Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.

<h4>Background</h4>Snakebite incidence shows both spatial and temporal variation. However, no study has evaluated spatiotemporal patterns of snakebites across a country or region in detail. We used a nationally representative population sample to evaluate spatiotemporal patterns of snake...

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Autores principales:	Dileepa Senajith Ediriweera, Anuradhani Kasthuriratne, Arunasalam Pathmeswaran, Nipul Kithsiri Gunawardene, Shaluka Francis Jayamanne, Kris Murray, Takuya Iwamura, Geoffrey Isbister, Andrew Dawson, David Griffith Lalloo, Hithanadura Janaka de Silva, Peter John Diggle
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/471eb7b9c6ec480bae88051276418a20
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spelling	oai:doaj.org-article:471eb7b9c6ec480bae88051276418a202021-11-25T06:31:49ZEvaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.1935-27271935-273510.1371/journal.pntd.0009447https://doaj.org/article/471eb7b9c6ec480bae88051276418a202021-06-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009447https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Snakebite incidence shows both spatial and temporal variation. However, no study has evaluated spatiotemporal patterns of snakebites across a country or region in detail. We used a nationally representative population sample to evaluate spatiotemporal patterns of snakebite in Sri Lanka.<h4>Methodology</h4>We conducted a community-based cross-sectional survey representing all nine provinces of Sri Lanka. We interviewed 165 665 people (0.8% of the national population), and snakebite events reported by the respondents were recorded. Sri Lanka is an agricultural country; its central, southern and western parts receive rain mainly from Southwest monsoon (May to September) and northern and eastern parts receive rain mainly from Northeast monsoon (November to February). We developed spatiotemporal models using multivariate Poisson process modelling to explain monthly snakebite and envenoming incidences in the country. These models were developed at the provincial level to explain local spatiotemporal patterns.<h4>Principal findings</h4>Snakebites and envenomings showed clear spatiotemporal patterns. Snakebite hotspots were found in North-Central, North-West, South-West and Eastern Sri Lanka. They exhibited biannual seasonal patterns except in South-Western inlands, which showed triannual seasonality. Envenoming hotspots were confined to North-Central, East and South-West parts of the country. Hotspots in North-Central regions showed triannual seasonal patterns and South-West regions had annual patterns. Hotspots remained persistent throughout the year in Eastern regions. The overall monthly snakebite and envenoming incidences in Sri Lanka were 39 (95%CI: 38-40) and 19 (95%CI: 13-30) per 100 000, respectively, translating into 110 000 (95%CI: 107 500-112 500) snakebites and 45 000 (95%CI: 32 000-73 000) envenomings in a calendar year.<h4>Conclusions/significance</h4>This study provides information on community-based monthly incidence of snakebites and envenomings over the whole country. Thus, it provides useful insights into healthcare decision-making, such as, prioritizing locations to establish specialized centres for snakebite management and allocating resources based on risk assessments which take into account both location and season.Dileepa Senajith EdiriweeraAnuradhani KasthuriratneArunasalam PathmeswaranNipul Kithsiri GunawardeneShaluka Francis JayamanneKris MurrayTakuya IwamuraGeoffrey IsbisterAndrew DawsonDavid Griffith LallooHithanadura Janaka de SilvaPeter John DigglePublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 6, p e0009447 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Dileepa Senajith Ediriweera Anuradhani Kasthuriratne Arunasalam Pathmeswaran Nipul Kithsiri Gunawardene Shaluka Francis Jayamanne Kris Murray Takuya Iwamura Geoffrey Isbister Andrew Dawson David Griffith Lalloo Hithanadura Janaka de Silva Peter John Diggle Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
description	<h4>Background</h4>Snakebite incidence shows both spatial and temporal variation. However, no study has evaluated spatiotemporal patterns of snakebites across a country or region in detail. We used a nationally representative population sample to evaluate spatiotemporal patterns of snakebite in Sri Lanka.<h4>Methodology</h4>We conducted a community-based cross-sectional survey representing all nine provinces of Sri Lanka. We interviewed 165 665 people (0.8% of the national population), and snakebite events reported by the respondents were recorded. Sri Lanka is an agricultural country; its central, southern and western parts receive rain mainly from Southwest monsoon (May to September) and northern and eastern parts receive rain mainly from Northeast monsoon (November to February). We developed spatiotemporal models using multivariate Poisson process modelling to explain monthly snakebite and envenoming incidences in the country. These models were developed at the provincial level to explain local spatiotemporal patterns.<h4>Principal findings</h4>Snakebites and envenomings showed clear spatiotemporal patterns. Snakebite hotspots were found in North-Central, North-West, South-West and Eastern Sri Lanka. They exhibited biannual seasonal patterns except in South-Western inlands, which showed triannual seasonality. Envenoming hotspots were confined to North-Central, East and South-West parts of the country. Hotspots in North-Central regions showed triannual seasonal patterns and South-West regions had annual patterns. Hotspots remained persistent throughout the year in Eastern regions. The overall monthly snakebite and envenoming incidences in Sri Lanka were 39 (95%CI: 38-40) and 19 (95%CI: 13-30) per 100 000, respectively, translating into 110 000 (95%CI: 107 500-112 500) snakebites and 45 000 (95%CI: 32 000-73 000) envenomings in a calendar year.<h4>Conclusions/significance</h4>This study provides information on community-based monthly incidence of snakebites and envenomings over the whole country. Thus, it provides useful insights into healthcare decision-making, such as, prioritizing locations to establish specialized centres for snakebite management and allocating resources based on risk assessments which take into account both location and season.
format	article
author	Dileepa Senajith Ediriweera Anuradhani Kasthuriratne Arunasalam Pathmeswaran Nipul Kithsiri Gunawardene Shaluka Francis Jayamanne Kris Murray Takuya Iwamura Geoffrey Isbister Andrew Dawson David Griffith Lalloo Hithanadura Janaka de Silva Peter John Diggle
author_facet	Dileepa Senajith Ediriweera Anuradhani Kasthuriratne Arunasalam Pathmeswaran Nipul Kithsiri Gunawardene Shaluka Francis Jayamanne Kris Murray Takuya Iwamura Geoffrey Isbister Andrew Dawson David Griffith Lalloo Hithanadura Janaka de Silva Peter John Diggle
author_sort	Dileepa Senajith Ediriweera
title	Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
title_short	Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
title_full	Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
title_fullStr	Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
title_full_unstemmed	Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.
title_sort	evaluating spatiotemporal dynamics of snakebite in sri lanka: monthly incidence mapping from a national representative survey sample.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/471eb7b9c6ec480bae88051276418a20
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Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample.

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