ABSTRACT:
Snakebite and snakebite envenoming (SBE) is an underreported public health calamity with huge socioeconomic consequences. SBE is a condition associated with impoverishment, inequity and neglect. India is considered the snakebite capital of the globe burdened with half the incidence and deaths reported worldwide. The Indian Council of Medical Research (ICMR) funded National Task Force (NTF) study on the incidence, morbidity, mortality and socioeconomic impact of snakebite was pan-India, covering 36 districts across 14 states across the 5 geographical zones of India. The situations and contexts leading to bite, health seeking behaviour, therapy, complications, delay in initiating therapy, first-aid measures, alongside region, snake species were recorded in 20000 victims across India. Based on the geography; demography, socio-cultural and economic factors; ethnobiology; health care systems; occupation; climate, soil and rainfall; and other social determinants we study the determinants of snake-human conflict through a one-health approach. The framework we have utilised for the one-health approach is that of the ‘epidemiological triad’ of an agent (snake), host (humans and livestock) and environment. We have assessed the various determinants based on the epidemiological triad supplemented by an outer setting which includes the health systems, social determinants and other associated factors. This is the first study looking at the determinants of snake-human conflict from a holistic one-health aspect factoring for the medical and non-medical determinants, environment, contexts and situations that have contributed to the accident. We used logistic regression to assess the association of 14 determinants with snake-human conflict. We are in the process of creating ‘hotspots’ for the country based on the results of the study.