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

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 th...

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Autores principales:	Guilherme Kemeron Maciel Salazar, Joseir Saturnino Cristino, Alexandre Vilhena Silva-Neto, Altair Seabra Farias, João Arthur Alcântara, Vinícius Azevedo Machado, Felipe Murta, Vanderson Souza Sampaio, Fernando Val, André Sachett, Paulo Sérgio Bernarde, Marcus Lacerda, Fan Hui Wen, Wuelton Monteiro, Jacqueline Sachett
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/ba0d57296928495595c1fd78cc9d657f
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spelling	oai:doaj.org-article:ba0d57296928495595c1fd78cc9d657f2021-12-02T20:24:09ZSnakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.1935-27271935-273510.1371/journal.pntd.0009758https://doaj.org/article/ba0d57296928495595c1fd78cc9d657f2021-09-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009758https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735In 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<0.001)] and the use of traditional medicine [OR = 11.6 (95% CI = 3.4-39.8; p<0.001)] were variables that were independently associated to the lack of access to healthcare. The main reasons for not accessing healthcare were the pprioritization of traditional treatments (70.4%), and the failure to recognize the situation as being potentially severe (50.6%). Four deaths from complications arising from the snakebite were reported, and three of these were from communities on the banks of the Juruá River. Only one of these received medical assistance. We found an unexpectedly high underreporting of snakebite cases and associated deaths. Snakebite victims utilized three main different healing systems: 1) self-care using miscellaneous techniques; 2) official medical healthcare generally combined with traditional practices; and 3) self-care using traditional practices combined with Western medicines. To mitigate snakebite burden in the Brazilian Amazon, an innovative intervention that would optimize timely delivery of care, including antivenom distribution among existing community healthcare centers, is needed.Guilherme Kemeron Maciel SalazarJoseir Saturnino CristinoAlexandre Vilhena Silva-NetoAltair Seabra FariasJoão Arthur AlcântaraVinícius Azevedo MachadoFelipe MurtaVanderson Souza SampaioFernando ValAndré SachettPaulo Sérgio BernardeMarcus LacerdaFan Hui WenWuelton MonteiroJacqueline SachettPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 9, p e0009758 (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 Guilherme Kemeron Maciel Salazar Joseir Saturnino Cristino Alexandre Vilhena Silva-Neto Altair Seabra Farias João Arthur Alcântara Vinícius Azevedo Machado Felipe Murta Vanderson Souza Sampaio Fernando Val André Sachett Paulo Sérgio Bernarde Marcus Lacerda Fan Hui Wen Wuelton Monteiro Jacqueline Sachett Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
description	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<0.001)] and the use of traditional medicine [OR = 11.6 (95% CI = 3.4-39.8; p<0.001)] were variables that were independently associated to the lack of access to healthcare. The main reasons for not accessing healthcare were the pprioritization of traditional treatments (70.4%), and the failure to recognize the situation as being potentially severe (50.6%). Four deaths from complications arising from the snakebite were reported, and three of these were from communities on the banks of the Juruá River. Only one of these received medical assistance. We found an unexpectedly high underreporting of snakebite cases and associated deaths. Snakebite victims utilized three main different healing systems: 1) self-care using miscellaneous techniques; 2) official medical healthcare generally combined with traditional practices; and 3) self-care using traditional practices combined with Western medicines. To mitigate snakebite burden in the Brazilian Amazon, an innovative intervention that would optimize timely delivery of care, including antivenom distribution among existing community healthcare centers, is needed.
format	article
author	Guilherme Kemeron Maciel Salazar Joseir Saturnino Cristino Alexandre Vilhena Silva-Neto Altair Seabra Farias João Arthur Alcântara Vinícius Azevedo Machado Felipe Murta Vanderson Souza Sampaio Fernando Val André Sachett Paulo Sérgio Bernarde Marcus Lacerda Fan Hui Wen Wuelton Monteiro Jacqueline Sachett
author_facet	Guilherme Kemeron Maciel Salazar Joseir Saturnino Cristino Alexandre Vilhena Silva-Neto Altair Seabra Farias João Arthur Alcântara Vinícius Azevedo Machado Felipe Murta Vanderson Souza Sampaio Fernando Val André Sachett Paulo Sérgio Bernarde Marcus Lacerda Fan Hui Wen Wuelton Monteiro Jacqueline Sachett
author_sort	Guilherme Kemeron Maciel Salazar
title	Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
title_short	Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
title_full	Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
title_fullStr	Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
title_full_unstemmed	Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.
title_sort	snakebites in "invisible populations": a cross-sectional survey in riverine populations in the remote western brazilian amazon.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ba0d57296928495595c1fd78cc9d657f
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Snakebites in "Invisible Populations": A cross-sectional survey in riverine populations in the remote western Brazilian Amazon.

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