A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study).
Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to ce...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2021
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0009245 https://doaj.org/article/d17b1b996c7947e08e319303b047683d |
id |
ftdoajarticles:oai:doaj.org/article:d17b1b996c7947e08e319303b047683d |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:d17b1b996c7947e08e319303b047683d 2023-05-15T15:16:54+02:00 A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). Joseir Saturnino Cristino Guilherme Maciel Salazar Vinícius Azevedo Machado Eduardo Honorato Altair Seabra Farias João Ricardo Nickenig Vissoci Alexandre Vilhena Silva Neto Marcus Lacerda Fan Hui Wen Wuelton Marcelo Monteiro Jacqueline Almeida Gonçalves Sachett 2021-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009245 https://doaj.org/article/d17b1b996c7947e08e319303b047683d EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009245 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009245 https://doaj.org/article/d17b1b996c7947e08e319303b047683d PLoS Neglected Tropical Diseases, Vol 15, Iss 3, p e0009245 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009245 2022-12-31T14:49:06Z Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient's admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 3 e0009245 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Joseir Saturnino Cristino Guilherme Maciel Salazar Vinícius Azevedo Machado Eduardo Honorato Altair Seabra Farias João Ricardo Nickenig Vissoci Alexandre Vilhena Silva Neto Marcus Lacerda Fan Hui Wen Wuelton Marcelo Monteiro Jacqueline Almeida Gonçalves Sachett A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient's admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community ... |
format |
Article in Journal/Newspaper |
author |
Joseir Saturnino Cristino Guilherme Maciel Salazar Vinícius Azevedo Machado Eduardo Honorato Altair Seabra Farias João Ricardo Nickenig Vissoci Alexandre Vilhena Silva Neto Marcus Lacerda Fan Hui Wen Wuelton Marcelo Monteiro Jacqueline Almeida Gonçalves Sachett |
author_facet |
Joseir Saturnino Cristino Guilherme Maciel Salazar Vinícius Azevedo Machado Eduardo Honorato Altair Seabra Farias João Ricardo Nickenig Vissoci Alexandre Vilhena Silva Neto Marcus Lacerda Fan Hui Wen Wuelton Marcelo Monteiro Jacqueline Almeida Gonçalves Sachett |
author_sort |
Joseir Saturnino Cristino |
title |
A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
title_short |
A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
title_full |
A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
title_fullStr |
A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
title_full_unstemmed |
A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study). |
title_sort |
painful journey to antivenom: the therapeutic itinerary of snakebite patients in the brazilian amazon (the qualisnake study). |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009245 https://doaj.org/article/d17b1b996c7947e08e319303b047683d |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 3, p e0009245 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009245 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009245 https://doaj.org/article/d17b1b996c7947e08e319303b047683d |
op_doi |
https://doi.org/10.1371/journal.pntd.0009245 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
15 |
container_issue |
3 |
container_start_page |
e0009245 |
_version_ |
1766347197276749824 |