Original Article
Public Health
Kasmera 53:e5241855 2025
ISSN 0075-5222 E-ISSN 2477-9628
https://doi.org/10.56903/kasmera.5341855
Dispelling Snake Bite Myths
in Sri Lanka: Ensuring Proper Management and Safety
Disipando los mitos sobre las
mordeduras de serpiente en Sri Lanka: garantizar una gestión y seguridad
adecuadas
Marikar F (Corresponding Author). https://orcid.org/0000-0003-4579-7263.
General Sir John Kotelawala Defence University, Staff
Development Centre, Ratmalana, Sri Lanka. Zip-Code 10350. Phone:
+94-11-2635268. E-mail: faiz@kdu.ac.lk.
Herath P. https://orcid.org/0000-0001-6470-2229. General Sir John Kotelawala Defence University. Department of Nursing and Midwifery.
Ratmalana. Sri Lanka. E-mail: prasannah@kdu.ac.lk.
Banneheka B. https://orcid.org/0000-0003-0764-9913. University of Peradeniya. Faculty of Dental
Sciences. Peradeniya. Sri Lanka. E-mail: bmhsk@pdn.ac.lk.
Amarakoon M. https://orcid.org/0009-0009-8976-9361.
University of Peradeniya.
Department of Nursing. Peradeniya. Sri Lanka. E-mail: amakoo@pdn.ac.lk.
Bandara S. https://orcid.org/0009-0008-6770-0593.
University of Peradeniya.
Department of Radiography. Peradeniya. Sri Lanka. E-mail: rmbanda@pdn.ac.lk.
Abstract
Keywords: snake bites, misconceptions, public health.
Las mordeduras de serpiente
siguen siendo un problema de salud pública en Sri Lanka debido a los mitos y
conceptos erróneos que dificultan el tratamiento eficaz y aumentan el riesgo de
complicaciones. Este estudio busca desmentir mitos comunes y proporcionar
información precisa para guiar respuestas adecuadas y garantizar un manejo
adecuado. Se llevó a cabo un estudio transversal en una aldea de la región
centro-norte de Sri Lanka, entrevistando a jefes de familia mediante un
cuestionario prediseñado. Los hallazgos clave revelaron varios conceptos
erróneos dañinos. Creencias erróneas como cortar y succionar el sitio de la
picadura para eliminar el veneno: la aplicación de un torniquete para
restringir el avance del veneno; la identificación de la especie de serpiente
para el instaurar tratamiento con antídotos; además, la noción de que los
encantadores de serpientes pueden manejar y curar de manera segura las
mordeduras de serpiente, y la creencia en la efectividad de que ciertas plantas
o hierbas para neutralizar el veneno. Estos hallazgos resaltan la necesidad de
intervenciones de salud pública para abordar los mitos y promover prácticas
basadas en la evidencia, mediante la difusión de información precisa y la
mejora del acceso a la atención sanitaria, se puede reducir significativamente
la carga de las mordeduras de serpiente en Sri Lanka.
Palabras claves: mordeduras
de serpientes, malentendido terapéutico, salud pública.
Received: 29/03/2024 | Accepted: 15/10/2024 | Published: 13/07/2025
How to Cite: Marikar M, Herath P, Banneheka B, Amarakoon M, Bandara S. Dispelling Snake Bite Myths in Sri
Lanka: Ensuring Proper Management and Safety. Kasmera.
2025;53:e5341855. doi:
10.56903/kasmera.5341855
Snake bites, a prevalent and often ignored public health
issue in tropical and subtropical regions, disproportionately impact
individuals of lower socioeconomic classes, particularly farmers and those
working outdoors. Considered an occupational hazard, snake bites have only
recently received global attention, being added to the WHO's list of neglected
tropical diseases in 2017 (1). In
Sri Lanka, an estimated 15,000 snake bites occur annually, with 10% leading to
envenomation and a further 10% mortality rate among those bitten by venomous
snakes (2).
These instances are more common in the North Central Province, which is in the
dry zone (3).
Though recent measures involving enhanced supervisory visits to reporting sites
attempt to address this issue, under-reporting is still a concern. Sri Lanka
can save lives and enhance the general well-being of its people by
acknowledging the seriousness of snake bites as a public health emergency and
putting into practice efficient preventative measures (4).
