Snakebites in children - a five year retrospective review of victims admitted to two hospitals in Sri Lanka

Abstract

INTRODUCTION: Snakebite in children causes great parental concern and medical unease. AIMS: To determine characteristics of paediatric snakebite in two hospitals, in the wet zone (Colombo North Teaching Hospital (CNTH) and dry zone (Base Hospital Polonnaruwa-BHP). METHODS: A retrospective study collected data on snakebite by reviewing records of children admitted to CNTH and BHP from January 2007 to December 2011. RESULTS: There were 188 snakebite victims (CNTH 71, BHP 117).Similarities in the two cohorts were (CNTH and BHP -M:F=35:36and 64:53; mean age 6 years (SD3) and 7 years (SD3); definite bites 30(53.6%) and 39(37.5%); circumstantial evidence in 57(80.3%) and 84(71.8%);time of bite: between 4- 8pm 42.6% and 47.2%. Majority of confirmed bites were HNV (60%) in CNTH and Kraits (30.8%) in BHP. Differences in the cohorts were :place of bite: in and around the home, median time from bite to hospital, administration of first aid, antivenom use, intensive care, median (range) duration of hospitalization and deaths (CNTH vs BHP): 37(56.9%) and 29(27.6%),35 vs 102.5 minutes, 21.4% vs 1%, 5.6% vs 17.1%, 1.4% vs 5.1%, 1 (1-7) days vs 2 (1-13), 0 vs 3.4% (Krait bites). CONCLUSIONS: Snakebites occur in ambulatory children, diagnosed mainly on circumstantial evidence and occur in and around homes irrespective of geographic location. Clinical features and outcome depend on offending species and availability of resources.