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Tackling the second deadliest Neglected Tropical Disease: predicting and reducing the impact of Snakebite on human and animal health through interdisciplinary analyses of hotspots and access to care (SNAKE-BYTE project)

English title Tackling the second deadliest Neglected Tropical Disease: predicting and reducing the impact of Snakebite on human and animal health through interdisciplinary analyses of hotspots and access to care (SNAKE-BYTE project)
Applicant Ray Nicolas
Number 176271
Funding scheme Project funding
Research institution Institut de santé globale Faculté de Médecine Université de Genève
Institution of higher education University of Geneva - GE
Main discipline Methods of Epidemiology and Preventive Medicine
Start/End 01.03.2018 - 31.05.2022
Approved amount 835'450.00
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All Disciplines (4)

Discipline
Methods of Epidemiology and Preventive Medicine
Other disciplines of Environmental Sciences
Public Health and Health Services
Ecology

Keywords (12)

Physical accessibility; Hotspots; Environmental change; Predictive model; Snakebite; One health; Nepal; Cameroon; Snakebite; Accessmod; Snake; Global health

Lay Summary (French)

Lead
Les morsures de serpent affectent les communautés pauvres, causant chaque année plus de 120 000 décès et 400 000 victimes de handicaps et traumatismes psychologiques. Cette crise humanitaire silencieuse a été ignorée par les décideurs, scientifiques et entreprises privées, mais en juin 2017, l'OMS a reconnu les morsures de serpent comme un problème de santé majeur et les a inclus dans la liste des maladies tropicales négligées. Le milieu de la santé et les experts des morsures de serpent appellent maintenant à des actions urgentes.
Lay summary
Ce projet propose une collecte de données sans précédent du niveau local à national dans les secteurs humain et animal au Cameroun et Népal. Avec une équipe interdisciplinaire et internationale, nous chercherons à répondre aux questions suivantes: Quel est l'impact direct des morsures de serpent sur les populations humaines au Népal et Cameroun? Et l'impact indirect à travers un impact sur le bétail et les moyens de subsistance? Où sont les populations les plus exposées aux morsures de serpent dans ces pays? Quelle est l'accessibilité géographique aux traitements vitaux (ex. antivenin)? Quel sera l’impact des changements environnementaux et démographiques au Cameroun et Népal sur le fardeau des morsures de serpent?
Ce projet sensibilisera le monde scientifique, politique et publique sur les morsures de serpent au niveau national, régional (Afrique subsaharienne et Asie du Sud) et international, tout en donnant un poids politique aux communautés négligées concernées. Grâce aux liens de l'équipe avec l'OMS, MSF, le PNUE, etc. et la communauté académique, ce projet renforcera l'élan politique et scientifique actuel autour des morsures de serpent en favorisant une meilleure compréhension de cette maladie et d'autres maladies liées à la pauvreté.
Direct link to Lay Summary Last update: 21.12.2017