This entails creating focused interventions in high-risk areas like the North
Central Province, offering treatment options that are easily accessible, and
promoting awareness through educational initiatives. Widespread
misunderstandings about snakes and snake bites have a negative effect on
patient prognoses and treatment outcomes in Sri Lanka.
Traditional healers frequently end up being the initial
point of contact for snake bite victims despite developments in modern
medicine, which can worsen results by delaying necessary medical intervention (5). It
has been stated that identical circumstances exist in India and even China,
therefore this negative trend is not exclusive to Sri Lanka (6). It
is demonstrated by traditional medical systems such as Ayurveda, Ahikuntaka, Sidda, and Unani that Sri Lankans have long
been aware of colubrid snakes, which are non-venomous (7).
These systems give snake bite treatment recommendations and characterize the
properties of snakes. But there's still a big misconception: these snakes are
very venomous, according to most old local literature. Seneviratne's 1967 book
even went so far as to name "Mapila" snakes
as the most deadly and venomous, endangering the lives of innocent people (8).
The actual situation differs greatly. Even though there are an estimated 80,000
snake bites and 400 fatalities in Sri Lanka each year, snake bites can be
effectively treated with timely and appropriate medical attention (9).
In order to improve patient outcomes and lower
fatality rates, it is imperative to debunk damaging myths and enlighten
communities about accurate facts regarding snake identification, bite
management, and first-aid protocols. In human history, snakes have always held
a complicated place that evokes both dread and devotion. A complex web of myths
and beliefs about snake bites is entwined with this complex relationship,
impacting how we view and react to these potentially fatal situations.
Regrettably, a lot of these ideas are based on false assumptions that raise the
danger of snake bites and make therapy ineffective. This investigation explored
the domain of these myths, looking at their genesis, enduring power, and
implications for human health in the context of Sri Lanka. We revealed the ways
in which these deeply embedded ideas impact both personal behavior and public
health procedures, with the ultimate goal of dispelling falsehoods and opening
the door to well-informed and efficient reactions to snake bites.
Method
The most frequent offending
snakes and their bite sites were examined in this investigation, which took
place in the rural First Mile Post-Padaviya community in Sri Lanka's North Central
Province in April 2023. In the North Central region of Sri Lanka, at the
village of First Mile Post-Padaviya, a
cross-sectional observational study was conducted. An interview with the family
head was conducted using a pre-tested and pre-designed timetable. In order to
arrive at a comprehensive understanding, 124 people were interviewed and
questionnaires were used to study complete families. This method made it
possible to record a range of viewpoints and experiences—focused on
families—relating to snake bites. Three participants actively participated in
data collecting, including the study author, to ensure thorough and accurate
information acquisition. This study investigated possible causes of snake bites
in the Padaviya area around the first milepost. 124
adults between the ages of 18 and 70 were interviewed by the researchers; those
with speech or hearing problems or those dealing with mental health issues were
not included. A maximum of two adults from each family willingly participated
in order to guarantee a diversity of opinions. Some homes were not included
because the residents were not present when the data were gathered. Of the
participants, 65 people (52%) had personal experience with snake bites; these
people will be analyzed as the "victim" group. The research team
analyzed the data gathered and found substantial correlations between snake
bites and other risk variables using Minitab 16.0 and Statistical Analysis
Software. P-values of less than 0.05 in the log-linear model, which was
employed, denoted statistically significant relationships.
This study aimed to identify key
factors that contribute to this public health concern by shedding light on the
local context of snake bite episodes within Padaviya.
The study aimed to educate targeted actions and preventive strategies to lower
the incidence of snake bites in the community and similar settings by analyzing
the data and finding meaningful relationships. Inclusion criteria was set as timely transportation to the nearest medical
facility, along with antivenom administration. Furthermore, who accepted the
decision to participate for this study was included. We excluded the
individuals with severe pre-existing conditions that could interfere with the
study or impact data interpretation. With respect to the decision of
individuals who choose not to participate in the study, they were excluded as
well. The world of snake bites is shrouded in a web of myths, passed down
through generations like tangled vines. From applying ice to sucking out venom,
these misconceptions can be more dangerous than the bite itself. Consent was
obtained from the study participants before administering the questionnaire. We
had adhered to the Declaration of Helsinki in enrolling our participants. The
study was ethically approved by the Ethics Review Committee, Faculty of
Medicine, General Sir John Kotelawla Defense
University (IRB number is RP/S/2022/10) before commencing the study.
