DIFERENÇAS MUNICIPAIS PERSISTENTES NO INTERVALO ATÉ O PRIMEIRO ATENDIMENTO APÓS ACIDENTES OFÍDICOS: ESTUDO OBSERVACIONAL NO PARÁ, 2018-2025

To examine trends in recorded time to first medical care after snakebite and the persistence of differences among municipalities in Pará, Brazil, from 2018 to 2025. Methods: An observational study was conducted using de-identified notifications from the Brazilian Notifiable Diseases Information System, made available through PDD/Cidacs-Fiocruz. The outcome included time-to-care categories starting at six hours. Annual proportions were standardized for age, sex, and municipality; municipal observed-to-expected ratios and Spearman correlations were calculated for distinct periods. Results: Of 42,751 selected notifications, 41,036 met the analytical criteria, including 7,793 (19.0%) in time-to-care categories starting at six hours. The adjusted proportion fell from 21.41% in 2018 to 16.30% in 2025 (difference: −5.10 percentage points; 95% confidence interval: −8.35 to −1.85). Municipal rankings were correlated between 2018-2022 and 2023-2025 (Spearman's ρ=0.782; 118 municipalities). The analysis restricted to final records from 2018-2022 yielded a correlation of ρ=0.697 across 120 municipalities. Conclusion: Although the adjusted statewide proportion declined, municipal differences in recorded time to first care persisted. The findings should be interpreted in light of the preliminary status of records from 2023-2025 and possible differences in reporting practices.