Snakebites in 'Invisible Populations': A cross-sectional survey in riverine populations in the remote western Brazilian Amazon

Autor: Felipe Leão Gomes Murta, André Sachett, João Arthur Alcântara, Paulo Sérgio Bernarde, Jacqueline de Almeida Gonçalves Sachett, Alexandre Vilhena Silva-Neto, Marcus V. G. Lacerda, Joseir Saturnino Cristino, Guilherme Kemeron Maciel Salazar, Fan Hui Wen, Wuelton Marcelo Monteiro, Vanderson de Souza Sampaio, Fernando Val, Altair Seabra Farias, Vinícius Azevedo Machado
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Rural Population
Cross-sectional study
Economics
RC955-962
Distribution (economics)
Marine and Aquatic Sciences
Social Sciences
Snake Bites
Geographical locations
Health Services Accessibility
Medical Conditions
Arctic medicine. Tropical medicine
Health care
Medicine and Health Sciences
Medicine
Snakebite
Community Health Services
Geographic Areas
Geography
Amazon rainforest
Antivenins
Infectious Diseases
Public aspects of medicine
RA1-1270
Brazil
Research Article
Neglected Tropical Diseases
Freshwater Environments
Urban Areas
Demographics
Interview
MEDLINE
Pain
Human Geography
Urban Geography
Signs and Symptoms
Rivers
Complementary and Alternative Medicine
Environmental health
Intervention (counseling)
Animals
Humans
Demography
business.industry
Ecology and Environmental Sciences
Public Health
Environmental and Occupational Health
Aquatic Environments
Bodies of Water
South America
Tropical Diseases
Traditional Medicine
Self Care
Cross-Sectional Studies
Earth Sciences
Medicine
Traditional
People and places
Clinical Medicine
business
Finance
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 15, Iss 9, p e0009758 (2021)
ISSN: 1935-2735
1935-2727
Popis: In the Brazilian Amazon, long distances, low healthcare coverage, common use of ineffective or deleterious self-care practices, and resistance to seeking medical assistance have an impact on access to antivenom treatment. This study aimed to estimate snakebite underreporting, and analyze barriers that prevent victims from obtaining healthcare in communities located in 15 municipalities on the banks of the Solimões, Juruá and Purus Rivers, in the remote Western Brazilian Amazon. Information on the participants’ demographics, previous snakebites, access to healthcare, time taken to reach medical assistance, use of self-care practices, and the reason for not accessing healthcare were collected through semi-structured interviews. In the case of deaths, information was collected by interviewing parents, relatives or acquaintances. A total of 172 participants who reported having suffered snakebites during their lifetime were interviewed. A total of 73 different treatment procedures was reported by 65.1% of the participants. Participants living in different river basins share few self-care procedures that use traditional medicine, and 91 (52.9%) participants reported that they had access to healthcare. Living in communities along the Juruá River [OR = 12.6 (95% CI = 3.2–49.7; p
Author summary Many patients bitten by snakes in the Brazilian Amazon do not seek medical care since they live great distinces from health facilities and often do not have the financial resources to travel in search of assistance. In this situation of vulnerability, a wide variety of traditional methods, without proven efficacy, and some known to be harmful, are used by individuals. As a result, many cases of snakebites that are not treated in the official health network are consequently not reported to the epidemiological surveillance system, thus generating underreporting. Knowing the proportion of underreported cases and their hostspots is very important for planning interventions that will improve the coverage of the healthcare network and the logistics of delivery of antivenoms. In a pioneering way in Brazil, this study was carried out to estimate snakebite underreporting and analyze obstacles that prevent victims from obtaining healthcare in the communities located in 15 municipalities on the banks of the Solimões, Juruá and Purus Rivers, in the remote Western Brazilian Amazon. Cases of deaths due to snakebites were also investigated. A total of 172 participants who reported having suffered snakebites during their lifetime were interviewed, as well as the circumstances of 4 deaths. Most patients recalled using some traditional medicine in the form of self-care to treat snakebite. In total, there were 73 different treatment procedures, which were quite different between the different regions studied. Almost half of the participants did not seek medical advice, claiming as reason for that the prioritization for traditional treatments and the non-regognition of the situation as potentially severe. In the Juruá River communities, this frequency was around 70%. The preference of traditional medicine was also associated with the lack of access to healthcare. We believe that this situation will only be mitigated if the antivenoms are made available closer to snakebite victims, i.e., in riverside and rural health units.
Databáze: OpenAIRE
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