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
Assessment of the effect of snakebite on health and socioeconomic factors using a One Health perspective in the Terai region of Nepal: a cross-sectional study
Babo Martins Sara, Bolon Isabelle, Alcoba Gabriel, Ochoa Carlos, Torgerson Paul, Sharma Sanjib J., Ray Nicolas, Chappuis François, Ruiz de CastañedaRafael (2022), Assessment of the effect of snakebite on health and socioeconomic factors using a One Health perspective in the Terai region of Nepal: a cross-sectional study, in The Lancet Global Health, 10(3), e409–15-e415.
Snakebite epidemiology in humans and domestic animals across the Terai region in Nepal: a multicluster random survey
Alcoba Gabriel, Sharma Sanjib, Bolon Isabelle, Ochoa Carlos, Babo Martins Sara, Subedi Manish, Shah Bhupendra, Ghimire Anup, Gignoux Etienne, Luquero Francisco, Ruiz de Castañeda Rafael, Ray Nicolas, Chappuis François (2022), Snakebite epidemiology in humans and domestic animals across the Terai region in Nepal: a multicluster random survey, in The Lancet Global Health, 10(3), e398-e408.
Estimating and predicting snakebite risk in the Terai region of Nepal through a high-resolution geospatial and One Health approach
Ochoa Carlos, Pittavino Marta, Babo Martins Sara, Alcoba Gabriel, Bolon Isabelle, Ruiz de Castañeda Rafael, Joost Stéphane, Sharma Sanjib Kumar, Chappuis François, Ray Nicolas (2021), Estimating and predicting snakebite risk in the Terai region of Nepal through a high-resolution geospatial and One Health approach, in Scientific Reports, 11(1), 23868-23868.
Access to antivenoms in the developing world: A multidisciplinary analysis
Potet Julien, Beran David, Ray Nicolas, Alcoba Gabriel, Habib Abdulrazaq Garba, Iliyasu Garba, Waldmann Benjamin, Ralph Ravikar, Faiz Mohammad Abul, Monteiro Wuelton Marcelo, de Almeida Gonçalves Sachett Jacqueline, di Fabio Jose Luis, Cortés María de los Ángeles, Brown Nicholas I., Williams David J. (2021), Access to antivenoms in the developing world: A multidisciplinary analysis, in Toxicon: X, 12, 100086-100086.
Defining service catchment areas in low-resource settings
Macharia Peter M, Ray Nicolas, Giorgi Emanuele, Okiro Emelda A, Snow Robert W (2021), Defining service catchment areas in low-resource settings, in BMJ Global Health, 6(7), e006381-e006381.
What is the impact of snakebite envenoming on domestic animals? A nation-wide community-based study in Nepal and Cameroon
Bolon Isabelle, Babo Martins Sara, Ochoa Carlos, Alcoba Gabriel, Herrera María, Bofia Boyogueno Henri Magloire, Sharma Barun Kumar, Subedi Manish, Shah Bhupendra, Wanda Franck, Sharma Sanjib Kumar, Nkwescheu Armand Seraphin, Ray Nicolas, Chappuis François, Ruiz de Castañeda Rafael (2021), What is the impact of snakebite envenoming on domestic animals? A nation-wide community-based study in Nepal and Cameroon, in Toxicon: X, 9-10, 100068-100068.
Novel transdisciplinary methodology for cross-sectional analysis of snakebite epidemiology at a national scale
