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Snakebite: a multifactorial approach is required

Posted by plosmedicine on 31 Mar 2009 at 00:02 GMT

Author: Jose Maria Gutierrez
Position: Instituto Clodomiro Picado
Institution: Universidad de Costa Rica
Submitted Date: November 20, 2006
Published Date: November 29, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

The comment of A. Kumar (1) to our essay on snakebite (2) focuses on a relevant aspect: the impact of religion, as exemplified by the common belief in the Hindu population of India and Nepal that cobras should not be harmed. The author proposes that, in such circumstances, education and awareness campaigns would be of little help, and that universal antivenom availability would be the only effective solution.

The design of effective strategies to counteract the impact of snakebite envenomings, especially in tropical regions, is a complex task that requires a multifactorial approach which goes beyond the availability of antivenoms. The increase in antivenom production and its deployment to areas where it is required is essential, but other issues should be considered in order to make this intervention really effective.

Health facilities of diverse sort should be extended to areas where snakebites are common, and community participation in confronting this problem has to be promoted. In addition, health staff has to be trained in the correct diagnosis of snakebites and in the appropriate use of antivenoms. This is a largely neglected issue that complicates the management of this disease, since in many regions health personnel do not know how to properly diagnose and treat snakebites. The development of regional guidelines for treating these envenomings, and their permanent teaching to health staff, are urgent tasks. Finally, large scale educational campaigns to the population, tailored to the sociocultural and religious characteristics of each region, should be promoted in order to improve prevention and to assure rapid transportation of patients to facilities where antivenoms are available.


1. Kumar A (2006) Snakebite: Sociocultural anthropological bias. PLoS Med 3: e412 doi:10.1371/journal.pmed.0030412.

2. Gutierrez JM, Theakston RDG, Warrell DA (2006) Confronting the neglected problem of snake bite envenoming: The need for a global partnership. PLoS Med 3: e150 doi:10.1371/journal.pmed.0030150.

No competing interests declared.