Using geographical information systems to identify populations in need of improved accessibility to antivenom treatment for snakebite envenoming in Costa Rica

PLoS Negl Trop Dis. 2013;7(1):e2009. doi: 10.1371/journal.pntd.0002009. Epub 2013 Jan 31.


Introduction: Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper. The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. In many regions of the world, insufficient health care systems and lack of antivenom in remote and poor areas where snakebites are common, means that efficient treatment is unavailable for many snakebite victims, leading to unnecessary mortality and morbidity. In this study, geographical information systems (GIS) were used to identify populations in Costa Rica with a need of improved access to antivenom treatment: those living in areas with a high risk of snakebites and long time to reach antivenom treatment.

Method/principal findings: Populations living in areas with high risk of snakebites were identified using two approaches: one based on the district-level reported incidence, and another based on mapping environmental factors favoring B. asper presence. Time to reach treatment using ambulance was estimated using cost surface analysis, thereby enabling adjustment of transportation speed by road availability and quality, topography and land use. By mapping populations in high risk of snakebites and the estimated time to treatment, populations with need of improved treatment access were identified.

Conclusion/significance: This study demonstrates the usefulness of GIS for improving treatment of snakebites. By mapping reported incidence, risk factors, location of existing treatment resources, and the time estimated to reach these for at-risk populations, rational allocation of treatment resources is facilitated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Antivenins / therapeutic use*
  • Child
  • Child, Preschool
  • Costa Rica / epidemiology
  • Female
  • Geographic Information Systems*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Risk Factors
  • Snake Bites / epidemiology*
  • Snake Bites / therapy*
  • Snake Venoms / toxicity*
  • Topography, Medical*
  • Young Adult


  • Antivenins
  • Snake Venoms

Grants and funding

The Swedish Society of Medicine supported this study by granting a travel grant for Erik Hansson to go to Costa Rica to perform the study. This grant consisted of approximately $2000. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors did not receive any specific funding.