The Indian Council of Medical Research (ICMR) task force has started a first-of-its-kind study on the incidence, mortality, morbidity and socio-economic burden of snakebite in the country.

It will look prospectively at the incidence of snakebite covering 13 states, including Himachal Pradesh, in five zones of India with a population of 84 million.

The other states are Rajasthan, Maharashtra, Kerala, Tamil Nadu, Andhra Pradesh, Odisha, West Bengal, Uttarakhand, Meghalaya, Arunachal Pradesh, Mizoram and Tripura.

An article on the study 'ICMR task force project, survey of the incidence, mortality, morbidity and socio-economic burden of snakebite in India: A study protocol' was published in the international research journal Plos One on August 22.

While the national Principal Investigator for the ICMR study is Jaideep C. Menon from Preventive Cardiology and Population Health Sciences, Amrita Institute of Medical Sciences and Research Centre, Kochi, while Omesh Bharti, state Epidemiologist with Department of Health and Family Welfare, Himachal Pradesh, is the national Principal Co-Investigator.

"This study will generate real data on snakebite incidence, mortality, morbidity and socio-economic burden of snakebite for the first time in the country to help the decision makers in policy framing to prevent and control snakebite in India. The country still doesn't know the real snakebite burden and is hence groping in the dark when it comes to policy," Bharti told IANS on Tuesday.

He said the survey is in progress and it takes into consideration all the geographical areas like hilly, plains, marshy, desert and coastal. "It is the first such study designed for the survey of snakebite incidence in South East Asia. Sri Lanka has done it, but they covered a population of one per cent only, whereas our study would cover a population of 6.12 per cent," explained Bharti.

He said the snakebite incidence study is being carried out in 31 districts in six geographical zones in the country, including West, Central, South, East, North and North-East, in 13 states. Three districts of Himachal -- Kangra, Chamba and Una -- are also included in it.

According to the article on 'study protocol' to know snakebite incidence, snakebite is possibly the most neglected of the NTDs (neglected tropical diseases).

Half of the global deaths due to venomous snakebites, estimated at 100,000 per year, occur in India. The only representative data on snakebite available from India is the mortality data from the Registrar General of India - Million Death Study and another study on mortality from Bihar. The incidence data on snakebite is available for two districts of West Bengal.

It was only in 2017 that snakebite was added back onto the WHO (World Health Organization) list of neglected tropical diseases (NTDs), after being struck off the list in 2013.

Geographically, the greatest impact of snakebite is in the tropical and subtropical regions, with the highest occurrence in India.

Global estimates of snakebite range from 4.5 million to 5.4 million bites annually with an estimated two million of them in India with significant physical, mental and socioeconomic consequences.

The ICMR's study protocol for snakebite incidence and burden mentions that the hospital-based data on snakebite admissions and use of anti-snake venom are gross underestimates as most snakebite victims in rural India depend more on alternate treatment methods which do not get represented in national registries.

The ICMR study is a multi-centric study to determine the incidence, morbidity, mortality and economic burden of snakebites in India covering all five geographical zones of the country.

"The protocol involves community-level surveillance for snakebite covering 31 districts in 13 states of India in order to obtain annual incidence of snakebites from the community. The frontline health workers will be trained to gather information on new cases of snakebite over the study period of one year, from wards (smallest administrative subunit of a village or town) that they represent in the study districts.

"Dedicated field officers would collect data on snakebites, victim characteristics, outcomes, utilization of health facilities on a questionnaire sheet designed for this purpose. The study duration is for 18 months from April 2022 to October 2023," added Bharti.

As per a study, the number of deaths due to venomous snakebite in India is 46,900 per year.

This is considerably high, compared to only 10-12 deaths per year, due to venomous snakebite in the US and Australia, this despite the fact that less populous Australia has probably more venomous species.

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