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

BACKGROUND: 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....

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Autores principales: Ediriweera, Dileepa Senajith, Kasthuriratne, Anuradhani, Pathmeswaran, Arunasalam, Gunawardene, Nipul Kithsiri, Jayamanne, Shaluka Francis, Murray, Kris, Iwamura, Takuya, Isbister, Geoffrey, Dawson, Andrew, Lalloo, David Griffith, de Silva, Hithanadura Janaka, Diggle, Peter John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195360/
https://www.ncbi.nlm.nih.gov/pubmed/34061839
http://dx.doi.org/10.1371/journal.pntd.0009447
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author Ediriweera, Dileepa Senajith
Kasthuriratne, Anuradhani
Pathmeswaran, Arunasalam
Gunawardene, Nipul Kithsiri
Jayamanne, Shaluka Francis
Murray, Kris
Iwamura, Takuya
Isbister, Geoffrey
Dawson, Andrew
Lalloo, David Griffith
de Silva, Hithanadura Janaka
Diggle, Peter John
author_facet Ediriweera, Dileepa Senajith
Kasthuriratne, Anuradhani
Pathmeswaran, Arunasalam
Gunawardene, Nipul Kithsiri
Jayamanne, Shaluka Francis
Murray, Kris
Iwamura, Takuya
Isbister, Geoffrey
Dawson, Andrew
Lalloo, David Griffith
de Silva, Hithanadura Janaka
Diggle, Peter John
author_sort Ediriweera, Dileepa Senajith
collection PubMed
description BACKGROUND: 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. METHODOLOGY: 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. PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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.
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spelling pubmed-81953602021-06-21 Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample Ediriweera, Dileepa Senajith Kasthuriratne, Anuradhani Pathmeswaran, Arunasalam Gunawardene, Nipul Kithsiri Jayamanne, Shaluka Francis Murray, Kris Iwamura, Takuya Isbister, Geoffrey Dawson, Andrew Lalloo, David Griffith de Silva, Hithanadura Janaka Diggle, Peter John PLoS Negl Trop Dis Research Article BACKGROUND: 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. METHODOLOGY: 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. PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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. Public Library of Science 2021-06-01 /pmc/articles/PMC8195360/ /pubmed/34061839 http://dx.doi.org/10.1371/journal.pntd.0009447 Text en © 2021 Ediriweera et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ediriweera, Dileepa Senajith
Kasthuriratne, Anuradhani
Pathmeswaran, Arunasalam
Gunawardene, Nipul Kithsiri
Jayamanne, Shaluka Francis
Murray, Kris
Iwamura, Takuya
Isbister, Geoffrey
Dawson, Andrew
Lalloo, David Griffith
de Silva, Hithanadura Janaka
Diggle, Peter John
Evaluating spatiotemporal dynamics of snakebite in Sri Lanka: Monthly incidence mapping from a national representative survey sample
title 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_short 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195360/
https://www.ncbi.nlm.nih.gov/pubmed/34061839
http://dx.doi.org/10.1371/journal.pntd.0009447
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