{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:27:02Z","timestamp":1787495222893,"version":"build-2736575974"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["CEX2018-000806-S"],"award-info":[{"award-number":["CEX2018-000806-S"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2024,1,30]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Snakebite envenoming (SBE) is a public health problem in Paraguay where the presence of 15 medically important snake species has been reported. Blessed with large forested areas, its economy largely relies on agricultural production which increases the exposure of outdoor workers to the morbidity and mortality of SBE. Lack of sufficient and accurate epidemiological data highlights the importance of drawing an updated picture of SBE burden in the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective descriptive study on secondary SBE data reported to the national surveillance system between 2015 and 2021. We addressed the availability and quality of the data and assessed its epidemiological and sociodemographic burden in Paraguay over that time period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 1651 cases of SBE were reported between 2015 and 2021 representing an average of 235 cases per year (3.33 cases per 100\u2009000 population). Overall, young males (68%, n=1125) of productive age (25 years old, IQR 29) in agricultural and\/or livestock settings (47%, n=653) were the most affected population. Departments with a higher number of notifications were San Pedro (12%, n=191), Caazap\u00e1 and Alto Paran\u00e1 (10%, n=163). Regarding data quality, variables about clinical outcomes, treatment administration and case management were the worst reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SBE is a public health issue that affects young workers in rural areas in Paraguay. It mostly remains unattended and improvements in its reporting need to be done in order to gain a better insight into both the health and social burden of this neglected disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2023-000359","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T13:21:15Z","timestamp":1713273675000},"page":"e000359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiological and sociodemographic description of snakebite envenoming cases in Paraguay reported between 2015 and 2021"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3194-590X","authenticated-orcid":false,"given":"Sofia","family":"Ardiles-Ruesjas","sequence":"first","affiliation":[{"name":"Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Sanabria","sequence":"additional","affiliation":[{"name":"National Zoonosis Programme and National Rabies Centre, San Lorenzo, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Hugo","family":"Segovia Portillo","sequence":"additional","affiliation":[{"name":"National Zoonosis Programme and National Rabies Centre, San Lorenzo, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Jara Oroa","sequence":"additional","affiliation":[{"name":"National Zoonosis Programme and National Rabies Centre, San Lorenzo, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"de Egea","sequence":"additional","affiliation":[{"name":"Communicable Disease Surveillance Directorate, General Directorate of Health Surveillance, Asuncion, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Sequera","sequence":"additional","affiliation":[{"name":"General Directorate of Health Surveillance, Asuncion, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Alonso-Padilla","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"},{"name":"Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Losada","sequence":"additional","affiliation":[{"name":"Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Pinazo","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain"},{"name":"Drugs for Neglected Diseases Latin America, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"2025083110013198000_2.1.e000359.1","doi-asserted-by":"crossref","first-page":"17063","DOI":"10.1038\/nrdp.2017.63","article-title":"Snakebite Envenoming","volume":"3","author":"Guti\u00e9rrez","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2025083110013198000_2.1.e000359.2","doi-asserted-by":"crossref","DOI":"10.1186\/s40409-017-0127-6","article-title":"Snakebite Envenomation turns again into a neglected tropical disease","volume":"23","author":"Chippaux","year":"2017","journal-title":"J Venom Anim Toxins Incl Trop Dis"},{"key":"2025083110013198000_2.1.e000359.3","unstructured":"World Health Organization (WHO) . 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