{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T02:46:27Z","timestamp":1786502787108,"version":"build-2736575974"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014092","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000}}],"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Snakebite prevention is often neglected despite snake envenoming being a major problem in the rural tropics. We aimed to describe the epidemiology of snakebites in rural Sri Lanka to identify potential focused preventative strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Anuradhapura Snakebite Cohort prospectively recruits snakebites admitted to the Teaching Hospital, Anuradhapura, in Sri Lanka. Epidemiological data on all snakebites from August 2013 to October 2014 and May 2017 to January 2023 were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 4708 snakebites, and 2202 were authenticated by specimen identification or serum analysis using enzyme-linked immunosorbent assay [\n                      <jats:italic>H. hypnale<\/jats:italic>\n                      , 988 (44\u00b76%),\n                      <jats:italic>D. russelii<\/jats:italic>\n                      , 737 (33\u00b73%),\n                      <jats:italic>B. caeruleus<\/jats:italic>\n                      , 101 (4\u00b76%),\n                      <jats:italic>N. naja<\/jats:italic>\n                      , 62 (2\u00b78%)]. Median age was 42y (IQR:29-54y), and 3027 were male (64\u00b76%). There were 1659 (37\u00b75%) snakebites in domestic gardens, 1153 (26\u00b70%) on farmland, and 870 (19\u00b76%) indoors. 3642\/4620 (78\u00b78%) were lower-limb bites, mainly the foot (3273; 70\u00b79%). 1435\/4671 (30\u00b77%) occurred between 6 and 9 pm. Increased numbers of bites were reported from September to February. Of 988\n                      <jats:italic>H. hypnale<\/jats:italic>\n                      bites, 781 (82\u00b71%) occurred outdoors, 493 (51\u00b78%) on the foot, and 252 (26\u00b72%) on the hand. 704 (73\u00b70%)\n                      <jats:italic>H. hypnale<\/jats:italic>\n                      bites occurred at home, and on the hand while cleaning the surrounding environment and collecting firewood. Of 721\n                      <jats:italic>D. russelii<\/jats:italic>\n                      bites, 643 (89\u00b72%) occurred on the foot, 310 (43\u00b70%) on farmland and 286 (39\u00b77%) outdoors. Of the 101\n                      <jats:italic>B. caeruleus<\/jats:italic>\n                      bites, 75 (74\u00b73%) occurred at night, and sixty (60\u00b76%) while victims slept. Of 62\n                      <jats:italic>N. naja<\/jats:italic>\n                      bites, 53 (85\u00b75%) occurred during the day and 37 (59\u00b77%) outdoors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      We identified epidemiological findings that indicate possible avenues for prevention. Protective footwear would prevent outdoor bites, including 83%\n                      <jats:italic>D. russelii<\/jats:italic>\n                      bites and 52%\n                      <jats:italic>H. hypnale<\/jats:italic>\n                      bites. Long-handled tools would prevent\n                      <jats:italic>H. hypnale<\/jats:italic>\n                      bites to the hands, and safer sleeping environments would prevent\n                      <jats:italic>B. caeruleus<\/jats:italic>\n                      bites.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014092","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:45:52Z","timestamp":1773078352000},"page":"e0014092","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Snakebite patterns in rural Sri Lanka and their implications for preventive 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