Risk Factors Associated with Bites due to Two Viperid Snakes: A Case Control Study
Senanayake Abeysinghe Mudiyanselage Kula
Department of Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
Kosala Gayan Abeysundara Dissanayake Wee *
Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
Ashoka Rathnathilake
General Hospital, Kurunegala, Sri Lanka
Pallegoda Vithanage Ranjith Kumarasiri
Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka
*Author to whom correspondence should be addressed.
Abstract
Aims: This study was to assess victim’s environmental and behavioural risk factors that promote bites from two viperid snakes.
Study Design: A case control study.
Place and Duration of Study: Medical wards, General Hospital, Kurunegala, Sri Lanka, between June to December 2010.
Methodology: Cases were recruited prospectively from consecutive admissions to the General Hospital, Kurunegala, Sri Lanka with proven viperid bites. Age and gender matched control group was selected from relatives and neighbourhood of the cases in a ratio of 1 case: 2 controls.
Results: There were 56 cases and 112 controls with mean age 44 years and 45 years respectively. Of the 13 risk factors assessed, 7 risk factors showed a significant association with viperid bites. Those were (1) being in an ill lit place (OR, 95% CI= 6.6 (3.25-13.4), (2) being in outdoor places (OR, 95% CI= 148.8 (43.7-506), (3) working in a field (OR, 95% CI= 175 (31.4 – 976), (4) occupation as a field worker (OR, 95% CI= 5.3 (2.3-12 ), (5) low level of financial status (OR, 95% CI=9.9(2.75- 35.5), (6) lack of attached toilet (OR, 95% CI= 7.38 (2.15- 25.3), (7) presence of small rodents in the compounds (OR, 95% CI= 11 (4.88-24.9).
Conclusion: Identifying easily remediable risk factors would help in preventing viperid snake bites.
Keywords: Snake-bite, viperid snakes, Russell’s viper, hump-nosed viper, risk factors, Sri Lanka