CLINICAL AND EPIDEMIOLOGICAL PROFILE OF SNAKEBITE PATIENTS PRESENTING TO A TERTIARY REFERRAL EMERGENCY DEPARTMENT IN EAST JAVA, INDONESIA
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Abstract
Background. . Indonesia carries one of the highest snakebite burdens in Southeast Asia, yet national epidemiological data are scarce and derive almost entirely from isolated hospital reports. This study aims to describes the clinical and epidemiological profile of snakebite patients presenting to the emergency department (ED).
Research Method. A descriptive observational study was conducted on all 82 snakebite patients who presented between January and December 2025, identified by total sampling from the ED register and medical records of Dr. Saiful Anwar General Hospital, Malang. The variables evaluated included demographic characteristics, reported snake type, clinical manifestations classified using standard envenoming criteria, emergency department disposition, and short-term outcomes.
Findings. Bites attributed by patients to green snakes, consistent with Trimeresurus species, accounted for 46 cases (56.1%). Majority patients presented without symptoms or with mild local manifestations only (29 asymptomatic, 35.4%; 33 mild local, 40.2%), whereas severe local and systemic envenoming occurred in 11 (13.4%) and 7 (8.5%) patients respectively. Sixty-one patients (74.4%) were discharged after ED observation, for a median of 5.10 hours (interquartile range 3.55–6.60), and 21 (25.6%) were admitted, of whom 12 (57.1%) received antivenom. The median length of stay was 3 days (interquartile range 3–4). Readmission within 48 hours occurred in 4 discharged patients (6.6%) and one death was recorded (1.2%).
Conclusion. The profile is dominated by green pit viper bites of low initial severity, a pattern for which the nationally available polyvalent antivenom offers no coverage.
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