International Society on Toxinology - Global Snakebite Initiative

Global Snakebite Statistics - Epidemiology
Recent research by Kasturiaratne et al, published in PLoS, has redefined global estimates of snakebite epidemiology. However, this is, to some extent, a "work in progress". One of the authors, Prof. Janaka de Silva (Sri Lanka) has kindly made available some of the data tables on which the study conclusions were based, with a "challenge" to IST members (and others) to provide more definitive data for each listed country. These tables will be listed on a separate page structure for this website. All interested membewrs are urged to peruse this information and contact Prof. de Silva if they have additional data that might be used to update the tables. This work may be considered as one section of the Global Snakebite Initiative.

Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, Savioli L, Lalloo DG, de Silva HJ.. (2008) The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med.. 5:e218.
ABSTRACT: BACKGROUND: Envenoming resulting from snakebites is an important public health problem in many tropical and subtropical countries. Few attempts have been made to quantify the burden, and recent estimates all suffer from the lack of an objective and reproducible methodology. In an attempt to provide an accurate, up-to-date estimate of the scale of the global problem, we developed a new method to estimate the disease burden due to snakebites. METHODS AND FINDINGS: The global estimates were based on regional estimates that were, in turn, derived from data available for countries within a defined region. Three main strategies were used to obtain primary data: electronic searching for publications on snakebite, extraction of relevant country-specific mortality data from databases maintained by United Nations organizations, and identification of grey literature by discussion with key informants. Countries were grouped into 21 distinct geographic regions that are as epidemiologically homogenous as possible, in line with the Global Burden of Disease 2005 study (Global Burden Project of the World Bank). Incidence rates for envenoming were extracted from publications and used to estimate the number of envenomings for individual countries; if no data were available for a particular country, the lowest incidence rate within a neighbouring country was used. Where death registration data were reliable, reported deaths from snakebite were used; in other countries, deaths were estimated on the basis of observed mortality rates and the at-risk population. We estimate that, globally, at least 421,000 envenomings and 20,000 deaths occur each year due to snakebite. These figures may be as high as 1,841,000 envenomings and 94,000 deaths. Based on the fact that envenoming occurs in about one in every four snakebites, between 1.2 million and 5.5 million snakebites could occur annually. CONCLUSIONS: Snakebites cause considerable morbidity and mortality worldwide. The highest burden exists in South Asia, Southeast Asia, and sub-Saharan Africa.

Important venomous snakes, estimates of number of snake bite envenomings and deaths, and AVS required per year by country

Geographical Region

Medically important snakes

Country

Current population (2007

Number of cases (Low)

Number of cases (High)

Number of deaths (Low)

Number of deaths (High)

AVS (vials) required

Asia, Central	Armenia	3002271	74	74	0.0	0.0
Asia, Central	Azerbaijan	8467167	17	115	0.9	4.4
Asia, Central	Georgia	4395420	9	63	0.0	0.0
Asia, Central	Kazakhstan	15421861	32	186	0.0	0.0
Asia, Central	Kyrgyzstan	5316543	11	91	2.8	2.8
Asia, Central	Mongolia	2628840	5	32	0.3	1.4
Asia, Central	Tajikistan	6735996	14	125	0.7	3.5
Asia, Central	Turkmenistan	4965278	10	73	0.5	2.6
Asia, Central	Uzbekistan	27372260	56	453	3.0	14.2

Asia, East	China	1336317116	1136	212118	450.0	4081.0
Asia, East	DPR Korea	23790245	20	2359	0.0	0.0
Asia, East	Republic of Korea	48223853	192	621	5.0	5.0
Asia, East	Hong Kong	7057000	427	427	5.3	176.4
Asia, East	Japan	127966709	509	2529	7.4	13.3
Asia, East	Taiwan	22858872	2999	3769	7.2	571.5

Asia, South	Afghanistan	27145275	687	128738	192.5	1368.7
Asia, South	Bangladesh	158664959	4014	8280	1680.0	8000.0
Asia, South	Bhutan	658479	2458	2977	4.7	33.2
Asia, South	India	1169015509	81399	163051	10835.0	15000.0
Asia, South	Nepal	28195994	19991	142727	200.0	1000.0
Asia, South	Pakistan	163902405	12784	17578	1200.0	8264.1
Asia, South	Sri Lanka	18963553	32902	32902	132.7	948.2

