A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.

<h4>Background</h4>Snakebite envenoming is a neglected tropical disease affecting deprived populations, and its burden is underestimated in some regions where patients prefer using traditional medicine, case reporting systems are deficient, or health systems are inaccessible to at-risk p...

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Main Authors: Carlos Bravo-Vega, Camila Renjifo-Ibañez, Mauricio Santos-Vega, Leonardo Jose León Nuñez, Teddy Angarita-Sierra, Juan Manuel Cordovez
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-02-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0011117
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author Carlos Bravo-Vega
Camila Renjifo-Ibañez
Mauricio Santos-Vega
Leonardo Jose León Nuñez
Teddy Angarita-Sierra
Juan Manuel Cordovez
author_facet Carlos Bravo-Vega
Camila Renjifo-Ibañez
Mauricio Santos-Vega
Leonardo Jose León Nuñez
Teddy Angarita-Sierra
Juan Manuel Cordovez
author_sort Carlos Bravo-Vega
collection DOAJ
description <h4>Background</h4>Snakebite envenoming is a neglected tropical disease affecting deprived populations, and its burden is underestimated in some regions where patients prefer using traditional medicine, case reporting systems are deficient, or health systems are inaccessible to at-risk populations. Thus, the development of strategies to optimize disease management is a major challenge. We propose a framework that can be used to estimate total snakebite incidence at a fine political scale.<h4>Methodology/principal findings</h4>First, we generated fine-scale snakebite risk maps based on the distribution of venomous snakes in Colombia. We then used a generalized mixed-effect model that estimates total snakebite incidence based on risk maps, poverty, and travel time to the nearest medical center. Finally, we calibrated our model with snakebite data in Colombia from 2010 to 2019 using the Markov-chain-Monte-Carlo algorithm. Our results suggest that 10.19% of total snakebite cases (532.26 yearly envenomings) are not reported and these snakebite victims do not seek medical attention, and that populations in the Orinoco and Amazonian regions are the most at-risk and show the highest percentage of underreporting. We also found that variables such as precipitation of the driest month and mean temperature of the warmest quarter influences the suitability of environments for venomous snakes rather than absolute temperature or rainfall.<h4>Conclusions/significance</h4>Our framework permits snakebite underreporting to be estimated using data on snakebite incidence and surveillance, presence locations for the most medically significant venomous snake species, and openly available information on population size, poverty, climate, land cover, roads, and the locations of medical centers. Thus, our algorithm could be used in other countries to estimate total snakebite incidence and improve disease management strategies; however, this framework does not serve as a replacement for a surveillance system, which should be made a priority in countries facing similar public health challenges.
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spelling doaj.art-b8bac2a1724a4eac97433c723b68e67b2023-03-01T05:32:32ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-02-01172e001111710.1371/journal.pntd.0011117A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.Carlos Bravo-VegaCamila Renjifo-IbañezMauricio Santos-VegaLeonardo Jose León NuñezTeddy Angarita-SierraJuan Manuel Cordovez<h4>Background</h4>Snakebite envenoming is a neglected tropical disease affecting deprived populations, and its burden is underestimated in some regions where patients prefer using traditional medicine, case reporting systems are deficient, or health systems are inaccessible to at-risk populations. Thus, the development of strategies to optimize disease management is a major challenge. We propose a framework that can be used to estimate total snakebite incidence at a fine political scale.<h4>Methodology/principal findings</h4>First, we generated fine-scale snakebite risk maps based on the distribution of venomous snakes in Colombia. We then used a generalized mixed-effect model that estimates total snakebite incidence based on risk maps, poverty, and travel time to the nearest medical center. Finally, we calibrated our model with snakebite data in Colombia from 2010 to 2019 using the Markov-chain-Monte-Carlo algorithm. Our results suggest that 10.19% of total snakebite cases (532.26 yearly envenomings) are not reported and these snakebite victims do not seek medical attention, and that populations in the Orinoco and Amazonian regions are the most at-risk and show the highest percentage of underreporting. We also found that variables such as precipitation of the driest month and mean temperature of the warmest quarter influences the suitability of environments for venomous snakes rather than absolute temperature or rainfall.<h4>Conclusions/significance</h4>Our framework permits snakebite underreporting to be estimated using data on snakebite incidence and surveillance, presence locations for the most medically significant venomous snake species, and openly available information on population size, poverty, climate, land cover, roads, and the locations of medical centers. Thus, our algorithm could be used in other countries to estimate total snakebite incidence and improve disease management strategies; however, this framework does not serve as a replacement for a surveillance system, which should be made a priority in countries facing similar public health challenges.https://doi.org/10.1371/journal.pntd.0011117
spellingShingle Carlos Bravo-Vega
Camila Renjifo-Ibañez
Mauricio Santos-Vega
Leonardo Jose León Nuñez
Teddy Angarita-Sierra
Juan Manuel Cordovez
A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
PLoS Neglected Tropical Diseases
title A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
title_full A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
title_fullStr A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
title_full_unstemmed A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
title_short A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia.
title_sort generalized framework for estimating snakebite underreporting using statistical models a study in colombia
url https://doi.org/10.1371/journal.pntd.0011117
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