Delayed reporting to health care facilities: a significant determinant of fatalities in cases of snake bites.

Context: Envenomation due to snake bites is one of the major Neglected Tropical Disease worldwide. In rural areas exposure to snake bite and reliance on traditional healing is high. Hence, there is a need to evaluate clinical characteristics to identify patients at high risk of developing fatal complications. Settings & design: This study was carried out on 160 patients who were admitted with history of snake bite in Department of Medicine, Shyam Shah Medical College and associated S.G.M. Hospital, Rewa (MP). Material & methods: Data was categorized into demographic characteristics, type of snake bite, history of self/home/ faith healer treatment, time lapse from the time of bite till hospital admission, clinical characteristics, severity, quantity of polyvalent antisnake venom used, duration of hospitalisation, and clinical status at discharge. Data was analysed using the Chi-square test. Results: The study of 160 snake bites revealed a significant demographic predilection to age (p=0.01), rural habitat (p=0.03) and farming occupation (p=0.03). They were significantly higher during monsoons (p=0.01), night time (p=0.03) and outdoor activity (p=0.009). The mean time till admission was 3.8 hours and patients most commonly presented with difficulty in eye opening (83.33%) and swallowing (77.78%). Conclusion: The access to hospitals is low in the locality accounting for untoward deaths from snake bites. Hence, better transport facilities and provision of ASV along with adequately trained medical and paramedical staff should be made at primary health centres where patients can be protected from home remedies as well.