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

• Published in: PLoS neglected tropical diseases 2021-09, Vol.15 (9), p.e0009758
• Main Authors: Maciel Salazar, Guilherme Kemeron, Saturnino Cristino, Joseir, Vilhena Silva-Neto, Alexandre, Seabra Farias, Altair, Alcântara, João Arthur, Azevedo Machado, Vinícius, Murta, Felipe, Souza Sampaio, Vanderson, Val, Fernando, Sachett, André, Bernarde, Paulo Sérgio, Lacerda, Marcus, Hui Wen, Fan, Monteiro, Wuelton, Sachett, Jacqueline
• Format: Article
• Language: English
• Subjects: Access; Access to information; Activities of daily living; Animals; Antivenins; Antivenom; Bites; Bites and stings; Brazil - epidemiology; Care and treatment; Community health care; Community Health Services - organization & administration; Complications; Consent; Cross-Sectional Studies; Demographics; Demography; Earth Sciences; Ecology and Environmental Sciences; Fatalities; Health aspects; Health care; Health services; Health Services Accessibility; Humans; Medical sciences; Medicine; Medicine and Health Sciences; Medicine, Traditional; Municipalities; People and places; Podocnemis unifilis; Populations; Procedures; River banks; River basins; Rivers; Roads & highways; Rural areas; Rural Population; Sanitation; Self Care; Self-care, Health; Snake bites; Snake Bites - epidemiology; Social Sciences; Surveying; Surveys; Traditional medicine; Tropical diseases; Urban areas
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0009758

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