Challenges in paediatric snakebite management: physician perspectives from rural Sri Lanka

Purpose

This study aims to explore the challenges encountered by paediatric emergency care teams in managing snakebite cases in children across three major referral hospitals in Sri Lanka.

Methods

A qualitative exploratory study was conducted using focus group discussions (FGDs) with physicians who manage paediatric snakebites from Polonnaruwa and Trincomalee District General Hospitals, Kurunegala Teaching Hospital, and peripheral hospitals in the same districts. Thematic analysis was used to identify key challenges related to clinical decision-making, access to healthcare services, availability of antivenom and medical supplies, capacity building, interdisciplinary collaboration, and policy-related issues.

Results

Several challenges were identified, including delays in seeking medical care due to community misconceptions, limited access to antivenom in peripheral hospitals, inadequate intensive care facilities, and gaps in clinical training. Variability in clinical decision-making and the absence of standardized paediatric treatment guidelines further complicated management. Participants emphasized the need for interdisciplinary collaboration, improved referral networks, and targeted educational interventions to address these gaps.

Conclusions

Paediatric snakebite management in Sri Lanka is hindered by systemic, infrastructural, and educational challenges. Strengthening healthcare infrastructure, ensuring equitable access to antivenom, implementing standardized treatment protocols, and enhancing training programs for healthcare providers are crucial steps in improving patient outcomes. Policy-level interventions and community education initiatives are necessary to mitigate delays in care-seeking and enhance awareness.