Mapping of clinical management resources for snakebites and other animal envenomings in the Brazilian Amazon
Timothy P. Beck,
Anna Tupetz,
Altair Seabra Farias,
Alexandre Silva-Neto,
Thiago Rocha,
Emily R. Smith,
Felipe Murta,
Flavio Santos Dourado,
Deugles Cardoso,
Tatyana A. Ramos,
André Sachett,
Thiago Serrão Pinto,
Manuela Berto Pucca,
Vanderson Sampaio,
Flavia Ramos,
João Nickenig Vissoci,
Jacqueline Sachett,
Fan Hui Wen,
Catherine A. Staton,
Charles J. Gerardo,
Wuelton Monteiro
Affiliations
Timothy P. Beck
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Anna Tupetz
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Altair Seabra Farias
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Alexandre Silva-Neto
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Thiago Rocha
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Emily R. Smith
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Felipe Murta
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Flavio Santos Dourado
Technical Group of Venomous Animal, Ministério da Saúde, Brasília, Brazil
Deugles Cardoso
Zoonosis Department, Fundação de Vigilância Em Saúde Dra. Rosemary Costa Pinto, Manaus, Brazil
Tatyana A. Ramos
Zoonosis Department, Fundação de Vigilância Em Saúde Dra. Rosemary Costa Pinto, Manaus, Brazil
André Sachett
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Thiago Serrão Pinto
School of Pharmaceutical Sciences, Universidade Federal Do Amazonas, Manaus, Brazil
Manuela Berto Pucca
Medical School, Federal University of Roraima, Boa Vista, Roraima, Brazil
Vanderson Sampaio
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
Flavia Ramos
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, Brazil
João Nickenig Vissoci
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Jacqueline Sachett
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, Brazil; Department of Teaching and Research, Fundação Alfredo da Matta, Manaus, Brazil
Fan Hui Wen
Butantan Institute, São Paulo, São Paulo, Brazil
Catherine A. Staton
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Charles J. Gerardo
Department of Emergency Medicine, Department of Surgery, Durham, NC, 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
Wuelton Monteiro
School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil; Department of Teaching and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, Brazil; Corresponding author. School of Health Sciences, Universidade Do Estado Do Amazonas, Manaus, Brazil.
Snakebite envenomings (SBEs) and other envenomings triggered by venomous animals (VAEs) represent a significant disease burden in Brazil, with 29,152 SBEs reported in 2021 alone with nearly half of those occurring in the remote Brazilian Amazon. In 2021, Brazil recorded 240,294 envenomings from snakes, scorpions, spiders, and caterpillars. Therefore, there is an unequal distribution of SBEs with high morbidity and mortality in the Brazilian Amazon. The severity of SBEs increases when patients require more than 6 h to access antivenom treatment, a common issue for the rural and indigenous populations. Understanding currently available resources and practices in Amazon remote areas of Brazil can serve to inform future interventions and guide health care policies. This study aims to develop a resource map of existing healthcare resources for the Brazilian Amazon's clinical management of VAEs with emphasis in SBEs, which will aid future strategic interventions. Data collection included a literature review, secondary data collected by government departments and organizational records, GIS mapping activities, and expert input. Our framework was guided by the three levels of healthcare service ecosystem analysis (macro, meso, and micro). Our resource map lays out a comprehensive overview of antivenom access, the distribution landscape, differences in patient transportation, and barriers to access healthcare that face populations in the Brazilian Amazon.