Results
While a large
majority of the population (76.61%-80.64%) correctly identified several
venomous snakes, their understanding of snake bite treatment remains concerning
(Table 1). Despite 95.56% seeking hospital treatment, a significant 80%
subscribed to myths related to snake bites. This highlights the need for
comprehensive educational programs to dispel harmful myths and empower
communities with accurate knowledge about snake bite prevention,
identification, and treatment. A significant lack of awareness about the venom
potency of certain snakes was evident, with the majority misidentifying some
venomous snakes as either mild or highly venomous. While 96.77% correctly
identified the Cobra as highly venomous, only 17.74% recognized the moderately
venomous Green Pit Viper, and a surprising 79.83% mistakenly classified the
mildly venomous Cat Snake as highly venomous (Table 1). This highlights the need for
targeted education campaigns to equip communities with accurate information
about snake venom strength and mitigate risks associated with
misidentification.
Table 1. Belief and myths about snake bites
|
Variables |
Frequency
(%) |
|
Belief about
Myths by the community |
|
|
Believe myths |
97 (78.22%) |
|
Not believe
myths |
27 (21.77%) |
|
Treatment
preference of the community |
|
|
Indigenous
physician |
04 (3.22%) |
|
Hospital |
119 (95.56%) |
|
Home
medicines |
01 (0.8%) |
|
Ability to
identify the snakes |
|
|
Russell's
viper |
95(76.61%) |
|
Saw scaled
viper |
01(0.8%) |
|
Ceylon krait |
53(42.74%) |
|
Common krait |
62(50.0%) |
|
Green pit
viper |
70(56.45%) |
|
Cobra |
100(80.64%) |
|
Hump nosed
viper |
89(71.77%) |
|
Knowledge
about venom |
|
|
Russell's
viper |
108 (87.09%) |
|
Saw scaled
viper |
99 (79.83%) |
|
Ceylon krait |
80 (64.51%) |
|
Common krait |
|
|
Green pit
viper |
22 (17.74%) |
|
Cobra |
120 (96.77%) |
|
Hump nosed
viper |
47 (37.90%) |
Nearly
62% of analyzed homes were overgrown with grass, potentially harboring snakes.
Further, 42.74% of dwellings were cluttered with coconut husks and firewood,
providing ideal hiding places for these reptiles. Additionally, 18.54% of homes
were frequented by frogs and rats, attracting snakes seeking prey. Notably,
55.64% had tree palms near roofs, allowing snakes easy access to dwellings
(Table 2). Anthills, present in 54.03% of homes, are also known to attract
snakes. These environmental factors create a high-risk environment for snake
encounters. Analysis of sleeping habits revealed that while 57% of people
utilized mosquito nets, potentially offering some protection from insect-borne
diseases, a significant portion (19%) slept on temporary beds in watch huts,
23% on mats on the floor, and 2% directly on the verandah floor. These sleeping
arrangements offered minimal protection from snakes. Occupational analysis
showed that 55.64% of the population are paddy cultivators, 2.41% were Chena
cultivators, and 4.83% were involved in gardening/cultivation, indicating a
close connection to the outdoors, where snake encounters are more likely.
Nighttime activities also revealed potential risks: 62.9% stayed at home,
33.87% looked after their cultivation, 0.8% used to go hunting, and 2.41% went
out often (Table 2).
These activities increase exposure to snakes. These combined insights provide
valuable information about the environmental and behavioral factors
contributing to snake bites in this region. Addressing these factors through
vegetation clearing, utilizing protective gear, and adopting safer sleeping
habits can significantly reduce the risk of snake encounters and enhance
community safety.
