02918nas a2200241   4500000000100000008004100001653001800042653000900060653001400069653003900083100001700122700001600139700001300155700001400168700001500182700001600197245013700213856009800350300001300448490000600461520219500467022001402662       2015                            d10aPublic health10aLaos10asnakebite10aNeglected tropical diseases (NTDs)1 aVongphoumy I1 aPhongmany P1 aSydala S1 aPrasith N1 aReintjes R1 aBlessmann J00aSnakebites in two rural districts in Lao PDR: Community-based surveys disclose high incidence of an invisible public health problem.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003887&type=printable  ae00038870 v93 a<p><strong>BACKGROUND: </strong>The Lao PDR (Laos) is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high.</p>

<p><strong>METHODS: </strong>Two cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months.</p>

<p><strong>RESULTS: </strong>Thirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014.</p>

<p><strong>CONCLUSION: </strong>Incidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this important public health problem in order to prevent fatalities and disabilities.</p>
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