Results
bite, snakebites, co-morbidities, snakebite
RECRUITMENT
The intervention group consisted of 22 divisional hospitals and two base hospitals. Each hospital sent two to three healthcare professionals, including first-contact physicians and nurses, to the workshop. Compared to base hospitals, which have much greater staff numbers, divisional hospitals had a higher percentage of staff attending the training, with a representation of > 30% of the hospital's clinical staff and, in some cases, up to 100% [the median number of doctors working in the divisional hospitals was 3 and nursing officers were 6].Fifty participants from interventional hospitals participated in the training workshop. The pre-test results for the initial evaluation were available for all the participants. For the subsequent analysis, only 34 post-test results were available, as 16 participants left the workshop just before the post-test to attend to their official duties or personal commitments. However, they were present during the whole workshop, which ran into both the morning and afternoon of the day. After the workshop, Knowledge had improved significantly from a pre-test median score of 16/40 (IQR: 10.25–20) to a post-test median score of 23.5/40 (IQR: 18.25–28) (Within the intervention group of hospitals, in-house education was provided by staff who attended the workshop in all but two hospitals. Those two hospitals were among the four hospitals excluded from the cluster analysis as they had no snake bite admissions. Furthermore, it was estimated that more than 90% of the staff in each hospital were engaged in the in-house interactive sessions.After one year of follow-up, the primary analysis included 1021 snakebite cases from 20 intervention hospitals and 1165 cases from 17 control hospitals. There were 107 patients (10.5%) in the intervention group and 142 (12%) patients in the control group who reported comorbid medical conditions. The total number of co-morbidities was reported either as sole manifestations or in combination, without taking into account the differences in patient baseline characteristics of age, gender, and type of bite reported (Tables Baseline Characteristics of Snakebite patients admitted to study Hospitals in Kurunegala District of Sri LankaBaseline characteristics of co-morbidities of patients with snakebites in the study hospitals in Kurunegala district
Hospital outcomes of snakebite patients admitted to primary Hospitals in Kurunegala District in North Western Province of Sri LankaFour hospitals in the intervention group and three hospitals in the control group did not have cases of snakebite and were subsequently excluded from the cluster analysis (Fig. Consort flow diagram Recruitment flow chart of clusters and participants; a hospital-based educational intervention program to improve the snakebite management in Primary Hospitals