{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:27:41Z","timestamp":1787318861179,"version":"build-2736575974"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["IIRPSG-2024-01-02944"],"award-info":[{"award-number":["IIRPSG-2024-01-02944"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>India faces substantial challenges from snakebite envenoming secondary to the high morbidity, mortality and financial burden, particularly in rural communities. While concentrated on the \u2018Big Four\u2019 venomous species, recent research indicates a necessity to expand the focus to encompass additional medically relevant species. This review emphasizes the geographic heterogeneity in venom among these snakes, which impacts antivenom effectiveness and necessitating region-specific formulations. This analysis highlights the shortcomings of current antivenoms and identifies non\u2013Big Four species involved in snakebite envenoming, advocating for an urgent shift to inclusive antivenom strategies that integrate local venom profiles to enhance treatment effectiveness and thereby reduce snakebite-related morbidity and mortality. Improved training for healthcare providers and enhancements in anti-snake venom quality are essential for meeting the World Health Organization\u2019s 2030 Sustainable Development Goal objective of halving snakebite-related fatalities and disabilities. Incorporating snakebite management into national health programs and conducting epidemiological research systematically are crucial to mitigating this preventable health concern.<\/jats:p>","DOI":"10.1093\/trstmh\/traf042","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T18:08:37Z","timestamp":1743358117000},"page":"1016-1022","source":"Crossref","is-referenced-by-count":9,"title":["Snakebite envenoming in India: it is time we look beyond the concept of the Big Four species"],"prefix":"10.1093","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8123","authenticated-orcid":false,"given":"Jaideep C","family":"Menon","sequence":"first","affiliation":[{"name":"Amrita Institute of Medical Sciences Adult Cardiology and Public Health, , Kochi 682041 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T P","family":"Sreekrishnan","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences Emergency Medicine, , Kochi 682041 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabarish B","family":"Nair","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences Emergency Medicine, , Kochi 682041 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay V","family":"Pillay","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences Poison Control Centre, Professor, , Amrita Vishwa Vidyapeetham, Kochi 682041 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanta","family":"Kanungo","sequence":"additional","affiliation":[{"name":"ICMR\u2013Regional Medical Research Centre , Bhubaneshwar 751023 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Aravind","sequence":"additional","affiliation":[{"name":"Amrita Institute of Medical Sciences Department of Public Health, , Kochi 682041 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omesh K","family":"Bharti","sequence":"additional","affiliation":[{"name":"State Institute of Health and family Welfare , Himachal Pradesh ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K","family":"Joseph","sequence":"additional","affiliation":[{"name":"Little Flower Hospital and Research Centre Department of Nephrology, , Angamaly, Kochi 683572 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7717-5592","authenticated-orcid":false,"given":"Sanghamitra","family":"Pati","sequence":"additional","affiliation":[{"name":"ICMR\u2013Regional Medical Research Centre , Bhubaneshwar 751023 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