Table 1.

Chronic health effects of snake bites.

No	Authors	Location	Long term health effects
			Physical	Psychological
1	Caiaffa et al. (1994)	Southeast Brazil	•Muscle contractures •Amputations •Chronic renal failure	Not reported
2	Sharma et al. (2004)	South Eastern Nepal	•Scar with deformity •Chronic wound	Not reported
3	Kidmas et al., 2004	Jos, Nigeria	•Gangrene •Amputation	Not reported
4	Bell et al. (2010)	Teaching Hospital, Kurunegala, Sri Lanka	•Abnormal nerve conduction	Not reported
5	Williams et al. (2011)	North Central Province, Sri Lanka	•Blindness •Tooth decay •Body aches •Headaches •Tiredness •Weakness.	•Depressive disorder •Post-traumatic stress disorder
6	Khosrojerdi and Amini (2013)	Imam Reza Hospital, Iran	Not reported	•Post-traumatic stress disorder
7	Spano et al. (2014)	UCSF-Fresno Medical Education Program Medical Centre, Fresno Central California	•Localised pain at bite site •Numbness/paraesthesiae •Abnormal skin peeling and discolouration •Persistent weakness of the bitten extremity	Not reported
8	Wijesinghe et al. (2015)	District General Hospital, Polonnaruwa, Sri Lanka	Not reported	•Depression •Anxiety
9	Habib et al. (2015)	Northeastern Nigeria	Not reported	•Post-traumatic stress disorder •Impaired family/school functioning •Psychological morbidity
10	Jayawardana et al. (2016)	Ampara, Sri Lanka	•Local pain in affected limb •Swelling of affected limb •Muscle wasting •Chronic non-healing ulcer •Chronic lump •Reduced muscle power •Reduced range of motion •Balance impairment •Abnormal gait •Fixed deformities •Amputation	Not reported
11	Naqvi (2016)	Sindh Institute of Urology and Transplantation, Karachi, Pakistan	•Chronic kidney disease	Not reported
12	Tsai et al., 2017	Chia-Yi Chang Gung Memorial Hospital in Taiwan	•Necrotizing fasciitis	Not reported
13	Islam et al., 2017	Rangamati Sadar Hospital, Rangamati, Bangladesh	•Numbness •Severe asthenia •Tingling •Generalized pain •Localised pain	•Depression •Post-traumatic stress disorder •Anxiety
14	Naik et al. (2018)	Chandigarh, India	•Chronic pituitary failure	Not reported
15	Yerawar et al. (2020)	Nanded, India	•Hypopitiutarism	Not reported
16	Proby et al. (1990)	London, UK	•Anterior Pituitary Faliure	Not reported
17	Jayawardana et al. (2018)	Ampara, Sri Lanka	•Migraine-like syndrome •Musculoskeletal disorders •Visual impairment •Chronic renal failure •Skin blisters at the bite site •Hemiplegia •Facial palsy •Local paresthesia •General shivering •Chronic non healing ulcer •Hearing loss •Excessive hair loss •Lassitude with body aches •Abdominal colic •Chest tightness •Wheezing •Receding gums	•Psychological distress
18	Arias-Rodríguez and Gutiérrez (2020)	South-eastern (Brunca region) Costa Rica	•Functional limitation of affected limb •Amputation	•Anxiety •Depression •Post-traumatic stress disorder
19	Brenes-Chacon et al. (2020)	National Children's Hospital in Costa Rica	•Hypertrophic scars needing skin graft •Functional limitation of affected limb •Deformity •Amputation	Not reported
20	Sachett et al. (2020a)	Brazil	•Disability in mobility	•Poor cognition •Disability in self-care, getting along, impact in life activities, participating in society
21	Pucca et al. (2020)	Las Claritas Bolívar, Venezuela	•Chronic Kidney Disease	Not reported
22	Pulimaddi et al. (2017)	India	•Chronic Kidney Disease	Not reported
23	Priyamvada et al. (2019)	Puducherry, India	•Chronic Kidney Disease	Not reported
24	Alcoba et al. (2020)	Akonolinga health district, Centre Region, Cameroon	•Amputation of distal phalanges •Ankylosis of phalanges •Tingling •Chronic recurrent pain	•Subjective psychological trauma