Asia, Southeast	Brunei Darussalam	390056	2	6	0.0	0.0
Asia, Southeast	Cambodia	14443679	794	21482	80.0	722.2
Asia, Southeast	Indonesia	231626978	12739	214883	20.0	11581.3
Asia, Southeast	Laos	5859393	322	8383	0.5	293.0
Asia, Southeast	Malaysia	26571879	11812	23637	8.0	79.7
Asia, Southeast	Maldives	305556	0	0	0.0	0.0
Asia, Southeast	Mauritius	1261641	0	0	0.0	0.0
Asia, Southeast	Mayotte	0	0	0	0.0	0.0
Asia, Southeast	Myanmar	48798212	8832	14633	336.7	649.0
Asia, Southeast	Philippines	87960117	4838	58989	200.0	300.0
Asia, Southeast	Seychelles	86606	0	0	0.0	0.0
Asia, Southeast	Singapore	4436281	0	0	0.0	0.0
Asia, Southeast	Thailand	63883662	8465	9101	5.0	94.0
Asia, Southeast	Timor Leste	1154775	64	1501	0.1	57.7
Asia, Southeast	Viet Nam	87375196	29970	117583	6.8	4368.8

Australasia		Australia	20743179	1099	1260	1.8	4.1
Australasia		New Zealand	4178525	0	0	0.0	0.0

Oceania	American Samoa	65000	0	0	0.0	0.0
Oceania	Cook Islands	13325	0	0	0.0	0.0
Oceania	Fiji	838698	0	0	0.0	0.0
Oceania	French Polynesia	252000	0	0	0.0	0.0
Oceania	Guam	168000	0	0	0.0	0.0
Oceania	Kiribati	95067	0	0	0.0	0.0
Oceania	Marshall Islands	59286	0	0	0.0	0.0
Oceania	Micronesia (Fed States)	111117	6	60	3.5	7.2
Oceania	Nauru	10152	0	0	0.0	0.0
Oceania	New Caledonia	237000	0	0	0.0	0.0
Oceania	Niue	1565	0	1	0.0	0.1
Oceania	Northern Mariana Islands	86000	0	0	0.0	0.0
Oceania	Palau	20314	1	6	0.6	1.0
Oceania	Papua NG	6331010	313	4051	200.0	455.7
Oceania	Pitcairn Islands	0	0	0	0.0	0.0
Oceania	Samoa	187023	0	0	0.0	0.0
Oceania	Solomon Islands	495662	25	328	15.7	36.5
Oceania	Tokelau	2000	0	0	0.0	0.0
Oceania	Tonga	100336	5	54	0.0	0.0
Oceania	Tuvalu	10530	0	0	0.0	0.0
Oceania	Vanuatu	226180	11	135	7.1	15.6
Oceania	Wallis & Futuna islands	15000	0	0	0.0	0.0

Europe, Central	Albania	3190012	1	94	0.0	0.0
Europe, Central	Bosnia & Herzegovina	3934816	12	67	0.0	0.0
Europe, Central	Bulgaria	7638831	2	119	0.0	0.0
Europe, Central	Croatia	4555398	26	108	1.0	1.0
Europe, Central	Czech Republic	10186330	31	158	0.2	2.2
Europe, Central	Hungary	10029683	3	174	0.2	2.2
Europe, Central	Montenegro	597983	0	0	0.0	0.1
Europe, Central	Poland	38081971	11	765	2.6	8.4
Europe, Central	Romania	21437887	6	523	0.0	0.0
Europe, Central	Serbia	9858424	3	262	1.0	2.2
Europe, Central	Slovakia	5390035	9	124	0.6	1.2
Europe, Central	Slovenia	2001506	1	51	0.0	0.0
Europe, Central	Macedonia	2038464	1	44	0.0	0.0

