{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T22:10:00Z","timestamp":1758665400975,"version":"3.44.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000683","name":"Royal Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000683","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Bhutan is a tropical country where snakebite is supposedly common, but official data are scanty and unmethodical. Deaths from snakebites were reported from areas where snakebites are common. Four\u2010year (2018\u20132021) data of snakebite from 45 Bhutanese hospitals were collected and analysed to describe the burden and map by districts. A total of 371 snakebites were recorded from 45 hospitals during the 4 years. Most cases were seen in the southern and central parts of the country. There was a definite rise in the number of cases in the warmer months, starting from March and peaking between June and August. About 240 (65%) of the bites occurred in males, and the highest number of snakebites occurred during farming (<jats:italic>n<\/jats:italic>\u00a0=\u00a0100, 27%), bush walking (<jats:italic>n<\/jats:italic>\u00a0=\u00a042, 11.3%), herding (<jats:italic>n<\/jats:italic>\u00a0=\u00a015, 4%) and trekking (<jats:italic>n<\/jats:italic>\u00a0=\u00a01, 0.2%). The most common anatomical bite site was the leg (<jats:italic>n<\/jats:italic>\u00a0=\u00a0167, 45.01%), followed by the hand (<jats:italic>n<\/jats:italic>\u00a0=\u00a081, 21.8%), finger (<jats:italic>n<\/jats:italic>\u00a0=\u00a056, 15.09%), toes (<jats:italic>n<\/jats:italic>\u00a0=\u00a011, 2.96%), thigh region (<jats:italic>n<\/jats:italic>\u00a0=\u00a06, 1.6%), head and face (<jats:italic>n<\/jats:italic>\u00a0=\u00a03, 0.8%), chest and shoulder (<jats:italic>n<\/jats:italic>\u00a0=\u00a03, 0.8%) and abdomen (<jats:italic>n<\/jats:italic>\u00a0=\u00a01, 0.3%). Most snakes were unidentified (<jats:italic>n<\/jats:italic>\u00a0=\u00a0266, 71.7%). Those identified were vipers (<jats:italic>n<\/jats:italic>\u00a0=\u00a074, 19.9%), rat snakes (<jats:italic>n<\/jats:italic>\u00a0=\u00a012, 3.2%), kraits (<jats:italic>n<\/jats:italic>\u00a0=\u00a07, 1.88%), cobras (<jats:italic>n<\/jats:italic>\u00a0=\u00a06, 1.61%), river snakes (<jats:italic>n<\/jats:italic>\u00a0=\u00a05, 1.34%) and wolf snakes (<jats:italic>n<\/jats:italic>\u00a0=\u00a01, 0.26%). Forty\u2010three (11.6%) of the bite victims had resorted to non\u2010medical home treatment. Even with an obvious underreporting, snakebite is a significant public health problem, and Bhutan should embrace more public health and clinical activities to prevent morbidities and mortalities from snakebite.<\/jats:p>","DOI":"10.1002\/puh2.70077","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T04:48:35Z","timestamp":1751604515000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Epidemiology of Snakebite in Bhutan: A Retrospective Study"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5122-1482","authenticated-orcid":false,"given":"Tshokey","family":"Tshokey","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Jigme Dorji Wangchuck National Referral Hospital (JDWNRH)  Thimphu Bhutan"},{"name":"Faculty of Postgraduate Medicine Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB)  Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rixin","family":"Jamtsho","sequence":"additional","affiliation":[{"name":"Medical Education Centre for Research Innovation and Technology (MECRIT) Khesar Gyalpo University of Medical Sciences of Bhutan  Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangay","family":"Rinchen","sequence":"additional","affiliation":[{"name":"National Centre for Animal Health, Serbithang  Thimphu Bhutan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"\u201cGlobal Snakebite Statistics \u201dKnoema.com accessed January 25 2023 https:\/\/knoema.com\/fyqqxee\/global\u2010snakebite\u2010statistics."},{"issue":"5","key":"e_1_2_11_3_1","first-page":"515","article-title":"Snake\u2010Bites: Appraisal of the Global Situation","volume":"76","author":"Chippaux J. P.","year":"1998","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PMED.0050218"},{"key":"e_1_2_11_5_1","unstructured":"\u201cMan Dies From a Snakebite in Trongsa\u2014Bhutan Broadcasting Services Corporation Limited \u201dBhutan Broadcasting Services Corporation Limited accessed March 4 2023 http:\/\/www.bbs.bt\/news\/?p=142095."},{"journal-title":"Kuensel","article-title":"Man Dies of Snakebite","author":"Kuensel","key":"e_1_2_11_6_1"},{"journal-title":"Kuensel","article-title":"A doctor and 2 Nurses Transferred for Professional Misconduct","author":"Kuensel","key":"e_1_2_11_7_1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.11609\/jott.3882.10.13.12749\u201012754"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008793"},{"key":"e_1_2_11_10_1","unstructured":"Policy and Planning Division Ministry of Health Bhutan. Annual Health Bulletin 2022 (2022) https:\/\/www.moh.gov.bt\/wp\u2010content\/uploads\/ict\u2010files\/2022\/05\/Annual\u2010Health\u2010Bulleti\u20102022_Link.pdf."},{"key":"e_1_2_11_11_1","unstructured":"World Health Organization South East Asia Regional Office New Delhi India.Regional Action Plan for Prevention and Control of Snakebite Envenoming in the South\u2010East Asia 2022\u20132030.World Health Organization https:\/\/www.who.int\/publications\/i\/item\/9789290209829."},{"key":"e_1_2_11_12_1","unstructured":"Royal Centre for Disease Control Ministry of Health Bhutan.National Early Warning Alert and Response Surveillance (NEWARS) (2018) http:\/\/www.rcdc.gov.bt\/web\/?page_id=223."},{"key":"e_1_2_11_13_1","unstructured":"Centre for Genomic Pathogen Surveillance. Epicollect5 https:\/\/five.epicollect.net. Last accessed: 23\/04\/2025."},{"volume-title":"R Foundation for Statistical Computing","year":"2021","author":"R Core Team","key":"e_1_2_11_14_1"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T21:38:59Z","timestamp":1758663539000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/puh2.70077"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70077","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"type":"print","value":"2769-2450"},{"type":"electronic","value":"2769-2450"}],"subject":[],"published":{"date-parts":[[2025,7,4]]},"assertion":[{"value":"2025-02-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70077"}}