World practices of non-medical help for snakebites: a scoping review.

BACKGROUND

This study aimed to map the cumulative evidence on pre-hospital non-medical helping behaviours and interventions attempted for snakebites.

METHODS

The scoping review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

This review included 158 articles representing research conducted across 41 countries. Respective studies encompassed 83 317 snakebite cases. Visits to traditional healers and the use of traditional medicine represented the most common patterns of behaviour in response to snakebites, occurring with median rates of 21.7% and 38.7%, respectively. Particular helping actions were classified into 92 categories. The most prevalent non-evidence-based measures included washing the bite site (median occurrence rate 53.3%), use of a tourniquet (34.2%), application of herbal products through an unspecified route or various routes (20.2%), ingestion of herbs (12.0%) and incisions to the bite site (9.9%). Multiple studies confirmed an adverse influence of the guidelines-discordant helping actions on health outcomes. For low-income and lower-middle-income countries, the pooled median estimate of the occurrence of improper helping actions was significantly higher (15.0%) than for high-income and upper-middle-income countries (5.9% and 7.1%, respectively; p≤0.001).

CONCLUSIONS

Improper help-seeking behaviour and helping practices constitute a global health threat with disproportionately higher vulnerability of inhabitants of resource-limited regions of the world. Further research and widespread public awareness campaigns communicating the guidelines-recommended evidence-based methods of first aid response to snakebites are urgently needed.