The Epidemiology of Snakebite in Bhutan: A Retrospective Study

Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four‐year (2018–2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe t...

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Published inPublic health challenges Vol. 4; no. 3; p. e70077
Main Authors Tshokey, Tshokey, Jamtsho, Rixin, Rinchen, Sangay
Format Journal Article
LanguageEnglish
Published Hoboken John Wiley and Sons Inc 01.09.2025
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Abstract Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four‐year (2018–2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming ( n  = 100, 27%), bush walking ( n  = 42, 11.3%), herding ( n  = 15, 4%) and trekking ( n  = 1, 0.2%). The most common anatomical bite site was the leg ( n  = 167, 45.01%), followed by the hand ( n  = 81, 21.8%), finger ( n  = 56, 15.09%), toes ( n  = 11, 2.96%), thigh region ( n  = 6, 1.6%), head and face ( n  = 3, 0.8%), chest and shoulder ( n  = 3, 0.8%) and abdomen ( n  = 1, 0.3%). Most snakes were unidentified ( n  = 266, 71.7%). Those identified were vipers ( n  = 74, 19.9%), rat snakes ( n  = 12, 3.2%), kraits ( n  = 7, 1.88%), cobras ( n  = 6, 1.61%), river snakes ( n  = 5, 1.34%) and wolf snakes ( n  = 1, 0.26%). Forty‐three (11.6%) of the bite victims had resorted to non‐medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.
AbstractList Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four-year (2018-2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming (n = 100, 27%), bush walking (n = 42, 11.3%), herding (n = 15, 4%) and trekking (n = 1, 0.2%). The most common anatomical bite site was the leg (n = 167, 45.01%), followed by the hand (n = 81, 21.8%), finger (n = 56, 15.09%), toes (n = 11, 2.96%), thigh region (n = 6, 1.6%), head and face (n = 3, 0.8%), chest and shoulder (n = 3, 0.8%) and abdomen (n = 1, 0.3%). Most snakes were unidentified (n = 266, 71.7%). Those identified were vipers (n = 74, 19.9%), rat snakes (n = 12, 3.2%), kraits (n = 7, 1.88%), cobras (n = 6, 1.61%), river snakes (n = 5, 1.34%) and wolf snakes (n = 1, 0.26%). Forty-three (11.6%) of the bite victims had resorted to non-medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four-year (2018-2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming (n = 100, 27%), bush walking (n = 42, 11.3%), herding (n = 15, 4%) and trekking (n = 1, 0.2%). The most common anatomical bite site was the leg (n = 167, 45.01%), followed by the hand (n = 81, 21.8%), finger (n = 56, 15.09%), toes (n = 11, 2.96%), thigh region (n = 6, 1.6%), head and face (n = 3, 0.8%), chest and shoulder (n = 3, 0.8%) and abdomen (n = 1, 0.3%). Most snakes were unidentified (n = 266, 71.7%). Those identified were vipers (n = 74, 19.9%), rat snakes (n = 12, 3.2%), kraits (n = 7, 1.88%), cobras (n = 6, 1.61%), river snakes (n = 5, 1.34%) and wolf snakes (n = 1, 0.26%). Forty-three (11.6%) of the bite victims had resorted to non-medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.
Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four‐year (2018–2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming ( n  = 100, 27%), bush walking ( n  = 42, 11.3%), herding ( n  = 15, 4%) and trekking ( n  = 1, 0.2%). The most common anatomical bite site was the leg ( n  = 167, 45.01%), followed by the hand ( n  = 81, 21.8%), finger ( n  = 56, 15.09%), toes ( n  = 11, 2.96%), thigh region ( n  = 6, 1.6%), head and face ( n  = 3, 0.8%), chest and shoulder ( n  = 3, 0.8%) and abdomen ( n  = 1, 0.3%). Most snakes were unidentified ( n  = 266, 71.7%). Those identified were vipers ( n  = 74, 19.9%), rat snakes ( n  = 12, 3.2%), kraits ( n  = 7, 1.88%), cobras ( n  = 6, 1.61%), river snakes ( n  = 5, 1.34%) and wolf snakes ( n  = 1, 0.26%). Forty‐three (11.6%) of the bite victims had resorted to non‐medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.
Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four‐year (2018–2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming ( n  = 100, 27%), bush walking ( n  = 42, 11.3%), herding ( n  = 15, 4%) and trekking ( n  = 1, 0.2%). The most common anatomical bite site was the leg ( n  = 167, 45.01%), followed by the hand ( n  = 81, 21.8%), finger ( n  = 56, 15.09%), toes ( n  = 11, 2.96%), thigh region ( n  = 6, 1.6%), head and face ( n  = 3, 0.8%), chest and shoulder ( n  = 3, 0.8%) and abdomen ( n  = 1, 0.3%). Most snakes were unidentified ( n  = 266, 71.7%). Those identified were vipers ( n  = 74, 19.9%), rat snakes ( n  = 12, 3.2%), kraits ( n  = 7, 1.88%), cobras ( n  = 6, 1.61%), river snakes ( n  = 5, 1.34%) and wolf snakes ( n  = 1, 0.26%). Forty‐three (11.6%) of the bite victims had resorted to non‐medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite. This study reports 371 cases of snakebites in 4 years (2018–2021) from 45 Bhutanese hospitals. Snakebite is a neglected public health problem with no consistent recording and reporting system, no national treatment guidelines and no public health program activities in Bhutan.
Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four-year (2018-2021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming (  = 100, 27%), bush walking (  = 42, 11.3%), herding (  = 15, 4%) and trekking (  = 1, 0.2%). The most common anatomical bite site was the leg (  = 167, 45.01%), followed by the hand (  = 81, 21.8%), finger (  = 56, 15.09%), toes (  = 11, 2.96%), thigh region (  = 6, 1.6%), head and face (  = 3, 0.8%), chest and shoulder (  = 3, 0.8%) and abdomen (  = 1, 0.3%). Most snakes were unidentified (  = 266, 71.7%). Those identified were vipers (  = 74, 19.9%), rat snakes (  = 12, 3.2%), kraits (  = 7, 1.88%), cobras (  = 6, 1.61%), river snakes (  = 5, 1.34%) and wolf snakes (  = 1, 0.26%). Forty-three (11.6%) of the bite victims had resorted to non-medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.
Author Rinchen, Sangay
Jamtsho, Rixin
Tshokey, Tshokey
AuthorAffiliation 2 Faculty of Postgraduate Medicine Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) Thimphu Bhutan
1 Department of Pathology and Laboratory Medicine Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) Thimphu Bhutan
3 Medical Education Centre for Research Innovation and Technology (MECRIT) Khesar Gyalpo University of Medical Sciences of Bhutan Thimphu Bhutan
4 National Centre for Animal Health, Serbithang Thimphu Bhutan
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Keywords Bhutan | epidemiology | neglected tropical diseases | snakebite
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Funding: The study was funded by the Wellcome Trust through the Royal Society of Tropical Medicine and Hygiene (RSTMH) as part of an early career grant 2021 received by T.T.
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