SNAKEBITE MORTALITY IN COSTA-RICA

The mortality rate due to snakebite envenomation in Costa Rica was est imated from 1952 to 1993. The highest mortality was observed during th e 1950s and 1960s, with the highest rate of 4.83 per 100,000 populatio n in 1953. In contrast, a rate of 0.2 per 100,000 population per year was estimated from 1990 to 1993. The most conspicuous decline in morta lity occurred after 1970. The highest mortality rates were observed in the provinces of Limon and Puntarenas, especially in regions where tr opical rain forests had been transformed into agricultural fields. The lowest mortality was in the province of Guanacaste, where tropical dr y forest predominates and Bothrops asper (terciopelo), the most import ant poisonous snake in the country, is not abundant. The majority of f atalities occurred in the age groups from 10 to 19 years old. Males we re more affected than females in a ratio of 3.6:1. Before 1980 most fa tal cases did not receive medical attention in hospitals, whereas afte r 1980 the majority of cases with fatal outcome were attended in hospi tals. (C) 1997 Elsevier Science Ltd.