Snakebite care through the first two waves of COVID-19 in West Bengal, India: a qualitative study

IF 3.6 Q2 TOXICOLOGY Toxicon: X Pub Date : 2023-06-01 DOI:10.1016/j.toxcx.2023.100157
Soumyadeep Bhaumik , Deepti Beri , Anthony B. Zwi , Jagnoor Jagnoor
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Abstract

Snakebite is a public health problem in many countries, with India having the highest number of deaths. Not much is known about the effect of the COVID-19 pandemic on snakebite care. We conducted 20 in-depth interviews with those bitten by venomous snakes through the two waves of COVID-19 (March–May 2020; May–November 2021), their caregivers, health care workers and social workers in two areas (Sundarbans and Hooghly) of West Bengal, India. We used a constructivist approach and conducted a thematic analysis. We identified the following themes: 1. Snakebite continued to be recognised as an acute emergency during successive waves of COVID-19; 2. COVID-19 magnified the financial woes of communities with high snakebite burden; 3. The choice of health care provider was driven by multiple factors and consideration of trade-offs, many of which leaned toward use of traditional providers during COVID-19; 4. Rurality, financial and social disadvantage and cultural safety, in and beyond the health system, affected snakebite care; 5. There is strong and shared felt need for multi-faceted community programs on snakebite.

We mapped factors affecting snakebite care in the three-delay model (decision to seek care, reaching appropriate health facility, receiving appropriate care), originally developed for maternal mortality. The result of our study contextualises and brings forth evidence on impact of COVID-19 on snakebite care in West Bengal, India. Multi-faceted community programs, are needed for addressing factors affecting snakebite care, including during disease outbreaks - thus improving health systems resilience. Community programs for increasing formal health service usage, should be accompanied by health systems strengthening, instead of an exclusive focus on awareness against traditional providers.

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印度西孟加拉邦前两波新冠肺炎期间的蛇咬伤护理:一项定性研究
蛇咬伤是许多国家的公共卫生问题,其中印度的死亡人数最多。关于新冠肺炎大流行对蛇咬伤护理的影响,目前尚不清楚。我们在印度西孟加拉邦的两个地区(Sundarbans和Hooghly)对新冠肺炎两波疫情期间(2020年3月至5月;2021年5月至11月)被毒蛇咬伤的人、他们的护理人员、医护人员和社会工作者进行了20次深入采访。我们采用了建构主义的方法,并进行了专题分析。我们确定了以下主题:1。在连续几波新冠肺炎疫情期间,蛇咬伤继续被视为一种急性紧急情况;2.新冠肺炎加剧了高蛇咬伤负担社区的财务困境;3.医疗保健提供者的选择是由多种因素和权衡因素驱动的,其中许多因素倾向于在新冠肺炎期间使用传统提供者;4.卫生系统内外的不道德、经济和社会劣势以及文化安全影响了蛇咬伤护理;5.关于蛇咬伤的多方面社区项目有着强烈而共同的需求。我们在三延迟模型中绘制了影响蛇咬伤护理的因素(决定寻求护理、到达适当的卫生机构、接受适当的护理),该模型最初是为孕产妇死亡率开发的。我们的研究结果结合新冠肺炎对印度西孟加拉邦蛇咬伤护理的影响并提供了证据。需要多方面的社区计划来解决影响蛇咬伤护理的因素,包括在疾病爆发期间,从而提高卫生系统的复原力。增加正规医疗服务使用的社区计划应与加强卫生系统相结合,而不是只关注对传统提供者的认识。
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来源期刊
Toxicon: X
Toxicon: X Pharmacology, Toxicology and Pharmaceutics-Toxicology
CiteScore
6.50
自引率
0.00%
发文量
33
审稿时长
14 weeks
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