Alcoba Gabriel, Ochoa Carlos, Babo Martins Sara, Ruiz de Castañeda Rafael, Bolon Isabelle, Wanda Franck, Comte Eric, Subedi Manish, Shah Bhupendra, Ghimire Anup, Gignoux Etienne, Luquero Francisco, Nkwescheu Armand, Sharma Sanjib Kumar, Chappuis François, Ray Nicolas (2021), Novel transdisciplinary methodology for cross-sectional analysis of snakebite epidemiology at a national scale, in PLOS Neglected Tropical Diseases, 15(2), e0009023.
Assessing the Increase of Snakebite Incidence in Relationship to Flooding Events
Ochoa Carlos, Bolon Isabelle, Durso Andrew M., Ruiz de Castañeda Rafael, Alcoba Gabriel, Babo Martins Sara, Chappuis François, Ray Nicolas (2020), Assessing the Increase of Snakebite Incidence in Relationship to Flooding Events, in Journal of Environmental and Public Health, 2020, 1-9.
Identifying the snake: First scoping review on practices of communities and healthcare providers confronted with snakebite across the world
Bolon Isabelle, Durso Andrew M., Botero Mesa Sara, Ray Nicolas, Alcoba Gabriel, Chappuis François, Ruiz de Castañeda Rafael (2020), Identifying the snake: First scoping review on practices of communities and healthcare providers confronted with snakebite across the world, in PLOS ONE, 15(3), e0229989-e0229989.
Snakebite in domestic animals: First global scoping review
Bolon Isabelle, Finat Matias, Herrera María, Nickerson Andrea, Grace Delia, Schütte Stephanie, Babo Martins Sara, Ruiz de Castañeda Rafael (2019), Snakebite in domestic animals: First global scoping review, in Preventive Veterinary Medicine, 170, 104729-104729.
Snakebite and its impact in rural communities: The need for a One Health approach
Babo Martins Sara, Bolon Isabelle, Chappuis François, Ray Nicolas, Alcoba Gabriel, Ochoa Carlos, Kumar Sharma Sanjib, Nkwescheu Armand S., Wanda Franck, Durso Andrew M., Ruiz de Castañeda Rafael (2019), Snakebite and its impact in rural communities: The need for a One Health approach, in PLOS Neglected Tropical Diseases, 13(9), e0007608-e0007608.
Snake-byte: first national epidemiological study on snakebite shows high annual incidences in Nepal and Cameroon
Alcoba Gabriel, Ochoa Carlos, Sharma Sanjib K, Nkwescheu Armand S, Wanda Franck, Babo Martins Sara, Ruiz de Castaneda Rafael Luis, Bolon Isabelle, Ray Nicolas, Chappuis Francois (2019), Snake-byte: first national epidemiological study on snakebite shows high annual incidences in Nepal and Cameroon, 113(Supplement), S1-S98, Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 113, Issue Supplement_1, UK 113(Supplement), S1-S98.
Impact of snakebite on livestock and livelihood: a neglected issue?
Bolon Isabelle, Babo Martins Sara, Finat Matias, Schutte S., Ray Nicolas, Chappuis Francois, Alcoba Gabriel, Ochoa Carlos, Wanda Franck, Nkwescheu Armand S, Sharma Sanjib K, Herrera Maria, Ruiz de Castaneda Rafael (2019), Impact of snakebite on livestock and livelihood: a neglected issue?, 79, 66-66, Elsevier, Elsevier 79, 66-66.
Vulnerability to snakebite envenoming: a global mapping of hotspots
Longbottom Joshua, Shearer Freya M, Devine Maria, Alcoba Gabriel, Chappuis Francois, Weiss Daniel J, Ray Sarah E, Ray Nicolas, Warrell David A, Ruiz de Castañeda Rafael, Williams David J, Hay Simon I, Pigott David M (2018), Vulnerability to snakebite envenoming: a global mapping of hotspots, in The Lancet, 392(10148), 673-684.