Europe, Eastern	Belarus	9688795	37	37	0.0	0.0
Europe, Eastern	Estonia	1335333	5	5	0.4	0.6
Europe, Eastern	Latvia	2277040	9	9	1.0	1.0
Europe, Eastern	Lithuania	3389937	13	13	0.2	1.5
Europe, Eastern	Moldova	3793604	14	14	0.0	0.0
Europe, Eastern	Russian Federation	142498532	541	541	35.0	62.6
Europe, Eastern	Ukraine	46205382	176	176	0.0	0.0

Europe, Western	Andorra	74601	0	0	0.0	0.0
Europe, Western	Austria	8360746	8	151	0.0	0.0
Europe, Western	Belgium	10457343	0	0	0.0	0.0
Europe, Western	Channel Islands	149000	0	0	0.0	0.0
Europe, Western	Cyprus	854671	1	14	0.0	0.0
Europe, Western	Denmark	5442098	5	45	1.0	1.0
Europe, Western	Faro Islands	47000	0	0	0.0	0.0
Europe, Western	Finland	5276892	201	229	1.0	1.0
Europe, Western	France	61647375	1541	1880	1.0	11.7
Europe, Western	Germany	82599471	74	561	0.4	15.7
Europe, Western	Gibraltar	27000	0	0	0.0	0.0
Europe, Western	Greece	11146918	10	228	0.0	0.0
Europe, Western	Greenland	57000	0	0	0.0	0.0
Europe, Western	Holy See	1000	0	0	0.0	0.0
Europe, Western	Iceland	301006	0	0	0.0	0.0
Europe, Western	Ireland	4300902	0	0	0.0	0.0
Europe, Western	Isle of Man	78000	0	0	0.0	0.0
Europe, Western	Italy	58876834	465	1290	0.0	0.0
Europe, Western	Liechtenstein	34000	0	0	0.0	0.0
Europe, Western	Luxembourg	466560	0	0	0.0	0.0
Europe, Western	Malta	406582	0	0	0.0	0.0
Europe, Western	Monaco	32711	0	0	0.0	0.0
Europe, Western	Netherlands	16418824	15	293	0.0	0.0
Europe, Western	Norway	4698097	40	79	0.0	0.0
Europe, Western	Portugal	10623031	10	240	0.0	0.0
Europe, Western	San Marino	6000	0	0	0.0	0.0
Europe, Western	San Pierre et Miquelon	30926	0	0	0.0	0.0
Europe, Western	Spain	44279180	112	597	0.0	0.0
Europe, Western	Sweden	9118955	237	276	0.2	1.7
Europe, Western	Switzerland	7483973	43	93	0.5	1.4
Europe, Western	United Kingdom	60768946	200	522	0.4	11.5

North America		Canada	32876047	260	372	0.0	0.0
North America		USA	305826246	2422	3487	4.8	7.0

Latin America, Central	Colombia	46155958	2340	2696	72.5	345.1
Latin America, Central	Costa-Rica	4467625	572	695	3.8	8.9
Latin America, Central	El Salvador	6857328	51	2122	3.1	51.3
Latin America, Central	Guatemala	13353911	513	5715	6.0	99.9
Latin America, Central	Honduras	7106001	510	3294	3.2	53.1
Latin America, Central	Mexico	106534880	28 056	41009	47.6	796.6
Latin America, Central	Nicaragua	5603190	507	641	2.5	41.9
Latin America, Central	Panama	3343374	2542	2542	17.4	25.0
Latin America, Central	Venezuela	27656832	6997	8659	37.0	38.8

Latin America, Andean	Bolivia	9524568	856	5500	100.0	100.0
Latin America, Andean	Ecuador	13341197	1199	8189	42.6	140.1
Latin America, Andean	Peru	27902760	4492	13963	100.0	293.0

Latin America, Southern	Argentina	39531115	1957	1957	3.8	3.8
Latin America, Southern	Chile	16634760	1	102	0.2	1.6
Latin America, Southern	Falkland Islands	3000	0	0	0.0	0.0
Latin America, Southern	Uruguay	3339700	100	105	0.0	0.0