Table 2. Risk factors among the whole
population about snake bites
|
Variables |
Frequency
(%) |
|
Risk factors
among the whole population |
|
|
Overgrowth
with grass |
77 (62.09%) |
|
Full of
coconut husks, fire wood |
53 (42.74%) |
|
Full of frogs
and rats |
23 (18.54%) |
|
Tree palms
near the roof |
69 (55.64%) |
|
An area with
anthills |
67 (54.03%) |
|
None of the
above |
2 (1.61%) |
|
Sleeping
place at night |
|
|
Bed with a mosquito net |
71 (57%) |
|
Temporary bed in the paddy field |
23 (19%) |
|
Mats on the floor |
28 (23%) |
|
The floor of the verandah |
2 (02%) |
|
Occupation |
|
|
Paddy
cultivation |
69 (55.64%) |
|
Chena
cultivation |
03 (2.41%) |
|
Gardening/cultivation |
06 (4.83%) |
|
Forces
&none |
46 (37.09%) |
|
Visiting
place at night |
|
|
Hunting |
01 (0.80%) |
|
To look after
your cultivation |
42(33.87%) |
|
Go out often |
03 (2.41%) |
|
Stay at home |
78 (62.9%) |
|
Nature of the
House |
|
|
Thatched |
08 (6.4%) |
|
Mud hut |
28 (22.5%) |
|
Plastered –
wall |
52 (41.9%) |
|
Walls not
plastered |
36 (29.03%) |
When
asked about the most common highly venomous snake responsible for bites, 57.25%
of people identified the Russell's viper, followed by the hump-nosed viper at
29.03%. Cobras and kraits received significantly lower responses (5.64% and
1.61%, respectively). Notably, paddy fields were perceived as the most common
risk area by 76.6% of respondents. Despite this awareness, footwear usage for
protection was low, with only 8.06% wearing boots and 4.83% wearing long
trousers (Table 3).
Interestingly, 75% reported not wearing any protective gear when entering paddy
fields. While a high percentage used torches as a preventive measure during
travel, further analysis using Log-linear models is recommended to
comprehensively assess the association between snake bites and various risk
factors.
Table
3. Snake bites and prevention methods in Sri Lanka
|
Variables |
Frequency
(%) |
|
Snake that
bites the most |
|
|
Cobra |
07 (5.64%) |
|
Russell’s
viper |
71 (57.25%) |
|
Kraits |
02 (1.61%) |
|
Hump nosed
viper |
36 (29.03%) |
|
Cat snake |
08 (6.45%) |
|
Location most
of the attacks are recorded |
|
|
In the house
at night |
23 (18.54%) |
|
In the paddy
field |
95 (76.61%) |
|
At the chena |
05 (4.03%) |
|
When
traveling at night |
01 (0.8%) |
|
When go to
paddy field or night wear |
|
|
Wear boots |
10 (8.06%) |
|
Wear long
trousers |
06 (4.83%) |
|
Wear slippers |
15 (12.09%) |
|
None |
93 (75.0%) |
|
Preventive
method from bites at night |
|
|
Using an
electric torch |
117 (94.35%) |
|
Using a flame |
3 (2.41%) |
|
Tapping with
stick |
3 (2.41%) |
|
Using another
method |
1 (0.8%) |
The association
between the snake bite victims with the risk factors was investigated using
Pearson's correlation coefficient test as shown in Table 4.
Table 4. Victims’ relationship with risk factors
|
Variables |
Pearson's
correlation analysis |
|
Incidental
area |
0.1 |
|
Occupation |
0.7 |
|
Bitten place
of the body |
0.6 |
|
Wearing boots |
0.7 |
Discussion
A staggering
number of people (78.22%) hold onto harmful myths about snake bites. These
myths can be deadly as they prevent victims from getting proper medical
treatment. The reasons for such widespread misinformation are varied: lack of
access to accurate information, fear of snakes, and deeply ingrained cultural
beliefs (10). To combat this issue, it's crucial to
spread accurate knowledge through community talks, social media campaigns, and
awareness initiatives (11). This will empower everyone with the
knowledge to respond appropriately to snake bites. The data reveals a clear
preference for seeking treatment at hospitals in the event of a snake bite,
with 95.56% of respondents choosing this option. Home remedies and indigenous
doctors are far less common; only 3.22% and 0.8% of people choose them,
respectively. The overwhelming majority of the data indicates that hospital
care is the best course of action for treating snake bites, even though some
communities use home cures or traditional medicine. This is probably caused by
a number of things, such as the accessibility of skilled medical personnel who
are knowledgeable about the treatment procedures for snake bites and have the
means to provide antivenom if needed (12). Hospitals also give patients access
to cutting-edge medical devices like dialysis machines and ventilators, which
are essential for treating severe cases (13).
