Quantifying the mortality, health outcomes, and disability due to snakebite envenoming in India

Abstract

Venomous snakebites cause substantial mortality and morbidity in India, despite the existence of antivenom treatment for the most common Indian venomous snakes. There have been few efforts to quantify the disease burden at a population level, primarily due to scarce data. By incorporating data on snakebite habitat, nonfatal health outcomes, and mortality, this study measured the morbidity and mortality from venomous snakebites in India from 2000 to 2019 by sex, age, and state. This study expanded on estimates from the Global Burden of Disease (GBD) 2019 study, which modeled mortality in India due to “venomous animal contact”, an umbrella category that includes all venomous animals. The proportion of all venomous animal contact deaths due only to snakes was modeled and applied to GBD estimates of death and years of life lost (YLLs). Information on the relative occurrence of hemotoxic and neurotoxic snakes in India and each snake type’s case fatality rate and common health outcomes were analyzed to produce estimates of incidence, years lived with disability (YLDs), and disability-adjusted life years (DALYs). In 2019, 827,000 (95% CI: 411,000 to 1.6 million) venomous snakebites occurred in India and resulted in 51,000 (30,000 to 64,000) deaths and 3.0 million (1.8 to 3.7) DALYs. The disease burden was greatest in the central and eastern region of the country. Amputation was the greatest cause of nonfatal disability. Venomous snakebites are a large cause of preventable morbidity and mortality in India. By better understanding the epidemiology of venomous snakebites and its amenable nature, prevention initiatives, healthcare resource investment, and rural antivenom distribution interventions can be more effectively implemented.