Pre- Hospital Delay due to faith healers consultation had adverse impact on outcomes in snakebite patients- A Hospital-Based Study from Kangra District, Himachal Pradesh (2021–2025)

Nikunj  Kankodia; Jaideep C  Menon; Rajesh Kumar Sood; Archana Phull; Anu Suresh; Omesh Kumar Bharti; Tushar  Saini

Nikunj Kankodia Project Technical Support, Indian Council of Medical Research (ICMR) funded (Project SARPA), “Zero Snakebite Death Initiative, Community Empowerment & Engagement for Mitigation of Snake Bites Envenoming, PTS at District Kangra, Himachal Pradesh, India
Jaideep C Menon Department of Cardiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam District, Kochi, Kerala, India
Rajesh Kumar Sood 3. Medical Officer Health, O/o Chief Medical Officer, Kangra at Dharamshala, Himachal Pradesh, India
Archana Phull Research Scientist, Indian Council of Medical Research (ICMR) funded (Project SARPA), “Zero Snakebite Death Initiative, Community Empowerment & Engagement for Mitigation of Snake Bites Envenoming” District Kangra, Himachal Pradesh, India
Anu Suresh Research Scientist, Indian Council of Medical Research (ICMR) funded (Project SARPA), “Zero Snakebite Death Initiative, Community Empowerment & Engagement for Mitigation of Snake Bites Envenoming “District Ernakulum, Kerala, India
Omesh Kumar Bharti Deputy Director Health Services & State Epidemiologist, Directorate of Health Services, Kasumpti, Shimla, Himachal Pradesh, India
Tushar Saini Medical Officer, Civil Hospital Nurpur, District Kangra, Himachal Pradesh, India

Keywords: Snakebite Envenoming, Snakpathy, Anti- Snake Venom, Pre-Hospital Delay, Case Fatality Rate, Kangra, Faith Healers

Abstract

Background: Snakebite envenoming is a neglected tropical disease responsible for preventable deaths in rural India. In Kangra District, Himachal Pradesh, the unique combination of hilly terrain, dispersed habitation and wetland ecosystems resulting in unique risk factors for snakopathy.

Objective: To study the clinical profile, health seeking pathways and outcomes of snakebite cases at a secondary-care facility over five years.

Methods: A retrospective data analysis from Civil Hospital Nurpur was done from January 2021 to December 2025. A total, 222 snakebite cases presented in this time period. A structured proforma of 62 variables was used for data collection. We included largely data variables that were complete and relevant (demographics, clinical features, venom type, pre-hospital delay, ASV use, complications or outcomes).

Results: Of the 222 cases analyzed, 59.9% were males (mean age: 36.8 plus or minus to 17.6 years). Lower limb bites cases were predominated (52.3%). Envenomation type was classified in 127 cases; of these, haemotoxic envenomation accounted for 35 cases (15.8% of total; 27.6% of classified) and neurotoxic for 18 cases (8.1% of total; 14.2% of classified). Significant species identified (n equal to 49) were Russell’s viper (67.4%). The crude case fatality ratio (CFR) was 7.2% (n equal to 16) of which, 13 (81.3%) were brought dead or died on arrival. The majority of the cases (82.4%) occurred in the monsoon months. Administered anti-snake venom (ASV) in 52.3% of cases and 4.5% reported anaphylaxis. Significantly, 8 (50%) of the total 16 deaths were clustered in the area around the Pong Dam water reservoir.

Conclusion: Pre-hospital delay and faith-healer consultation are the important modifiable determinant for snakopathy mortality in Kangra. Of the cases with confirmed healthseeking behaviour, 43.7% (45 out of 103) consulted a faith healer or temple before presentation to hospital, with delay of between 1to 7 hours in some case. The Pong Dam reservoir area is an ecological mortality hotspot warranting targeted surveillance and community intervention.

DOI: https://doi.org/10.24321/2454.325X.202612

How to cite this article:
Kankodia N, Menon J C, Sood R, Phull A, Suresh A, Bharti O K, Saini T. Consultation Had Adverse Impact on Outcomes in Snakebite Patients- A Hospital-Based Study from Kangra District, Himachal Pradesh (2021–2025) . Int J Preven Curat Comm Med. 2026;12(3):10-21.

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