Abstract
INTRODUCTION
Poisoning and envenomation are among the top causes of deaths in Nepal. The highest burden occurs in the Terai region of the country, with an estimated 250 snake bites per 100,000 people each year. This region is a flat, tropical plain with a warm climate and dense agricultural activity, creating an ideal habitat for venomous snakes such as cobras and kraits. Additionally, the close proximity of human settlements to snake habitats and the lack of adequate protective measures during farming contribute to frequent human-snake encounters. Limited access to healthcare facilities and antivenom treatment further exacerbates the issue, making snakebite envenomation a critical public health concern in this region [1]. Self-harm through the ingestion of chemicals has also increased significantly in Nepal over the last decade. The rate of poisoning-related suicides increased significantly from 55 cases in 1980 (0.37 per 100,000) to 1,320 cases in 2018–19 (4.7 per 100,000), representing a 1,170% increase in the rate. Notably, the majority of this rise occurred during two periods: 1995–2003 and 2008–2012 [2. Recognizing the severity of this issue, the Government of Nepal has identified the need to develop a strategy to lower the large burden of poisoning emergencies in the country [3]. However, a lack of trained human resources and poor coordination in establishing a poison information center are barriers to the development of sustainable poison control programs [3,4]. Although hospital-based studies on poisoning are available [5], there is no aggregate data on the current status of toxicology care in the country.
This narrative review provides an update on the current state of toxicological care in Nepal, synthesizing the latest epidemiological data, educational programs, policy developments, and resource availability up to 2024. It includes insights from both historical and recent studies, with a particular focus on advancements and targets for improving the management of poisonings in the country.
Poisoning and envenomation are among the top causes of deaths in Nepal. The highest burden occurs in the Terai region of the country, with an estimated 250 snake bites per 100,000 people each year. This region is a flat, tropical plain with a warm climate and dense agricultural activity, creating an ideal habitat for venomous snakes such as cobras and kraits. Additionally, the close proximity of human settlements to snake habitats and the lack of adequate protective measures during farming contribute to frequent human-snake encounters. Limited access to healthcare facilities and antivenom treatment further exacerbates the issue, making snakebite envenomation a critical public health concern in this region [1]. Self-harm through the ingestion of chemicals has also increased significantly in Nepal over the last decade. The rate of poisoning-related suicides increased significantly from 55 cases in 1980 (0.37 per 100,000) to 1,320 cases in 2018–19 (4.7 per 100,000), representing a 1,170% increase in the rate. Notably, the majority of this rise occurred during two periods: 1995–2003 and 2008–2012 [2. Recognizing the severity of this issue, the Government of Nepal has identified the need to develop a strategy to lower the large burden of poisoning emergencies in the country [3]. However, a lack of trained human resources and poor coordination in establishing a poison information center are barriers to the development of sustainable poison control programs [3,4]. Although hospital-based studies on poisoning are available [5], there is no aggregate data on the current status of toxicology care in the country.
This narrative review provides an update on the current state of toxicological care in Nepal, synthesizing the latest epidemiological data, educational programs, policy developments, and resource availability up to 2024. It includes insights from both historical and recent studies, with a particular focus on advancements and targets for improving the management of poisonings in the country.
| Original language | English |
|---|---|
| Article number | 2452670 |
| Journal | Toxicology Communications |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 22 Jan 2025 |