Clinical challenges, controversies, and regional strategies in snakebite care in India

Siju V. Abraham; Deo Mathew; Aravind Sreekumar; Akhil V. George; Vijay Chanchal; Purushothaman Kuzhikkathu Kandiyil; Punchalil Chathappan Rajeev; Udaya Bhaskaran Valuvil; Jayesh Kumar; Kuruvath Bahuleyan Mohan; Joe Thomas; Manu Ayyan; Sandeep Das; Freston Marc Sirur; Indira Madhavan; Aboobacker Mohamed Rafi; Pradeoth Korambayil Mukundan; Kartik Sunagar; Vimal Krishnan S; Babu Urumese Palatty

doi:10.1016/j.lansea.2025.100598

Clinical challenges, controversies, and regional strategies in snakebite care in India

Siju V. Abraham^*
, Deo Mathew
, Aravind Sreekumar
, Akhil V. George
, Vijay Chanchal
, Purushothaman Kuzhikkathu Kandiyil
, Punchalil Chathappan Rajeev
, Udaya Bhaskaran Valuvil
, Jayesh Kumar
, Kuruvath Bahuleyan Mohan
, Joe Thomas
, Manu Ayyan
, Sandeep Das
, Freston Marc Sirur
, Indira Madhavan
, Aboobacker Mohamed Rafi
, Pradeoth Korambayil Mukundan
, Kartik Sunagar
, Vimal Krishnan S
, Babu Urumese Palatty

^*Corresponding author for this work

Department of Emergency Medicine, Kasturba Medical College, Manipal

Research output: Contribution to journal › Review article › peer-review

1 Citation (Scopus)

Abstract

Snakebite envenomation remains a significant public health issue, particularly in southeast Asia, where diverse venomous snake species and resource-limited healthcare settings complicate effective management. This Health Policy employed thematic analysis of a panel discussion involving multidisciplinary experts with over 300 years of combined experience. Four key themes were identified: (i) the evolution of snakebite treatment paradigms, (ii) clinical and procedural challenges, (iii) debates over controversial practices, and (iv) the role of policy and research in improving outcomes. The findings emphasise the need for region-specific antivenoms, enhanced peripheral healthcare capabilities, and evidence-based treatment protocols. This work provides actionable insights to inform health policy, guide targeted training initiatives, and prioritise research on neglected areas in the management of snakebite.

Original language	English
Article number	100598
Journal	The Lancet Regional Health - Southeast Asia
Volume	37
DOIs	https://doi.org/10.1016/j.lansea.2025.100598
Publication status	Published - 06-2025

All Science Journal Classification (ASJC) codes

Public Health, Environmental and Occupational Health
Psychiatry and Mental health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.lansea.2025.100598

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Abraham, S. V., Mathew, D., Sreekumar, A., George, A. V., Chanchal, V., Kuzhikkathu Kandiyil, P., Rajeev, P. C., Valuvil, U. B., Kumar, J., Mohan, K. B., Thomas, J., Ayyan, M., Das, S., Sirur, F. M., Madhavan, I., Rafi, A. M., Mukundan, P. K., Sunagar, K., Krishnan S, V., & Palatty, B. U. (2025). Clinical challenges, controversies, and regional strategies in snakebite care in India. The Lancet Regional Health - Southeast Asia, 37, Article 100598. https://doi.org/10.1016/j.lansea.2025.100598

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title = "Clinical challenges, controversies, and regional strategies in snakebite care in India",

abstract = "Snakebite envenomation remains a significant public health issue, particularly in southeast Asia, where diverse venomous snake species and resource-limited healthcare settings complicate effective management. This Health Policy employed thematic analysis of a panel discussion involving multidisciplinary experts with over 300 years of combined experience. Four key themes were identified: (i) the evolution of snakebite treatment paradigms, (ii) clinical and procedural challenges, (iii) debates over controversial practices, and (iv) the role of policy and research in improving outcomes. The findings emphasise the need for region-specific antivenoms, enhanced peripheral healthcare capabilities, and evidence-based treatment protocols. This work provides actionable insights to inform health policy, guide targeted training initiatives, and prioritise research on neglected areas in the management of snakebite.",

