Snakebite envenomation and community responses in an Amazonian floodplain: Public health and ethnobiological perspectives

Snakebite envenomation is a serious tropical public health problem, with a high incidence in the Amazon region. In floodplain areas, the seasonal flood pulse intensifies interactions between humans and snakes, making the riverine populations of the Lower Amazon particularly vulnerable. This study analyzed how the riverine population of a floodplain community in the Lower Amazon perceives, identifies, and manages snakebite accidents, investigating the influence of cultural practices on access to formal medical care. A mixed-methods (qualitative-quantitative), cross-sectional, and descriptive-exploratory approach was adopted, based on ethnobiology. Semi-structured interviews were conducted with 39 residents of the Salvação community (Alenquer, Pará), followed by content analysis and descriptive statistics. Most participants (84.6%) had a personal or family history of snakebites. Local classification systems (ethnotaxonomy) revealed taxonomic divergences, such as the use of the term "surucucu" to describe Bothrops atrox. Although 33.3% sought hospital care, traditional treatments were prevalent, including the use of dolphin fat (banha de boto), traditional antidotes (contravenenos), and the ingestion of kerosene. Reported sequelae, such as persistent pain, were frequently associated with natural cycles such as the phases of the moon. Knowledge transmission on the subject is predominantly oral and centralized within the family network (66.7%). Informational gaps were identified, especially in domestic prevention and the use of harmful substances in first aid. The management of snakebite accidents in the floodplain is guided by complex ethnobiological knowledge, where traditional and formal medicine coexist as adaptation strategies. The findings reinforce the need for intercultural public health policies that integrate local knowledge with biomedical practices, aiming to reduce the time spent seeking hospital treatment and mitigating the risks associated with inadequate management behaviors.