Vulnerability to snakebite envenoming and access to healthcare in the Terai region of Nepal: a geospatial analysis.
AccessMod
Accessibility to healthcare
Geospatial analysis
Nepal
Risk
Snakebite
Travel time
Vulnerability
Journal
The Lancet regional health. Southeast Asia
ISSN: 2772-3682
Titre abrégé: Lancet Reg Health Southeast Asia
Pays: England
ID NLM: 9918419282806676
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
30
06
2022
revised:
07
10
2022
accepted:
21
10
2022
medline:
29
6
2023
pubmed:
29
6
2023
entrez:
29
6
2023
Statut:
epublish
Résumé
Snakebite envenoming is a neglected tropical disease that mainly affects poor populations in rural areas. In hyperendemic regions, prevention could partially reduce the constant risk, but the population still needs timely access to adequate treatment. In line with WHO's snakebite roadmap, we aim to understand snakebite vulnerability through modelling of risk and access to treatment, and propose plausible solutions to optimise resource allocation. We combined snakebite-risk distribution rasters with travel-time accessibility analyses for the Terai region of Nepal, considering three vehicle types, two seasons, two snakebite syndromes, and uncertainty intervals. We proposed localised and generalised optimisation scenarios to improve snakebite treatment coverage for the population, focusing on the neurotoxic syndrome. In the Terai, the neurotoxic syndrome is the main factor leading to high snakebite vulnerability. For the most common scenario of season, syndrome, and transport, an estimated 2.07 (15.3%) million rural people fall into the high vulnerability class. This ranges between 0.3 (2.29%) and 6.8 (50.43%) million people when considering the most optimistic and most pessimistic scenarios, respectively. If all health facilities treating snakebite envenoming could optimally treat both syndromes, treatment coverage of the rural population could increase from 65.93% to 93.74%, representing a difference of >3.8 million people. This study is the first high-resolution analysis of snakebite vulnerability, accounting for uncertainties in both risk and travel speed. The results can help identify populations highly vulnerable to snakebite envenoming, optimise resource allocation, and support WHO's snakebite roadmap efforts. Swiss National Science Foundation.
Sections du résumé
Background
UNASSIGNED
Snakebite envenoming is a neglected tropical disease that mainly affects poor populations in rural areas. In hyperendemic regions, prevention could partially reduce the constant risk, but the population still needs timely access to adequate treatment. In line with WHO's snakebite roadmap, we aim to understand snakebite vulnerability through modelling of risk and access to treatment, and propose plausible solutions to optimise resource allocation.
Methods
UNASSIGNED
We combined snakebite-risk distribution rasters with travel-time accessibility analyses for the Terai region of Nepal, considering three vehicle types, two seasons, two snakebite syndromes, and uncertainty intervals. We proposed localised and generalised optimisation scenarios to improve snakebite treatment coverage for the population, focusing on the neurotoxic syndrome.
Findings
UNASSIGNED
In the Terai, the neurotoxic syndrome is the main factor leading to high snakebite vulnerability. For the most common scenario of season, syndrome, and transport, an estimated 2.07 (15.3%) million rural people fall into the high vulnerability class. This ranges between 0.3 (2.29%) and 6.8 (50.43%) million people when considering the most optimistic and most pessimistic scenarios, respectively. If all health facilities treating snakebite envenoming could optimally treat both syndromes, treatment coverage of the rural population could increase from 65.93% to 93.74%, representing a difference of >3.8 million people.
Interpretation
UNASSIGNED
This study is the first high-resolution analysis of snakebite vulnerability, accounting for uncertainties in both risk and travel speed. The results can help identify populations highly vulnerable to snakebite envenoming, optimise resource allocation, and support WHO's snakebite roadmap efforts.
Funding
UNASSIGNED
Swiss National Science Foundation.
Identifiants
pubmed: 37383041
doi: 10.1016/j.lansea.2022.100103
pii: S2772-3682(22)00119-6
pmc: PMC10306013
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100103Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
The project was funded by The 10.13039/501100001711Swiss National Science Foundation (10.13039/501100001711SNSF) (SNAKE-BYTE - project number 315130_176271) and the recipients of grant are Nicolas Ray and François Chappuis. The authors declare no competing interests.
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