author = "Abraham, \{Siju V.\} and Deo Mathew and Aravind Sreekumar and George, \{Akhil V.\} and Vijay Chanchal and \{Kuzhikkathu Kandiyil\}, Purushothaman and Rajeev, \{Punchalil Chathappan\} and Valuvil, \{Udaya Bhaskaran\} and Jayesh Kumar and Mohan, \{Kuruvath Bahuleyan\} and Joe Thomas and Manu Ayyan and Sandeep Das and Sirur, \{Freston Marc\} and Indira Madhavan and Rafi, \{Aboobacker Mohamed\} and Mukundan, \{Pradeoth Korambayil\} and Kartik Sunagar and \{Krishnan S\}, Vimal and Palatty, \{Babu Urumese\}",

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year = "2025",

month = jun,

doi = "10.1016/j.lansea.2025.100598",

language = "English",

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journal = "The Lancet Regional Health - Southeast Asia",

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Abraham, SV, Mathew, D, Sreekumar, A, George, AV, Chanchal, V, Kuzhikkathu Kandiyil, P, Rajeev, PC, Valuvil, UB, Kumar, J, Mohan, KB, Thomas, J, Ayyan, M, Das, S, Sirur, FM, Madhavan, I, Rafi, AM, Mukundan, PK, Sunagar, K, Krishnan S, V & Palatty, BU 2025, 'Clinical challenges, controversies, and regional strategies in snakebite care in India', The Lancet Regional Health - Southeast Asia, vol. 37, 100598. https://doi.org/10.1016/j.lansea.2025.100598

TY - JOUR

T1 - Clinical challenges, controversies, and regional strategies in snakebite care in India

AU - Abraham, Siju V.

AU - Mathew, Deo

AU - Sreekumar, Aravind

AU - George, Akhil V.

AU - Chanchal, Vijay

AU - Kuzhikkathu Kandiyil, Purushothaman

AU - Rajeev, Punchalil Chathappan

AU - Valuvil, Udaya Bhaskaran

AU - Kumar, Jayesh

AU - Mohan, Kuruvath Bahuleyan

AU - Thomas, Joe

AU - Ayyan, Manu

AU - Das, Sandeep

AU - Sirur, Freston Marc

AU - Madhavan, Indira

AU - Rafi, Aboobacker Mohamed

AU - Mukundan, Pradeoth Korambayil

AU - Sunagar, Kartik

AU - Krishnan S, Vimal

AU - Palatty, Babu Urumese

PY - 2025/6

Y1 - 2025/6

N2 - Snakebite envenomation remains a significant public health issue, particularly in southeast Asia, where diverse venomous snake species and resource-limited healthcare settings complicate effective management. This Health Policy employed thematic analysis of a panel discussion involving multidisciplinary experts with over 300 years of combined experience. Four key themes were identified: (i) the evolution of snakebite treatment paradigms, (ii) clinical and procedural challenges, (iii) debates over controversial practices, and (iv) the role of policy and research in improving outcomes. The findings emphasise the need for region-specific antivenoms, enhanced peripheral healthcare capabilities, and evidence-based treatment protocols. This work provides actionable insights to inform health policy, guide targeted training initiatives, and prioritise research on neglected areas in the management of snakebite.

AB - Snakebite envenomation remains a significant public health issue, particularly in southeast Asia, where diverse venomous snake species and resource-limited healthcare settings complicate effective management. This Health Policy employed thematic analysis of a panel discussion involving multidisciplinary experts with over 300 years of combined experience. Four key themes were identified: (i) the evolution of snakebite treatment paradigms, (ii) clinical and procedural challenges, (iii) debates over controversial practices, and (iv) the role of policy and research in improving outcomes. The findings emphasise the need for region-specific antivenoms, enhanced peripheral healthcare capabilities, and evidence-based treatment protocols. This work provides actionable insights to inform health policy, guide targeted training initiatives, and prioritise research on neglected areas in the management of snakebite.

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DO - 10.1016/j.lansea.2025.100598

M3 - Review article

AN - SCOPUS:105005010679

SN - 2772-3682

VL - 37

JO - The Lancet Regional Health - Southeast Asia

JF - The Lancet Regional Health - Southeast Asia

M1 - 100598

ER -

Clinical challenges, controversies, and regional strategies in snakebite care in India

Abstract

All Science Journal Classification (ASJC) codes

UN SDGs

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