Prevalence of Snake Envenomation History among Patients of Chronic Kidney Disease of Unknown Origin in Wilgamuwa Divisional Secretariat, Matale District, Sri Lanka

Abstract

Background: Snake envenomation and Acute Kidney Injury (AKI) following snake bite is more common among rural, agricultural workers in resource-poor community settings. Therefore, it is an additional risk factor for the occurrence of CKD in dry zone agricultural areas where the Chronic Kidney Disease of unknown origin (CKDu) is prevailing. Objectives: To assess the prevalence of snake envenomation history in CKDu diagnosed patients in Wilgamuwa, Sri Lanka. Methods: This was a cross-sectional study which was carried out among 293 CKDu diagnosed patients in Wilgamuwa Divisional Secretariat, Matale district, Sri Lanka. Random sampling technique was used when selecting participants for the study and an interviewer administered data collection form applied to collect the data from the patients. Results: Majority of the study participants were male (n=222; 75.8%). The study population ranged from 25 to 65 with the mean age of 53.5±8.3 years. Among that, 28.3% (n=83) patients reported with at least one event of snake envenomation before CKDu disease diagnosed period. An increased risk of snake envenomation is presented among farmers than non-farmers (RR=1.211; CI=0.836-1.754). Most common types of identified envenomation were Russell’s viper, Sri Lankan Cobra, Hump Nosed Viper and Common Krait as 32.5%, 13.2%, 6.02% and 16.9%, respectively. However, 31.3% of the patients reported with other types of snake envenomation and unidentified snake attacks. Conclusion: Prevalence of snake envenomation is significantly high among CKDu patients who are farmers. Hence, it can be accounted as an occupational hazard for CKDu patients, which can indirectly affect their future medical conditions.