Antivenom therapy in Brazil: efficacy, traditional practices, and access to antivenom mediated by digital technologies.
Snakebite envenoming; antivenom serum; pre-hospital practices; geoprocessing; web platform.
Snakebite envenoming is a major Neglected Tropical Disease (NTD) responsible for substantial morbidity and mortality across several regions of the world, particularly affecting vulnerable populations living in low-income resource tropical and subtropical countries. In Brazil, although antivenom therapy is available through the Unified Health System (SUS), geographic, structural, and informational barriers may still hinder timely access to specialized care. In this context, we investigated multiple dimensions related to the management of snakebite envenoming in the country through an integrative approach that combines biological, sociocultural, and geospatial data. First, the scientific literature was reviewed to analyze the preclinical efficacy of Brazilian antivenoms and the traditional first-aid practices used in envenoming cases. Subsequently, public administrative records were systematized to construct a georeferenced database containing information on healthcare facilities providing antivenom therapy in Brazil. Based on this dataset, we developed and published the digital platform RODA (Road to Antivenom), an interactive web-based system that integrates validated geospatial data for 1,944 healthcare facilities across the five Brazilian regions, along with epidemiological indicators, to facilitate the identification of facilities capable of providing clinical management of snakebite envenoming. Additionally, spatial analyses revealed regional discrepancies between population-based and territorial healthcare facility density, with the North showing the highest density per population (2.20/100,000) but the lowest per area (0.99/10,000 km²), whereas the South and Southeast exhibited the opposite pattern, with lower population-based densities (1.29 and 0.53/100,000) and higher territorial densities (6.67 and 4.86/10,000 km²), respectively, highlighting a marked regional asymmetry in the Brazilian antivenom distribution network.