A 10-Year Clinico-Epidemiological Study of Snake Bite Cases in Siraha District

BackgroundSnakebite envenoming is a major public health concern in Nepal, particularly in agricultural regions such as Siraha District. It disproportionately affects rural populations, where delayed hospital presentation and harmful first-aid practices contribute to preventable morbidity and mortality. Despite global WHO strategies to reduce the snakebite burden by 2030, comprehensive long-term data from Nepal remain limited. MethodsA retrospective descriptive study was conducted at Ram Kumar Sarda Uma Prasad Murarka Provincial Hospital, Lahan, covering ten years (2071-2080 BS / 2014-2024 AD). All clinically confirmed or strongly suspected snakebite cases were included. Data on demographics, bite characteristics, clinical features, prehospital interventions, treatments, and outcomes were extracted from hospital records and analyzed using SPSS version 25. Annual case fatality rates (CFR) were calculated. ResultsA total of 3,499 snakebite cases were recorded, with 58 deaths (CFR 1.66%). Adults aged 16-45 years (60.5%) and farmers were most affected. Most bites occurred on lower limbs (67.2%), during evening hours and the monsoon season (44.3%). Only 3.4% of patients presented within one hour, while 38.2% arrived after six hours. Harmful first-aid practices particularly tourniquet use (17.6%) and local incisions (3.9%) remained common. Cytotoxic manifestations predominated, while severe systemic symptoms were infrequent. ConclusionSnakebite remains a significant occupational and seasonal hazard in Siraha District. Although the low CFR indicates improved case management, delayed presentation and unsafe prehospital care persist. Strengthening community education, ensuring early access to antivenom, and improving diagnostic and referral systems are essential to further reduce mortality and disability.