The Epidemiology of Snakebite Injury in the Amazonian Regions of Ecuador

The epidemiology of snakebite injury in the Amazonian regions of Ecuador Introduction: Morbidity and mortality from snakebite envenomations is a major public health issue in remote areas of under-developed countries. Several attempts have been made to approximate the impact of snakebites worldwide, however these are assumed to be underestimations due to the lack of documentation on the local level. Ecuador\u27s Amazonian region lacks a comprehensive community-based surveillance system, however it is unique in that an aero-medical transport system is in place to transfer the patients requiring hospitalization to one of the five urban medical centers. Beginning in 1998, Servicio Aéreo Misional (SAM), one of the two transport companies serving three of the rural provinces, began documenting flight data including the demographics of patients and their diagnoses. Methods: The SAM database was used to conduct a retrospective study to describe the incidence, patient demographics and geographic location of snakebite injuries in three rural provinces of Ecuador. SPSS was used for frequencies and Chi squares analyses. Results: In the years 2003 to 2005 there were a total of 1,340 aero-medical transports in this region. Of those, snakebite injuries constituted 4.2% of all medical diagnoses. The majority of snakebites occurred in males (p=0.027) aged 10-29 (p\u3c0.001) and were concentrated in the low-lying areas of the province of Morona-Santiago. Discussion: These results describe the distribution of snakebites; efforts are now underway to identify the risk factors involved in this patient population. This information would then be used to optimize prevention and treatment