Demow Hospital achieves zero snake bite deaths for fourth year in a row

Guwahati, September 4: In a remarkable feat of snake bite management, Demow Rural Community Health Centre-cum-Model Hospital (DRCH-CMH) of Sivasagar district has achieved 'zero mortality' for the fourth consecutive year (2021-2024).

This accomplishment is particularly significant because it reflects the success of on-time reporting to the hospital and its management something attributable to growing awareness on the front.

The hospital registered 863 snake bite patients in 2024, of which 146 were venomous bites. The majority of snake bites occurred in the monsoon season (June to September) and most snake bite incidents were attributed to the green pit vipers (Trimeresurus sp.), followed by cobras (Naja sp.), banded kraits (Bungarus fasciatus), black kraits (B. niger B. livid us), and red-necked keelback (R. helleri).

"Patients exhibiting early symptoms of envenomation were treated with polyvalent antivenom administration and medication following a standardized treatment protocol developed in-house. All the envenomated patients recovered post-treatment resulting in no mortality," Dr Surajit Giri of DRCHCMH who has pioneered research and clinical management of snake bite patients, told The Assam Tribune.

A report published in Zoxicon, the peer-reviewed scientific journal published by Elsevier, the demographics, temporal trends, geographic patterns, morbidity and mortality trends, utilization data (length of hospital stay), interventions and treatment dynamics and outcome data were analyzed. Further, the correlation between the time taken for hospital admission and the snake species responsible for the bite has also been analyzed.

A total of 863 snake bite patients were registered at DRCHCMH in 2024 which is 7.84% of the annual snake bite incidents in Assam. Among them, 146 cases were of venomous snake bites from which 12 cases were referred to DRCHCMH from other health centres and 134 were registered at DRCHCMH directly. Among the registered patients, the majority of snake bites were from Sivasagar district (51%), followed by the neighbouring districts of Dibrugarh (30%), Charaideo (15%), Jorhat (3%) and Tinsukia (1%).

The heat map of the four snake bite-affected districts reveals that a majority of the snake bite cases registered were from Sivasagar district, whereas some cases were distributed in patches of the neighbouring districts.

Among the registered snake bite incidents, a total of 717 (83.06%) cases were diagnosed as non-venomous bites, and 146 (16.93%) cases were diagnosed as venomous bites. About 20.5% of the cases were identified as asymptomatic bites i.e., 18 from R. helleri, 10 from Trimeresurus sp., 1 from B. fasciatus and 1 from black krait (either B. niger or B. lividus), These patients did not present any clinical signs of envenomation and were discharged after 24 hours of observation.

The month-wise distribution of snake bite data reveals that majority (64.03%) of the incidents occurred during the monsoon season, i.e., the months of June (125), July (144), August (140) and September (143). The frequency of venomous bites revealed that one viperid species, namely, Trimeresurus spp. (100), and one colubrid (natricid) species, R. helleri (18), were responsible for 80.82% (118) of snake bite cases, and three elapid groups, namely, N. kaouthia (22), B. fasciatus (2), black kraits (B. wiger/B. lividus) (2), were responsible for 17.80% (26) of the snake bite cases.

The report notes that during the monsoon months, the snake bite incidents surged considerably and the most common snake species responsible for a majority of the snake bite cases were Trimeresurus spp. (65), R. helleri (16) and N. kaouthia (16). The snake species remained

unidentified in two cases. Demographic and clinical characteristics of snake bite patients reveal that among 146 patients of venomous snake bites, a small number of patients (12) were referred cases to DRCHCMH. The sex-based distribution pie-chart reveals that the proportion of snake bite incidences in fe-male victims (52%) was slightly higher than the male victims (48%). The age-based distribution of victims revealed that majority be-longed to the age group of 31-40 years (23.8%), followed by 21-30 years (18.6%) and 41-50 years (17.9%).

The report which was authored by Amit Talukdar, Prasenjit Roy, Jayaditya Purkayastha, Simanta Jyoti Taye, Deepak Agarwalla, Ruma Shyam, Hridoy Baruah, Rentu Kumar Gam, Gaurav Choudhary, Rajib Jangid, Anurag Borthakur, Surajit Giri, and Robin Doleyalso recommended that the snake bite management model of DRCH-CMH may be followed in other affected areas for managing snake bite cases.