# Using community health centers to mitigate the impact of snakebite envenoming in low resource areas

> **NIH NIH R21** · DUKE UNIVERSITY · 2021 · $234,520

## Abstract

Abstract
Globally, more than 90% of all snakebite envenomation (SBE) occur in low resource settings.
This neglected tropical disease, affects 2.7 million people, with 81,000-138,000 deaths, and
approximately 400,000 permanent disabilities annually. Antivenom is a safe, efficacious, time-
dependent, and evidence-based treatment, but the availability and timely access to this
standard of care is inadequate. It is critical to engage local communities to improve timely
access in remote, low resource areas where most SBE morbidity occurs. This proposal will
develop and evaluate an innovative multi-modal intervention to improve SBE care, including
decentralized antivenom distribution among the existing community healthcare center (CHC)
network in the Brazilian Amazon. This novel intervention will integrate (a) advanced geospatial
artificial intelligence to create decentralized antivenom distribution models using existing CHCs
that optimizes population coverage and time to reach care, (b) a cost-effectiveness evaluation
model developed with key stakeholders, and (c) a culturally relevant SBE care package
containing education, treatment guidelines, training on antivenom delivery and interfacility care
coordination. Using the Consolidated Framework for Implementation Research, we will conduct a
formative evaluation of this multi-modal intervention and prepare an implementation strategy for the
Brazilian Amazon, as well as prepare to scale up to other low resource locations. Consequently, we
will have a standardized approach to use advanced analytics to optimize healthcare delivery in low
resource settings that can be used in other countries and with other healthcare interventions.

## Key facts

- **NIH application ID:** 10288091
- **Project number:** 1R21TW011944-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Charles John Gerardo
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $234,520
- **Award type:** 1
- **Project period:** 2021-07-12 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10288091

## Citation

> US National Institutes of Health, RePORTER application 10288091, Using community health centers to mitigate the impact of snakebite envenoming in low resource areas (1R21TW011944-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10288091. Licensed CC0.

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