Management of Snakebite and Research Management of Snakebite ...

Acceptability Study of Protective Boots
Among Farmers of Taungdwingyi Township
Tun-Pe 1 , Aye-Aye-Myint 1 , Khin-Aye-Kyu 2 and Maung-Maung-Toe 3
1 Venom Research Laboratory, Department of Medical Research (Lower Myanmar), Yangon
2 Myanmar Railways Department, Taungdwingyi
3 Epidemiology Research Division, Department of Medical Research (Lower Myanmar), Yangon
INTRODUCTION
Abstract
Acceptability of fang-proof protective boots was studied in 180 farmers of Taungdwingyi
Township during the harvesting season, October 1995. The boots were provided free of
charge. A preliminary survey showed that 98% of farmers knew snakebite could be
prevented by working with boots on and only 72% wore them and 28% did not. At
present 88% wear locally available rubber boots, which could not withstand penetration
of Russell’s viper’s fangs. Following the trial, 99% enjoyed wearing the trial boots. These
provide full sense of protection against snakebite. These are light, comfortable and the
farmers could work with them on for the whole day either intermittently or continuously.
Ninety-nine percent preferred to wear the trial boots in future and intended to use
them even if these are not provided free of charge. The boots cost 350 kyats per pair.
Ninety-nine percent could afford to buy them at a price of 250 kyats per pair. However,
1% preferred a lower price of 150 or 200 kyats per pair. In order to reduce the incidence
of snakebite throughout the country, all-out wearing of the boots is needed and it is
suggested that health education, selling and distribution of the boots directly to the
users at an affordable (subsidised) price of 250 kyats or less per pair should be aimed
at.
Russell’s vipers (Daboia russelii siamensis) usually inhabit paddy fields and are plentiful
between October and December, which coincides with the harvesting season (Tun-Pe et
al., 1991). Most snakebites occur while the farmers are at work in the fields harvesting
crops, carrying bundles of hay, while caring livestock and on return from work or after
visiting friends or video houses after dark on poorly-lit roads. Majority of the bites occur
between 6 a.m.– 6 p.m. and at work (Sann-Mya et al., 1998). Although antivenom is the
mainstay in treatment of snakebite, there are delays of at least about 2-4 hours in getting
treatment at the nearest health centre. Majority of the effective bites resulted in systemic
envenoming while seeking treatment. Routinely used tourniquet was found to be ineffective
in retarding spread of venom (Tun-Pe et al., 1987a). Although local compression
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