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Scientific article
Open access
English

Vulnerability to snakebite envenoming and access to healthcare in the Terai region of Nepal: A geospatial analysis

Published inThe Lancet regional health. Southeast Asia, vol. 9, 100103
Publication date2023-02
Abstract

Background: Snakebite envenoming is a neglected tropical disease that mainly affects poor populations in rural areas. In hyperendemic regions, prevention could partially reduce the constant risk, but the population still needs timely access to adequate treatment. In line with WHO’s snakebite roadmap, we aim to understand snakebite vulnerability through modelling of risk and access to treatment, and propose plausible solutions to optimise resource allocation.

Methods: We combined snakebite-risk distribution rasters with travel-time accessibility analyses for the Terai region of Nepal, considering three vehicle types, two seasons, two snakebite syndromes, and uncertainty intervals. We proposed localised and generalised optimisation scenarios to improve snakebite treatment coverage for the population, focusing on the neurotoxic syndrome.

Findings: In the Terai, the neurotoxic syndrome is the main factor leading to high snakebite vulnerability. For the most common scenario of season, syndrome, and transport, an estimated 2.07 (15.3%) million rural people fall into the high vulnerability class. This ranges between 0.3 (2.29%) and 6.8 (50.43%) million people when considering the most optimistic and most pessimistic scenarios, respectively. If all health facilities treating snakebite envenoming could optimally treat both syndromes, treatment coverage of the rural population could increase from 65.93% to 93.74%, representing a difference of >3.8 million people.

Interpretation: This study is the first high-resolution analysis of snakebite vulnerability, accounting for uncertainties in both risk and travel speed. The results can help identify populations highly vulnerable to snakebite envenoming, optimise resource allocation, and support WHO’s snakebite roadmap efforts.

eng
Keywords
  • Snakebite
  • Vulnerability
  • Accessibility to healthcare
  • Travel time
  • Nepal
  • Risk
  • Geospatial analysis
  • Accessmod
Citation (ISO format)
OCHOA, Carlos et al. Vulnerability to snakebite envenoming and access to healthcare in the Terai region of Nepal: A geospatial analysis. In: The Lancet regional health. Southeast Asia, 2023, vol. 9, p. 100103. doi: 10.1016/j.lansea.2022.100103
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Identifiers
ISSN of the journal2772-3682
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Technical informations

Creation2022/11/18 14:21:00
First validation2022/11/18 14:21:00
Update time2023/03/16 09:04:02
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