Latin America, Tropical		Brazil	191790929	29536	31274	93.5	290.0
Latin America, Tropical		Paraguay	6127077	100	621	7.0	9.3

Caribbean	Anguilla	12000	0	0	0.0	0.0
Caribbean	Antigua & Barbuda	85109	0	0	0.0	0.0
Caribbean	Aruba	103000	50	364	0.1	55.1
Caribbean	Bahamas	331278	0	0	0.0	0.0
Caribbean	Barbados	293891	0	0	0.0	0.0
Caribbean	Belize	287699	51	884	0.4	153.9
Caribbean	Bermuda	83000	0	0	0.0	0.0
Caribbean	British Virgin Islands	22000	0	0	0.0	0.0
Caribbean	Cayman Islands	43000	0	0	0.0	0.0
Caribbean	Cuba	11267883	0	0	0.0	0.0
Caribbean	Dominica	67390	0	0	0.0	0.0
Caribbean	Dominican Republic	9759664	0	0	0.0	0.0
Caribbean	French Guiana	187000	84	334	100.0	100.0
Caribbean	Grenada	105672	0	0	0.0	0.0
Caribbean	Guadeloupe	446000	0	0	0.0	0.0
Caribbean	Guyana	737906	528	3017	4.3	394.6
Caribbean	Haiti	9597849	0	0	0.0	0.0
Caribbean	Jamaica	2713779	0	0	0.0	0.0
Caribbean	Martinique	397000	20	21	0.6	212.3
Caribbean	Montserrat	4000	0	0	0.0	0.0
Caribbean	Netherland Antilles	224000	0	0	0.0	0.0
Caribbean	St. Kitts & Nevus	50417	0	0	0.0	0.0
Caribbean	St. Lucia	164924	4	640	0.0	0.0
Caribbean	St. Vincent & Grenadine	120402	0	0	0.0	0.0
Caribbean	Suriname	457964	327	868	2.0	244.9
Caribbean	Trinidad & Tobago	1333272	33	1911	0.0	0.0
Caribbean	Turks & Caicos	22000	0	0	0.0	0.0

North Africa/ Middle East	Algeria	33857915	100	6470	2.9	6.3
North Africa/ Middle East	Bahrain	752648	2	38	0.0	0.0
North Africa/ Middle East	Egypt	75497913	223	21254	14.0	14.0
North Africa/ Middle East	Iran	71208384	210	11079	6.0	13.2
North Africa/ Middle East	Iraq	28993374	86	4366	2.4	5.4
North Africa/ Middle East	Israel	6927677	100	119	0.2	1.3
North Africa/ Middle East	Jordan	5924245	17	613	0.5	1.1
North Africa/ Middle East	Kuwait	2851144	8	56	0.0	0.0
North Africa/ Middle East	Lebanon	4099115	12	228	0.3	0.8
North Africa/ Middle East	Libya	6160483	18	388	0.5	1.1
North Africa/ Middle East	Morocco	31224137	92	6349	2.6	5.8
North Africa/ Middle East	Palestinian Territory	3762000	11	513	0.3	0.7
North Africa/ Middle East	Oman	2595133	361	583	0.2	0.5
North Africa/ Middle East	Qatar	840635	2	26	0.0	0.0
North Africa/ Middle East	Saudi Arabia	24734533	1484	1855	2.1	4.6
North Africa/ Middle East	Syria	19928516	59	4651	1.7	3.7
North Africa/ Middle East	Tunisia	10327285	30	1747	0.9	1.9
North Africa/ Middle East	Turkey	74876695	221	11777	6.3	13.9
North Africa/ Middle East	United Arab Emirates	4380439	13	239	0.4	0.8
North Africa/ Middle East	Western Sahara	324000	1	10	0.0	0.1
North Africa/ Middle East	Yemen	22389169	66	7949	1.9	4.2

