ICMR-National Task Force Project: Incidence, mortality and socioeconomic burden of snakebite in India, an interim report

Background: Snakebite envenomation (SBE), a neglected tropical disease is a significant cause of mortality and disability in India. Despite which comprehensive epidemiological data remains scarce. This study aimed to estimate the incidence, mortality, clinical outcomes, treatment-seeking behavior, and socio-economic burden of SBE across India. Methods: Cross-sectional survey involving residents from 31 districts across 13 states in India, representing an approximate population of 83.9 million. Data collection was managed by trained frontline health workers using a standardized questionnaire. Statistical analyses included incidence and mortality rates, with additional analysis based on treatment costs and socio-economic status. Findings: The survey reported 7,094 snakebite cases, with a mortality rate of 2.6%, of which 43.1% occurred outside a hospital setting. Incidence was highest among males (64.1%), in the age group 30–39 years (20.9%), and during the monsoon season (62.1%). 86.4% of victims required hospitalization, with 60.2% receiving anti-snake venom (ASV); however, 17.2% experienced adverse reactions. Socio-economic analysis revealed that 87.7% of victims lacked insurance highlighting the substantial economic burden imposed on affected families. Average out-of-pocket (OOP) expenditure for a victim was INR 6500. The mean cost towards treatment of SBE was INR 7500 (range 50-376600). Mean cost of treatment in the private sector was INR 27400, 3900 in the public sector and 3600 for alternate forms of treatment. Interpretation: Snakebites pose a significant public health challenge in India, with high out-of-pocket expenditure and a significant proportion of deaths occurring outside hospital settings, indicating delays in seeking medical care. Reliance on faith healers, inadequate access to quality healthcare and anti-snake venom (ASV), and financial hardship further exacerbate the burden. These findings highlight the urgent need for improved healthcare infrastructure, enhanced ASV availability, standardized treatment protocols, and financial protection measures to improve patient outcomes and reduce the economic impact on affected families.