Improved housing and environmental management, safer occupational practices, targeted behavioural change, and strengthened access to timely care, will help prevent snakebites that affect rural and agrarian populations in low- and middle-income countries, a new study has found.

The authors said, “While clinical management and antivenom availability have received increased attention, far less emphasis has been placed on synthesising the upstream behavioural, environmental, occupational, and socioeconomic circumstances that shape snake–human conflict and lead to snakebite.”

According to the World Health Organisation (WHO) snakebite is a neglected public health issue in many tropical and subtropical countries. Most of these occur in Africa, Asia and Latin America.

Figures produced by the WHO say in Asia, up to 2 million people are envenomed by snakes each year, while in Africa there are an estimated 435 000 to 580 000 snake bites annually that need treatment.

Envenoming affects women, children and farmers in poor rural communities in low- and middle-income countries.

The highest burden occurs in countries where health systems are weakest and medical resources sparse.

“Bites by venomous snakes can cause acute medical emergencies involving severe paralysis that may prevent breathing, cause bleeding disorders that can lead to fatal haemorrhage, cause irreversible kidney failure and severe local tissue destruction that can cause permanent disability and limb amputation,” the WHO added, “stating that, “children suffer more severe effects and can experience the effects more quickly than adults due to their smaller body mass.”

The authors in the study, “Behavioural and environmental risk factors associated with snake–human conflict: A scoping systematic review,” published on August 6, 2026, by PLOS Neglected Tropical journal, said, “although clinical management and antivenom therapy have historically dominated snakebite research, comparatively less attention has been directed toward upstream determinants of risk.

“In particular, the behavioural and environmental circumstances that shape snake–human interactions have not been comprehensively mapped. Existing studies point to a complex interplay of environmental, occupational, behavioural, and socioeconomic factors that influence when, where, and how snake–human conflict occurs,” the study said.

The authors, however, noted that, “evidence remains fragmented, context-specific, and unevenly distributed across regions, making it difficult to derive a consolidated understanding of the circumstances associated with snake–human conflict, especially in high-burden settings.”

The study said environmental conditions play a central role in shaping snakebite risk and snake–human encounters, adding that, “seasonal patterns, particularly during monsoon and post-monsoon periods (in India), have been consistently associated with increased snakebite incidence.”

They also pointed to flooding displacement of both human populations and snakes, which come to increase the probability of contact, adding that, “In India and Southeast Asia, snake activity peaks during rainy seasons when prey availability increases and human agricultural activity intensifies.

The study mentioned evidence from Tamil Nadu, India, which show that more than 70% of snakebite cases occurred between June and September.

In addition, land-use changes, including deforestation and habitat degradation, further contribute to snake displacement into human settlements, intensifying opportunities for snake–human conflict.

“Geographical and housing-related environmental features, including proximity to forests, rice paddies, water bodies, and poorly maintained dwellings have been identified as high-risk settings for snake encounters. Rural housing characterised by mud floors, open ventilation, and thatched roofing facilitates snake entry into living and sleeping spaces,” the study said.

The authors said that a case–control study from Bangladesh demonstrated that sleeping on the floor increased the risk of snakebite by more than fourfold. But, they were quick to point out that, “these environmental circumstances vary across ecological zones, climatic conditions, and snake species distributions, underscoring the need to systematically map context-specific patterns rather than assume uniform risk profiles.”

Research for the study synthesized data from 142 studies documenting over 200,000 snakebites worldwide as far back as the 1800s.

This review found that snakebite is strongly related to occupation, with nearly 70% of cases occurring during outdoor work such as farming and construction, and also to timing, with most cases occurring during rainy seasons and during the evening and early night hours.

Snakebite cases were also found to be correlated with factors related to poverty, such as lack of adequate footwear, poorly secured homes, and limited access to healthcare education.

“These results highlight areas where targeted policies might significantly reduce the risk of snakebite, including the realms of workplace safety, rural development, housing improvement, and health education,” the authors said.

They also pointed out that, their dataset is limited, being mostly focused on South Asia and suffering from inconsistent reporting of variables involved in each snakebite incident, and that future studies should focus on filling these gaps to form a more comprehensive global understanding of factors related to snakebite.

The authors said, “The scoping review told us something we needed to hear, limiting ourselves to antivenom will never address the behavioural and environmental factors that put people at risk in the first place.”

“The inverse care law is particularly relevant to snakebite; the people most exposed to snakes — because of where they live and the work they do — are also the people furthest from a hospital that can treat them. You cannot fix that gap with antivenom alone; antivenom sits at the wrong end of the problem,” they added.

Just about the time that this study was published, a historic resolution was led by the Republic of Malawi, alongside a core group of African member states including Burkina Faso, Kenya, Tanzania, the Gambia and Morocco, which for the first time, formally addressed the issue of Neglected Tropical Diseases (NTDs), with a Human Rights Council resolution – elevating them beyond the health sector and recognizing them as issues of dignity, equity, inclusion, and justice.

Since snakebite is considered an NTD, it is hoped that governments across Africa will take the lead to prevent this in the rural areas especially.

The adoption of the resolution is expected to help elevate these diseases within global and national policy agendas, thereby strengthening accountability.

It will also reinforce the links between health and human rights, in order to mobilize greater political will and resources to accelerate progress towards elimination.

The idea behind the resolution was to draw attention to the fact that, in addition to significant mortality and morbidity – approximately 120,000 deaths and 14.1 million disability adjusted life years (DALYs) lost annually, NTDs cost developing communities the equivalent of billions of dollars each year in direct health costs.

It has also led to the loss of productivity and reduced socioeconomic and educational attainment.

They are also responsible for other consequences such as disability, stigmatization, social exclusion and discrimination, and place considerable financial strain on patients and their families.

Hopefully, policy makers would combine the result of the study, and the adoption of the resolution, to quicken the fight against snakebites which is long overdue.

By FRANCIS KOKUTSE