25	Kumar et al. (2018)	Malabar, North Kerala, India	•Hypopituitarism •gangrene and amputation •Osteomyelitis •Intracranial hemorrhage and cerebrovascular accidents	Not reported
26	Brenes et al. (2018)	National Children's Hospital, Costa Rica	•Chronic lymphedema, •Functional impairment	Not reported
27	Pérez-Gómez et al. (2019)	Western Brazilian Amazon	•Haemorrhagic stroke	Not reported
28	Sachett et al. (2020a)	Guajará (Amazonas state), Western Brazilian Amazon	•Haemorragic stroke	Not reported
29	Kim et al. (2021a)	Chungnam National University Hospital, Daejeon, Korea	•Skin necrosis •Rhabdomyolysis	Not reported
30	van Oirschot et al. (2021)	Kajiado and Kilifi counties. Kenya	•Pain and numbness •Weakness or paralysis of the bitten area •Scarring •Amputation or permanent disability •Recurrent swelling •Recurrent wounds •Dizziness •Sleeping and breathing problems •Functional disability	Not reported
31	Kularatne (2002)	Anuradhapura, Sri Lanka	•Nerve conduction defects •Sensory loss at the site of bite •Bilateral ulnar nerve palsy with wasting of small muscles of the hands •Sensory motor neuropathy •Cerebella ataxia
32	Corneille et al. (2006)	Texas, USA	•Amputation	Not reported
33	Yates et al. (2010)	Meserani, Tanzania	•Amputation	Not reported
34	Herath et al. (2012)	Kandy, Sri Lanka	•Chronic Kidney Faliure	Not reported
35	Namal Rathnayaka et al., 2020	Sri Lanka	•Chronic Kidney disease	Not reported
36	Seneviratne and Dissanayake (2002)	Ratnapura and Polonnaruwa, Sri Lanka	•Peripheral sensory loss	Not reported
37	Elbey et al. (2017)	Diyarbakır, Turkey	•Amputation	Not reported
38	Weinstein et al. (2018)	Australia	•Amputation	Not reported
39	Zeng et al. (2019)	Chongqing, P.R. China	•Skin necrosis •Rhabdomyolysis	Not reported
40	Halilu et al. (2019)	Sub-Saharan Africa	•PTSD •Amputations	Not reported
41	Gerardo et al. (2019)	Southeastern United States	•Functional disability	Not reported
42	Banerjee et al. (2019)	India	•Cerebella ataxia	Not reported
43	Lizarazo et al. (2020)	Catatumbo, Colombia	•Cerebral hemorrhage	Not reported
44	Srirangan et al. (2020)	Kalubowila, Sri Lanka	•Gangreen leading to amputation •CRF	Not reported
45	Habib et al. (2021)	North-eastern Nigeria	Not reported	•Posttraumatic stress disorder •Poor QoL in psychological and social domains •Impaired family/school functioning •Psychological morbidity
46	Kazemi et al. (2021)	Iran	•Fasciotomy related long term morbidity	Not reported
47	Jelinek et al. (1998)	Nedlands, Western Australia	•Renal insufficiency	Not reported
48	Chroni et al. (2005)	Rion-Patras, Greece	•Neuropathy	Not reported
49	Sinha et al. (2009)	Kolkata, India	•Chronic Kidney Disease	Not reported
50	Golay et al. (2014)	West Bengal, India	•Chronic Kidney Disease •Hypopituitarism	Not reported
51	Mahmood et al. (2018)	Mandalay Division, Myanmar	•Chronic renal failure •Chronically infected bite site wound •Hypopituitarism •Loss of a limb from amputation	Not reported
52	Lee and Yao (2010)	Arizona, USA	•Stenosing flexor tenosynovitis	Not reported
53	Bonasso et al. (2015)	West Virginia, USA	•Osteonecrosis at bite site	Not reported
54	Gelman et al. (2021)	Texas, USA	•Septic arthritis at bite site	Not reported
55	Dhabhar et al. (2021)	India	•B/L axonopathic Optic neuritis	Not reported
56	Pérez-Gómez et al. (2019)	Western Brazilian Amazon	•Haemorrhagic stroke •Temporal hemianopsia •Headache •Tissue necrosis •Retinal haemorrhages •Skin ulcers •Visual defects •Hemipareisis	Not reported
57	Abraham et al. (2020)	Kerala, India	•Muscle and joint weakness	Not reported
58	KIm et al. (2021b)"	Republic of Korea	•Local tisssue necrosis •Scarring	Not reported
59	Gupta et al. (2021)	Delhi, India	•Neuromuscular weakness	Not reported