PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

A prospective cohort study of the effectiveness of the primary hospital management of all snakebites in Kurunegala district of Sri Lanka.

Abstract Sri Lanka records substantial numbers of snakebite annually. Primary rural hospitals are important contributors to health care. Health care planning requires a more detailed understanding of snakebite within this part of the health system. This study reports the management and epidemiology of all hospitalised snakebite in the Kurunegala district in Sri Lanka.
PMID
Related Publications

An open, randomized comparative trial of two antivenoms for the treatment of envenoming by Sri Lankan Russell's viper (Daboia russelii russelii).

Diagnostic 20-min whole blood clotting test in Russell's viper envenoming delays antivenom administration.

A study of snake bite among children presenting to a paediatric ward in the main Teaching Hospital of North Central province of Sri Lanka.

Prospective, consecutive case series of 158 snakebite patients treated at Savannakhet provincial hospital, Lao People's Democratic Republic with high incidence of anaphylactic shock to horse derived F(ab')2 antivenom.

Parallels between Russell's viper (Daboia russelii) and hump-nosed viper (Hypnale species) bites in the central hills of Sri Lanka amidst the heavy burden of unidentified snake bites.

Authors

Mayor MeshTerms
Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28827807
OWN - NLM
STAT- MEDLINE
DA  - 20170822
DCOM- 20170907
LR  - 20170907
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 8
DP  - 2017 Aug
TI  - A prospective cohort study of the effectiveness of the primary hospital
      management of all snakebites in Kurunegala district of Sri Lanka.
PG  - e0005847
LID - 10.1371/journal.pntd.0005847 [doi]
AB  - INTRODUCTION: Sri Lanka records substantial numbers of snakebite annually.
      Primary rural hospitals are important contributors to health care. Health care
      planning requires a more detailed understanding of snakebite within this part of 
      the health system. This study reports the management and epidemiology of all
      hospitalised snakebite in the Kurunegala district in Sri Lanka. METHODOLOGY: The 
      district has 44 peripheral/primary hospitals and a tertiary care
      hospital-Teaching Hospital, Kurunegala (THK). This prospective study was
      conducted over one year. All hospitals received copies of the current national
      guidelines on snakebite management. Clinical and demographic details of all
      snakebite admissions to primary hospitals were recorded by field researchers and 
      validated by comparing with scanned copies of the medical record. Management
      including hospital transfers was independently assessed against the national
      guidelines recommendation. Population rates were calculated and compared with
      estimates derived from recent community based surveys. RESULTS: There were 2186
      admissions of snakebites and no deaths in primary hospitals. An additional 401
      patients from the district were admitted directly to the teaching hospital, 2
      deaths were recorded in this group. The population incidence of hospitalized
      snakebite was 158/100,000 which was significantly lower than community survey
      estimates of 499/100,000. However there was no significant difference between the
      incidence of envenomation of 126/100,000 in hospitalised patients and 184/100,000
      in the community survey. The utilisation of antivenom was appropriate and
      consistent with guidelines. Seventy patients received antivenom. Anaphylactic
      reactions to antivenom occurred in 22 patients, treatment reactions was
      considered to be outside the guidelines in 5 patients. Transfers from the primary
      hospital occurred in 399(18%) patients but the majority (341) did not meet the
      guideline criteria. A snake was identified in 978 cases; venomous snakebites
      included 823 hump-nosed viper (Hypnalespp), 61 Russell's viper, 14 cobra, 13
      common krait, 03 saw scaled viper. CONCLUSIONS: Primary hospitals received a
      significant number of snakebites that would be missed in surveys conducted in
      tertiary hospitals. Adherence to guidelines was good for the use of antivenom but
      not for hospital transfer or treatment of anaphylaxis. The large difference in
      snakebite incidence between community and hospital studies could possibly be due 
      to non-envenomed patients not presenting. As the majority of snakebite management
      occurs in primary hospitals education and clinical support should be focused on
      that part of the health system.
FAU - Shahmy, Seyed
AU  - Shahmy S
AUID- ORCID: http://orcid.org/0000-0002-2339-1572
AD  - South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine,
      University of Peradeniya, Peradeniya, Sri Lanka.
FAU - Kularatne, Senanayake A M
AU  - Kularatne SAM
AD  - Department of Medicine, Faculty of Medicine, University of Peradeniya,
      Peradeniya, Sri Lanka.
FAU - Rathnayake, Shantha S
AU  - Rathnayake SS
AD  - South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine,
      University of Peradeniya, Peradeniya, Sri Lanka.
FAU - Dawson, Andrew H
AU  - Dawson AH
AD  - South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine,
      University of Peradeniya, Peradeniya, Sri Lanka.
AD  - Central Clinical School, University of Sydney, Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170821
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Antivenins)
SB  - IM
MH  - Adult
MH  - Anaphylaxis/chemically induced/*epidemiology
MH  - Animals
MH  - Antivenins/adverse effects/*therapeutic use
MH  - Bungarus
MH  - Female
MH  - Guideline Adherence
MH  - Hospitals, Rural/*standards
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Practice Guidelines as Topic
MH  - Prospective Studies
MH  - Russell's Viper
MH  - Snake Bites/*mortality/*therapy
MH  - Sri Lanka/epidemiology
MH  - Treatment Outcome
EDAT- 2017/08/23 06:00
MHDA- 2017/09/08 06:00
CRDT- 2017/08/23 06:00
PHST- 2017/05/02 [received]
PHST- 2017/08/02 [accepted]
PHST- 2017/08/31 [revised]
AID - 10.1371/journal.pntd.0005847 [doi]
AID - PNTD-D-17-00686 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Aug 21;11(8):e0005847. doi:
      10.1371/journal.pntd.0005847. eCollection 2017 Aug.