EPIDEMIOLOGICAL AND CLINICAL PROFILE OF SNAKEBITE CASES IN DISTRICT LOWER DIR, KHYBER PAKHTUNKHWA, PAKISTAN: A DESCRIPTIVE STUDY

Abstract

Snakebite is an important public health concern in rural communities, particularly in regions where agricultural exposure, limited healthcare access, and inappropriate first-aid practices may contribute to adverse outcomes. However, local epidemiological information from District Lower Dir, Khyber Pakhtunkhwa, Pakistan, remains limited. This study aimed to describe the epidemiological characteristics, clinical manifestations, healthcare-seeking practices, management, and outcomes of snakebite cases in District Lower Dir. An observational study with descriptive and analytical components was conducted from March 2024 to July 2026. Data from 88 identified snakebite cases were collected through hospital-record review and prospective data collection, as applicable. Information concerning sociodemographic characteristics, seasonal and geographical distribution, bite circumstances, clinical manifestations, first-aid practices, treatment, hospitalization, and outcomes was analyzed using Microsoft Excel and SPSS version 26. Frequencies and percentages were used to summarize categorical variables, while inferential tests were applied where appropriate. Out of the 88 patients, 54 (61.4%) were male, 67 (76.1%) were older than 15 years, and 84 (95.5%) were from rural areas. July and August accounted for 79.6% of cases. Samarbagh and Balambat contributed 51.1% of the total cases. The foot and toes were the most frequently affected sites (71.6%). Although 47 patients (53.4%) reported seeing the snake, its species was not identified. Tourniquet application followed by consultation with traditional or spiritual healers was reported in 28 cases (31.8%). Common systemic manifestations included ptosis or blurred vision (64.8%), vomiting (62.5%), and muscle weakness or paralysis with respiratory difficulty (47.7%). Three deaths were recorded, giving an observed case-fatality proportion of 3.4%. Post-discharge complications were reported in 12 patients (13.6%). Snakebite cases in Lower Dir predominantly affected rural residents and were concentrated during the summer monsoon period. The frequent use of tourniquets, reliance on traditional treatment, and occurrence of systemic manifestations and post-discharge complications highlight the need for community education, timely access to appropriate medical care, and improved follow-up. Further population-based research is required to establish the true burden of snakebite and its associated risk factors.