02664nas a2200253   4500000000100000008004100001260001200042653001900054653001400073653001300087653001300100653001400113653001600127100001900143700001100162700001500173700001200188245009600200856022000296300001100516490000900527520186000536022001402396       2021                            d  c07/202110aAccess to care10aAntivenom10aCOVID-1910aPandemic10aSnakebite10aVentilators1 avan Oirschot J1 aOoms G1 aWaldmann B1 aKadam P00aSnakebite incidents, prevention and care during COVID-19: Global key-informant experiences.  uhttps://reader.elsevier.com/reader/sd/pii/S2590171021000114?token=2BF277D354911711ACFCB995458BC1DADFD04AC3762DCFB9E19AADC146C446225C9E69D5745BFB85AB1C57CA7B76B85A&originRegion=eu-west-1&originCreation=20210818102626  a1000750 v9-103 a<p>Snakebite envenoming is a long-neglected disease causing significant morbidity and mortality in snakebite endemic low- and middle-income countries (LMICs). Global awareness on snakebite was increasing steadily up to 2020, and an increasing number of countries began to acknowledge the issue, when coronavirus disease 2019 (COVID-19) started to have an unprecedented impact on societies and health systems. To better understand how snakebite incidents, prevention and care are being affected during this global emergency, we collected perspectives of snakebite community- and health system stakeholders in a qualitative key-informant study. An open-ended survey and semi-structured interviews were conducted to gather information on changes in snakebite occurrence and circumstances, community responses, access to care and health outcomes in LMICs since the COVID-19 pandemic. Forty-three informants from 21 countries participated in the study. Based on informants' experiences, in spite of COVID-19 lockdowns, exposure to snakes did not change in many rural agrarian communities, where incidences are usually highest. However, we did find several access to care issues relating to avoidance of formal care, transport barriers, overburdened healthcare systems and -providers, and antivenom manufacturing and supply disruptions, which were unique per context. On a brighter note, ventilator availability had increased in several countries, although not automatically benefitting snakebite patients directly. In conclusion, we found apparent effects of the COVID-19 pandemic on snakebite prevention and care, although its severity was highly context- and time-dependent. Interactions between the pandemic effects and snakebite incidents most severely impact remote rural communities, showing the need to invest in community-based prevention and care.</p>  a2590-1710