Content area
Full text
About the Authors:
Anuradhani Kasturiratne
Affiliation: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
Arunasalam Pathmeswaran
Affiliation: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
A. Rajitha Wickremasinghe
Affiliation: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
Shaluka F. Jayamanne
Affiliations Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
Andrew Dawson
Affiliation: South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
Geoff K. Isbister
Affiliations South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Clinical Toxicology Research Group, University of Newcastle, Callaghan, Australia
Hithanadura Janaka de Silva
Affiliation: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
David G. Lalloo
* E-mail: [email protected]
Affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom
ORCID http://orcid.org/0000-0001-7680-2200Abstract
Background
Snakebite is a major problem affecting the rural poor in many of the poorest countries in the tropics. However, the scale of the socio-economic burden has rarely been studied. We undertook a comprehensive assessment of the burden in Sri Lanka.
Methods
Data from a representative nation-wide community based household survey were used to estimate the number of bites and deaths nationally, and household and out of pocket costs were derived from household questionnaires. Health system costs were obtained from hospital cost accounting systems and estimates of antivenom usage. DALYs lost to snakebite were estimated using standard approaches using disability weights for poisoning.
Findings
79% of victims suffered economic loss following a snakebite with a median out of pocket expenditure of $11.82 (IQR 2-28.57) and a median estimated loss of income of $28.57 and $33.21 for those in employment or self-employment, respectively. Family members also lost income to help care for patients. Estimated health system costs for Sri Lanka were $ 10,260,652 annually. The annual estimated total number of DALYS was 11,101 to 15,076 per year for envenoming following snakebite.
Interpretation
Snakebite places a considerable economic burden on the households of victims in Sri Lanka, despite a health system which is accessible and free at the point of care. The disability burden is also considerable, similar to that of meningitis or dengue, although the relatively low case...