What are the characteristics and where is the highest risk of snakebite accidents in the state of São Paulo?

Objectives: To understand the pattern of snakebite envenomation, the objective was to describe accidents and deaths by snake genus, age group, sex, race/ethnicity, education level, place of residence and occurrence, seasonality, vegetation cover, and to identify spatial clusters with a higher risk of accidents in the state of São Paulo.

Methods: A descriptive study using data from the Notifiable Diseases Information System (SINAN) on snakebite accidents between 2010 and 2022. The Getis-Ord Gi* index was applied to identify high- and low-risk clusters.

Results: Bothropic accidents predominated (61.5%), affecting men (78.7%), whites (64.7%), adults aged 20-59 years (67.1%), and individuals with low education levels (63.4%). Most accidents occurred in urban areas (55.7%), while deaths were more frequent in rural areas (68.1%), with longer treatment delays. Incidence remained stable, increasing during hot and rainy periods. Many cases were not autochthonous, and vegetation type influenced accident patterns: Bothrops in dense and humid areas, Crotalus in dry and open regions, and Micrurus in both. Spatial analysis highlighted areas of higher and lower risk, varying by accident type.

Conclusions: Identifying the most affected population, seasonality, and high-risk areas provides essential support for preventive actions and effective management. The findings can guide efforts towards vulnerable populations, anticipate preventive strategies during high-incidence periods, and optimize resources, such as professional training and antivenom serum distribution in high-risk regions.