon: X · 2021Article
- Snakebite Envenoming Diagnosis and Diagnostics.Frontiers in immunology · 2021Review
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Delays in treatment seeking and antivenom administration remain problematic for snake envenoming. We aimed to describe the treatment seeking pattern and delays in admission to hospital and administration of antivenom in a cohort of authenticated snakebite patients. Adults (> 16 years), who presented with a confirmed snakebite from August 2013 to October 2014 were recruited from Anuradhapura Hospital. Demographic data, information on the circumstances of the bite, first aid, health-seeking behaviour, hospital admission, clinical features, outcomes and antivenom treatment were documented prospectively. There were 742 snakebite patients [median age: 40 years (IQR:27-51; males: 476 (64%)]. One hundred and five (14%) patients intentionally delayed treatment by a median of 45min (IQR:20-120min). Antivenom was administered a median of 230min (IQR:180-360min) post-bite, which didn't differ between directly admitted and transferred patients; 21 (8%) receiving antivenom within 2h and 141 (55%) within 4h of the bite. However, transferred patients received antivenom sooner after admission to Anuradhapura hospital than those directly admitted (60min [IQR:30-120min] versus 120min [IQR:52-265min; p<0.0001]). A significantly greater proportion of transferred patients had features of systemic envenoming on admission compared to those directly admitted (166/212 [78%] versus 5/43 [12%]; p<0.0001), and had positive clotting tests on admission (123/212 [58%] versus 10/43 [23%]; p<0.0001). Sri Lankan snakebite patients present early to hospital, but there remains a delay until antivenom administration. This delay reflects a delay in the appearance of observable or measurable features of envenoming and a lack of reliable early diagnostic tests. Improved early antivenom treatment will require reliable, rapid diagnostics for systemic envenoming.
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