Datasets

Primary data of the SNAKE-BYTE project

Author Alcoba, Gabriel; Ochoa, Carlos; Ray, Nicolas; Chappuis, Francois
Publication date 08.06.2022
Persistent Identifier (PID) https://doi.org/10.26037/yareta:sydjpmew5nhq7l67qbnyuzqbym
Repository Primary data of the SNAKE-BYTE project
Abstract
This data includes the questionnaires and resulting primary data collected between November 2018 and July 2019 in Nepal and Cameroon during the fieldwork of the project. It includes the anonymized raw data and the processed data. Additional information in the ReadMe.txt file in each sub-folder.

Snakebite risk prediction in the Terai region of Nepal

Author Ochoa, Carlos; Ray, Nicolas
Publication date 18.06.2022
Persistent Identifier (PID) https://doi.org/10.26037/yareta:qqyq2a7mo5bdrgp4qolvc4q6cq
Repository Snakebite risk prediction in the Terai region of Nepal
Abstract
This data includes two geospatial rasters resulting from the prediction of snakebite risk in the Terai region of Nepal (Mean and Standard Deviation), and the original publication. Additionally, the ReadMe.txt file provides extra information on the characteristics of the file.

Collaboration

Group / person Country
Types of collaboration
Institute for Health Metrics and Evaluation United States of America (North America)
- Publication
University of Oxford Great Britain and Northern Ireland (Europe)
- Publication
Research Center for Statistics, UNIGE Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Epicentre, Médecins Sans Frontières Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Vetsuisse Faculty, University of Zurich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
LASIG laboratory, EPFL Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Annual meeting of the Swiss Society of Travel and Tropical Medicine Talk given at a conference A One health approach to snakebite in Cameroon and Nepal - the snake-byte project 02.09.2021 Montreux, Switzerland Chappuis François;
Geneva health Forum 8th Edition Poster Snakebite. A geospatial analysis of risk, and optimization of the accessibility to healthcare and resources allocation aiming at snakebite burden reduction in Nepal and Cameroon 15.11.2020 Virtual edition, Switzerland Ochoa Carlos;
6th World One Health Congress Talk given at a conference Assessing the socioeconomic impact of snakebite in Nepal and Cameroon: a One Health approach 30.10.2020 Virtual edition, Stateless Babo Martins Sara;
XXVes Actualités du Pharo Talk given at a conference Le fardeau des morsures de serpent sous l’angle One health: première étude communautaire nationale évaluant l’impact des morsures de serpent sur les animaux d’élevage et les moyens de subsistance au Cameroun et au Nepal 03.10.2019 Marseille, France Bolon Isabelle;
11th European Congress on Tropical Medicine and International Health 2019 (ECTMIH) Talk given at a conference A One Health approach to snakebite and its impact in rural communities 19.09.2019 Liverpool, Great Britain and Northern Ireland Babo Martins Sara;
International Meeting on Emerging Diseases and Surveillance 2018 (IMED 2018) Poster Impact of snakebite on livestock and livelihood: a neglected issue? 09.11.2018 Vienna, Austria Ruiz de Castaneda Rafael; Bolon Isabelle;
5th International One Health Congress Poster What is the cost of snakebite envenoming? A One Health approach to the economic impact assessment of snakebite based on primary data collection and multi-method analysis 22.06.2018 Saaskatoon, Canada Bolon Isabelle; Babo Martins Sara;
5th International One Health Congress Talk given at a conference Tackling the second deadliest NTD: Predicting and reducing the impact of snakebite on human and animal health through One Health analyses of hotspots and access to care 22.06.2018 Saaskatoon, Canada Ruiz de Castaneda Rafael;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
International Snakebite Awareness day (ISBAd 2021) in Cameroon Workshop 17.09.2021 Zoom event , Cameroon Chappuis François; Ray Nicolas;
Annual meeting of the Swiss Society of Travel and Tropical Medicine Talk 02.09.2021 Montreux, Switzerland Chappuis François;
Public conference during the event "10 ans de l'ISE", ISE, University of Geneva Talk 27.09.2019 Geneva, Switzerland Ray Nicolas;
High-Level Meeting and Workshop on Snakebite in Nepal: The Challenges and the Needs Talk 02.08.2019 Kathmandu, Nepal Ochoa Carlos; Ruiz de Castaneda Rafael; Sharma Sanjib Kumar;


Self-organised

Title Date Place
Final SNAKE-BYTE results dissemination event in Cameroon 16.05.2022 Yaoundé and Akonolinga , Cameroon

Communication with the public

Communication Title Media Place Year
Media relations: print media, online media 3 thousand die every year due to snakebite Ekantipur online journal International 2022
Media relations: print media, online media Humains et animaux : La double peine des morsures de serpent Campus journal, UNIGE Western Switzerland 2022
Media relations: radio, television La cartographie pour lutter contre les morsures de serpents RTS Western Switzerland 2022
Media relations: print media, online media Le Cameroun lutte contre les envenimations par morsures de serpents Allo Docteurs Africa International 2022
Talks/events/exhibitions Les morsures de serpent: un fléau négligé Western Switzerland 2022
Media relations: print media, online media Morsures de serpents: 4000 morts par an au Cameroun Mutations Quotidien journal International 2022
Media relations: print media, online media Snakebite in Nepal: 40,000 affected annually, how many die? Healthpost online journal International 2022
Media relations: print media, online media Snakebites with consequences Horizons - the Swiss research magazine Western Switzerland German-speaking Switzerland Rhaeto-Romanic Switzerland Italian-speaking Switzerland 2022
Media relations: print media, online media Tracking snakebite envenoming in Nepal Geospatial World International 2022
Media relations: print media, online media What does the research published in the world-famous medical journal Lancet say about snakebite in t Setopati online journal International 2022
Media relations: radio, television Session in French an in English National Radio station (CRTV) Cameroon International 2021
Media relations: radio, television Your health, your wealth Cameroon Radio & Television (CRTV), National Radio Station International 2020
Talks/events/exhibitions Public conference during the event "10 ans de l'ISE", ISE, University of Geneva, September 27, 2019 International Western Switzerland 2019
Media relations: print media, online media Combattre les morsures de serpent Campus Junior, University of Geneva Western Switzerland 2018
Media relations: radio, television LES MORSURES DE SERPENTS CARTOGRAPHIÉES RTS, CQFD Western Switzerland 2018
Media relations: print media, online media Les morsures de serpents, un fléau dans les pays du Sud Le Temps Western Switzerland 2018
Media relations: radio, television L'invité du 5h-6h30 La Matinale, RTS Western Switzerland 2018
Media relations: print media, online media SNAKE-BYTE, UN PROJET QUI A DU MORDANT Le Journal de l’Université de Genève Western Switzerland 2018
Media relations: print media, online media Une carte identifie les populations victimes de morsures de serpent Campus, University of Geneva Western Switzerland 2018
Media relations: print media, online media UNIGE: une carte planétaire des morsures de serpents SwissInfo Western Switzerland 2018

