Clinical epidemiology of snakebite envenoming in hospitals 11 provinces of Yangtze River Basin and southern regions of China: A retrospective hospital-based analysis

BACKGROUND: As the largest developing country, China works towards reducing mortality and disability from snakebite envenoming (SBE) by 50% before 2030, as epidemiological evidences are essential. METHODS: A cross-sectional survey was conducted in 11 provinces in China using a multistage stratified cluster random sampling, and hospitalized snakebite victims with complete case histories from January 1, 2017, to December 31, 2021, were included. RESULTS: A total of 40,817 snakebite victims were enrolled in this study. The most common snake species were Agkistrodon halys (16.04%) and Trimeresurus stejnegeri (11.40%). However, 56.36% of the snake species remained unidentified. Furthermore, our results revealed that 60.36% of snakebite victims were males, 63.71% were older than 50 years, 59.70% were peasants, 11.14% experienced moderate envenomation on admission, and 0.64% had severe envenomation on admission. Ultimately, only 6.82% of the victims achieved complete healing, whereas 82.44% of snakebite victims demonstrated improvement in their condition upon discharge. Only 69.57% of snakebite victims received antivenom treatments. Furthermore, age, occupation, hospitalization duration, snake specie, site of bite, location, activity, envenomation on admission, clinical manifestation, and treatment significantly affected the discharge outcomes of snakebite victims. CONCLUSIONS: This study is the first large-sample investigation focusing on the epidemiological characteristics of SBE in China, addressing research gaps and filling the void in the relevant the World Health Organization data. The findings call for authorities and managers to strengthen partnerships, coordination, and resources, reduce SBE incidents, and ensure that victims receive fair, safe, and effective treatments.