Sub Saharan Africa, Cent.	Angola	17024084	1262	8004	19.6	542.5
Sub Saharan Africa, Cent.	Central African Republic	4342735	322	1935	5.0	130.1
Sub Saharan Africa, Cent.	Congo	3768086	435	593	4.3	75.2
Sub Saharan Africa, Cent.	DR Congo	62635723	16021	36814	224.3	2305.9
Sub Saharan Africa, Cent.	Equatorial Guinea	507499	38	229	0.6	15.4
Sub Saharan Africa, Cent.	Gabon	1330574	99	246	2.3	13.6

Sub Saharan Africa, East	Burundi	8508232	1174	2230	38.3	322.7
Sub Saharan Africa, East	Comoros	839187	0	0	0.0	0.0
Sub Saharan Africa, East	Djibouti	833021	115	132	3.7	8.4
Sub Saharan Africa, East	Eritrea	4850763	669	1233	21.8	173.7
Sub Saharan Africa, East	Ethiopia	83099190	11468	21223	373.9	3002
Sub Saharan Africa, East	Kenya	37537716	5180	8194	168.9	980.8
Sub Saharan Africa, East	Madagascar	19683358	0	0	0.0	.0
Sub Saharan Africa, East	Malawi	13925070	1922	3556	62.7	503.0
Sub Saharan Africa, East	Mozambique	21396916	2953	4832	96.3	602.5
Sub Saharan Africa, East	Rwanda	9724577	1342	2399	43.8	328.5
Sub Saharan Africa, East	Somalia	8698534	1200	2289	39.1	332.4
Sub Saharan Africa, East	Sudan	38560488	5321	8554	173.5	1044.4
Sub Saharan Africa, East	Uganda	30883805	4262	8109	139.0	1175.5
Sub Saharan Africa, East	Tanzania	40453513	5583	9341	182.0	1194.4
Sub Saharan Africa, East	Zambia	11921999	1645	2731	53.6	346.2

Sub Saharan Africa, South	Botswana	1881504	21	58	2.7	10.0
Sub Saharan Africa, South	Lesotho	2007833	23	85	2.9	10.6
Sub Saharan Africa, South	Namibia	2074146	23	82	3.0	11.0
Sub Saharan Africa, South	South Africa	48576763	1383	1864	257.5	257.5
Sub Saharan Africa, South	Swaziland	1141427	13	48	1.6	6.0
Sub Saharan Africa, South	Zimbabwe	13349434	150	160	19.0	70.8

Sub Saharan Africa, West	Benin	9032787	5913	11392	650.0	764.1
Sub Saharan Africa, West	Burkina Faso	14784291	1109	8279	200.0	441.9
Sub Saharan Africa, West	Cameroon	18549176	2255	6206	33.8	265.9
Sub Saharan Africa, West	Cape Verde	530437	0	0	0.0	0.0
Sub Saharan Africa, West	Chad	10780571	87	14414	3.5	1008.1
Sub Saharan Africa, West	Cote d’Ivoire	19261821	6380	12366	200.0	300.0
Sub Saharan Africa, West	Gambia	1708681	14	2344	0.6	163.9
Sub Saharan Africa, West	Ghana	23478394	190	24515	7.6	1713.3
Sub Saharan Africa, West	Guinea-Bissau	1695043	14	2170	0.5	151.8
Sub Saharan Africa, West	Guinea	9370113	1275	6295	28.1	468.5
Sub Saharan Africa, West	Liberia	3750261	30	4104	1.2	286.9
Sub Saharan Africa, West	Mali	12336799	100	19516	4.0	1365.5
Sub Saharan Africa, West	Mauritania	3123813	25	2325	1.0	162.3
Sub Saharan Africa, West	Niger	14225521	1337	21527	26.7	76.5
Sub Saharan Africa, West	Nigeria	148092542	1200	141710	48.0	9900.9
Sub Saharan Africa, West	Saint Helena	5000	0	6	0.0	0.4
Sub Saharan Africa, West	Sao Tome & Principe	157638	1	217	0.1	15.2
Sub Saharan Africa, West	Senegal	12378532	1238	1946	185.7	867.0
Sub Saharan Africa, West	Sierra Leone	5865872	48	6724	1.9	470.1
Sub Saharan Africa, West	Togo	6585147	6783	8644	197.6	232.0