Evidence map›Paper›PMID 41325381›Full record

ArticlePLoS neglected tropical diseases2025

Therapeutic itineraries of children after snakebites in the Brazilian Amazon: A thematic drawing-and-story study.

Joseir Saturnino Cristino, Altair Seabra Farias, Erica Silva Carvalho, Jacqueline Sachett, Fan Hui Wen, Felipe Murta, Vinícius Azevedo Machado, Wuelton Monteiro

Abstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joseir Saturnino CristinoSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Altair Seabra FariasSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Erica Silva CarvalhoSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Jacqueline SachettSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Fan Hui WenBioindustrial Center, Instituto Butantan, São Paulo, Brazil.
Felipe MurtaSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Vinícius Azevedo MachadoSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
Wuelton MonteiroSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.ORCID 0000-0002-0848-1940

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado do Amazonas
6 · The paper itself

Abstract

backgroundSnakebite envenomations (SBEs) impose a significant burden on children living in the Brazilian Amazon. In this region, children are at a higher risk of long-term disabilities and death. Therapeutic itineraries refer to the paths individuals take to seek and manage their health, encompassing both formal and informal healthcare systems. Even with an increasing interest in involving children in qualitative research in health sciences, researchers generally neglect children as subjects capable of reporting on their health status. The aim of this study was to describe the healthcare itineraries of children presenting at a tertiary hospital in Manaus, Brazilian Amazon, for medical assistance after snakebites.

methodsA thematic drawing-and-story study was performed to explore the healthcare itinerary of children aged 4-12 years who were admitted with a diagnosis of SBE in a tertiary hospital in Manaus, Brazilian Amazon, from July 2022 to March 2024. Data was analyzed by deductive content analysis. Data collection involved drawing and storytelling based on the snakebite experience of the participant from the moment of the bite to hospital. Sample size was defined by saturation.

resultsThirteen (65%) boys and seven (35%) girls, with an average age of 8.7 years, were recruited. Most of them were accompanied to the hospital by their mothers (65%). Time to medical care ranged from 1 to 84 hours. Data analysis highlighted five key themes: 1) Identification and understanding of SBEs in the process of initial parental care; 2) Children's understanding of the SBE and their journey to care; 3) Children's experiences with SBEs and their exposure to them in the environment; (4) Use of therapeutic practices during the children's journey to care; and 5) Contingencies in the healthcare itinerary of the children. The initial response to SBE in children is marked by challenges in communication between them and adults, delaying proper care. The unexpected event is a traumatic experience for children, with intense pain and reactions such as fear. Fragmented itineraries significantly increase the time needed to access antivenom. In some cases, children try to take care of themselves, but parental care is still predominant.

conclusionThe experiences of a snakebite in children reinforce the need for public policies, such as specific educational interventions, aimed at promoting early recognition of signs, validating children's voices, and discouraging harmful practices. Strengthening culturally sensitive and child-focused strategies is important for public health, as it enables the transformation of long, fragmented and improvised therapeutic itineraries into more timely, safe, and effective care pathways for pediatric snakebite victims in the Amazon.

Indexed as

Snake BitesAntiveninsBrazilChildChild, PreschoolFemaleHumansMaleQualitative ResearchAntivenins

Identifiers

PMID41325381
PMCPMC12677774

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.