Management of Snakebite and Research Management of Snakebite ...

Management of Snakebite and Research
8
immobilization first-aid technique is found to be effective in delaying local spread of venom
(Tun-Pe et al., 1995), still very few victims applied it.
In spite of energetic antivenom treatment, the mortality rate of snakebite remains
high ranging from 5-10% in Tharrawaddy (Myint-Lwin et al., 1985) and 18% in Taungdwingyi
study (Sann-Mya etal., 1998) which has an annual tally of over 300 cases. Majority of the
victims are young adults (Sann-Mya et al., 1998), which are the working force of the
country. Some of the victims suffered from pituitary insufficiency following recovery (Tun-
Pe et al., 1987b) and needed permanent replacement therapy.
Since it is a preventable occupational hazard, it is expected that if a majority of the
farmers wear protective boots at work in the field or on the road after dark, the incidence
of snakebite and mortality will dramatically decrease and demand for production of
expensive antivenom will be reduced. Rubber boots were introduced to farmers nearly
three decades ago but because of the inconvenience, these did not receive much attention.
A few have a traditional belief that footwear is prohibited in the paddy field. However,
some have been using available rubber boots, which do not withstand penetration of
snake fangs (personal observations) at work. It is high time that the acceptability of the
new fang-proof rubber boots among farmers is studied.
MATERIALS AND METHODS
The rubber boots were developed through the concerted efforts of the Venom Research
laboratory, Department of Medical Research, Veterinary Section of Myanmar Pharma-ceutical
Factory, Ministry of Industry 1 and Rubber Shoe Factory 1, Ministry of Industry 1, Yangon.
Rubber Shoe Factory 1 manufactured a
knee-length protective boot made of
synthetic rubber compound. Several
modifications in length, design of the boots
and preparation of synthetic rubber
compound were made in order to prepare
rubber that could withstand penetration of
Russell’s viper’s fangs as shown in the
A Russell’s viper biting the trial boot
photograph.
Testing of the boot, that could withstand penetration of Russell’s viper’s fangs, was
conducted at the Veterinary Section, Myanmar Pharmaceutical Factory. The Venom
Research laboratory carried out acceptability trial of the boots among farmers.
A total of 180 pairs of boots were distributed free of charge to the participant farmers
from five villages of Taungdwingyi Township (Mahti, Mahti Sanpya, Nyaungbinhla,
Pandawgyi and Satthwa) with the help of local elders and health workers. Face-to-face
interviews were conducted using two sets of structured questionnaires, before and after
distribution of the boots to assess the acceptability of the boots in October 1995 and
February 1996 respectively. The questionnaires included demographic characteristics of
the users, knowledge on the use of protective boots, comfort, ability and duration of boot