Abstract

Snakebite is the second neglected tropical killer being responsible for over 100,000 human deaths and 400,000 victims of disability and disfigurement globally every year. It affects poor and rural communities in developing countries, where snakebite is more frequent and access to life-saving healthcare (e.g., antivenom) is limited. Also, snakebite affects livestock animals, which intensifies its impact on agricultural communities through an impact on livelihoods. As these communities lack political voice, snakebite is severely neglected by international and national policy makers and donors, pharmaceutical industry, media and academia. Médecins Sans Frontières refers to snakebite as a “public health emergency gone under the radar”, stressing the lack of reliable reporting systems and the serious underestimation of the global burden of snakebite. Therefore, not only is this a humanitarian crisis but also a crisis of data and scientific knowledge. A Swiss and international interdisciplinary team led by Prof. F. Chappuis (Faculty of Medicine) and Dr. N. Ray (Faculty of Sciences, UNIGE), with experts in tropical and humanitarian medicine (epidemiology, public health), One Health (veterinary public health, disease ecology), zoology (medical biodiversity research, herpetology), toxinology, and spatial analysis and modelling, proposes an unprecedented cross-sectoral collection of data at the household and regional/national levels of two representative hyper-endemic countries in Sub-Saharan Africa (Cameroon) and South Asia (Nepal) to improve our understanding of snakebite burden (e.g. mortality, DALYs), its direct and indirect impact on livelihoods, and the critical physical accessibility of existing human and animal health services. A total of 24'000 households (close to 120'000 people) will be included in a regional and national human-animal health integrated survey in Nepal and Cameroon (Research Question [RQ] 1). Outputs of RQ1 will feed an analysis of the impact of snakebite on livelihoods (RQ2) and will be complemented with geo-spatial information on national infrastructures (e.g., roads), demography, environment, etc., to map local and regional snakebite hotspots, delineates the population at highest risk, and develop predictive models (RQ3). Models of realistic physical accessibility of life-saving healthcare (RQ4) will help optimize the deployment of life-saving tools (antivenoms, ventilatory support) and understanding the impact of antivenom shortages. This will serve as an evidence-based tool to support local and national health policy at the present (RQ5) but also in the future, in view of environmental and population changes expected in these countries (RQ6). This project is aligned with strategic objectives of the University of Geneva and Hospitals (e.g. humanitarian action, global health) and, following a One Health approach, will reinforce collaborations across the human, animal and environmental fields within our institutions and across International Geneva. This extends to local teams in Cameroon and Nepal favoring capacity building in research and healthcare. Results, data, and experiences from this project will generate science (9 potential publications and 2 PhDs) and nourish teaching programs exposing snakebite and other Neglected Tropical Diseases (NTDs) more prominently, and favoring inter- and transdisciplinary teaching and learning. Evidence will raise scientific, political and public awareness on snakebite and other NTDs at the national level in Cameroon and Nepal, and at the regional level in Sub-Saharan Africa and South Asia due to the potential for extrapolation of our results, tools and recommendations. The current political momentum of snakebite in the Global Health agenda will be reinforced towards their inclusion in the WHO NTDs list. This project will promote the recognition of local lay knowledge (e.g., traditional medicine) and its integration in epidemiological investigations giving political voice to neglected communities of the world, particularly in Nepal and Cameroon. This will not only improve our understanding of the impact of snakebite but also other NTDs associated with poverty opening the opportunity to tackle them in an integrated and locally adapted manner.
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