Lastly, a
widespread belief in the efficacy of contemporary medicine encourages people to
visit hospitals right away for emergency care. Consequently, hospitalization is
the best and most efficient course of action for treating snake bites due to
the availability of highly qualified medical personnel, cutting-edge equipment,
and public confidence in contemporary medicine. Although home remedies and
traditional medicine have a long history of being used to treat snake bites,
their use is still somewhat restricted (14). This can be due to a number of
things, such as a lack of knowledge about their effectiveness, apprehension
about possible harm from unfamiliarity, accessibility issues, and unfavorable
opinions. But it's important to recognize that native tribes have a great deal
of experience and knowledge when it comes to using traditional treatments to
cure snake bites [15]. For certain communities, these
techniques have great cultural significance in addition to being efficacious.
Therefore, a more holistic and culturally conscious approach to treating snake
bites can be made possible by bridging the gap through awareness campaigns,
research, and cooperation between traditional healers and medical experts [16].
To combat
snakebites, it is imperative to adopt a multifaceted strategy that respects the
knowledge of indigenous traditions as well as the effectiveness of contemporary
treatment (17,18). Holistic treatment can be facilitated
by cross-cultural research on traditional practices, collaborative training
between healers and doctors, and customized community education (19,20). Building up the infrastructure for
rural healthcare, equipping people with first aid skills, and making sure it's
affordable are all necessary to guarantee access. Recall that although
traditional methods are very valuable, seeking medical assistance right away is
still crucial to preserving lives (21). Together, we can create a world in
which everyone has access to secure and efficient snakebite care (22). According to research showing that
over 80% of respondents acknowledged these links, overgrown areas, waste heaps,
and the presence of possible prey including frogs and rodents emerge as
important environmental risk factors for interactions with snakes (17,20). This ecological consciousness is
essential for prevention because it gives communities the ability to modify
their environment (removing vegetation, storing goods appropriately, and
reducing encounter hazards). Even if environmental awareness is important,
getting medical help right away is still crucial in cases of snakebite (23).
An increased
likelihood of encountering snakes is associated with dense vegetation, easily
accessible prey, and hiding areas, according to data examining environmental
factors that contribute to snake bites (24). Additionally, the presence of
anthills and tree palms adjacent to rooftops draws these reptiles nearer to
populated areas, increasing the likelihood of encounters. Remarkably, most
responders recognize these environmental factors, indicating a good degree of
understanding of the hazards associated with snake bites. To mitigate these
risks and prevent encounters, clearing overgrown vegetation, storing materials
securely, controlling rodent populations, and trimming tree branches are
strongly recommended (25,26). By implementing these measures and
fostering awareness through education and outreach programs, communities can
significantly reduce the risk of snake bites. Be extra cautious in areas known
for high snake densities. Equipping communities with knowledge about snake bite
prevention and first-aid is vital. These measures, coupled with increased
awareness, can significantly decrease encounters and enhance safety. Remember,
this data reflects risk perceptions within a specific context. Further research
and analysis are crucial for developing comprehensive risk maps and
implementing targeted snake bite prevention strategies.
While most
identify venomous snakes, alarming myth adherence among 80% seeking hospital
care underlines the urgent need for educational programs to dispel
misinformation and empower communities with accurate snake bite knowledge.
Overgrown dwellings, animal presence, and unprotected sleeping arrangements in
62% of analyzed homes paint a worrying picture of high snake encounter risk,
necessitating urgent environmental and behavioral adaptations. While paddy
fields are recognized as high-risk areas (76.6%), inadequate protective
measures like footwear (8.06% boots, 4.83% long trousers) expose a majority
(75%) to potential snake bites in these crucial work zones, despite awareness
of common venomous snakes (57.25% Russell's viper, 29.03% hump-nosed viper).
Conflict
Relationships and Activities
The authors
state that the research was conducted in the absence of business or financial
relationships that could be construed as a possible conflict of relationships
and activities.
Financing
This research
did not receive financing from public or private funds; it was self-financed by
the authors.
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PMID 34521877
PMCID PMC8440654
Authors contribution:
MF: methodology, drafting-preparation
of the original draft, writing-review and editing. HP: conceptualization, formal
analysis, data curation, BB: methodology,
investigation, supervision, planning and execution, AM: supervision, planning and
execution, project administration, BS: supervision,
planning and execution, project administration, Funding acquisition.
©2025. The Authors. Kasmera.
Publication of the Department of Infectious and Tropical Diseases of the
Faculty of Medicine. University of Zulia. Maracaibo-Venezuela. This is an open
access article distributed under the terms of the Creative Commons Attribution NonCommercial
(https://creativecommons.org/licenses/by-nc-sa/4.0/) license that allows
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as long as the original work is properly cited