Protection against Snake Bites by Sleeping under a Bed Net in Southeastern Nepal

François Chappuis Travel and Migration Medicine Unit, and Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Medicine, and Department of Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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Sanjib K. Sharma Travel and Migration Medicine Unit, and Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Medicine, and Department of Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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Nilhambar Jha Travel and Migration Medicine Unit, and Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Medicine, and Department of Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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Louis Loutan Travel and Migration Medicine Unit, and Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Medicine, and Department of Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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Patrick A. Bovier Travel and Migration Medicine Unit, and Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland; Department of Medicine, and Department of Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

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Snake bites in persons while they are asleep indoors are associated with a high risk of fatal outcome in southeastern Nepal. The preventive impact of sleeping under a bed net was assessed in four villages in a case-control study. A case was defined as a person with a history of snake bite that occurred indoors while asleep. Cases were matched with controls by village, type of household, sex, and age category. Of the 11,176 households visited, 56 cases, including 13 (23%) with a fatal outcome and 56 controls were included in the analysis. Sleeping under a bed net was a strong protective factor (odds ratio = 0.02, 95% confidence interval = 0.007–0.07, P < 0.0001), whereas the place of sleeping in the household and the use of a cot were not associated with the risk of snake bite. These findings provide further support for use of bed nets in this region.

Author Notes

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