Reading Part A

Snake Bite in South Asia

Part A Summary Gap Fill Time Limit: 15 minutes

Instructions
• Complete the following summary using the information in the texts for this
task.
• Skim and scan the texts to find the information required.
• Gaps may require 1, 2 or 3 words.
• Write your answers in the appropriate space in the column on the right hand
side.
• Make sure your spelling is correct.
Summary Answers
1.

Snake bite is one of the most neglected public health

2.
issues in poor rural communities living in South East
Asia. Yet this creature has been both (1)____ and 3.
(2)____since the earliest of times. To Hindus and
(3)____, it is considered to be (4)____. Despite 4.

being revered, however, there are (5)____ in the

5.
South Asia region than anywhere else in the world.

6.
There are many reasons for this situation including
(6) ____, extensive agricultural activities, lack of 7.
snake bite control programs and the fact that many of
the snakes are (7)____. 8.

9.
According to recent studies on the characteristics of
victims, (8) ____are twice as likely to be bitten as 10.
(9)____ and the average age of those bitten by a
snake is (10)____. While (11)_____ and (12)____ 11.
are commonly bitten, over 50% or the victims are
farmers. 12.

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Part A Answer Sheet continued

Summary Answers
13.
The (13) ____ is dependent on the species, and
Cobra bites usually occur during the (14)____ while 14.
(15) ____are more frequent at night. (16)____ of
bites occur on the foot, ankle or leg. 15.

16.
Regarding treatment, it (17)____by most experts that
snake bite victims require urgent transportation to a 17.
medical centre for clinical(18)_______ by
experienced medical staff. This fact is supported by 18.
research in (19) ____which confirmed that there is
19.
an increased risk of complication if antivenom
administration (20) _____. Unfortunately most
20.
studies also show that (21)____ snake bite victims
reach a health centre in less than one hour. To make 21.
matters worse, over half of snake bite victims
received (22)____ and (23)____ first aid, such as 22.
tourniquets which if left on for (24)____can cause
23.
severe local damage.

24.
The number of snake bites could be reduced if
prevention strategies were implemented. For 25.
example, many bites occur when people walk
(25)____ and step on a snake (26)____. Protective 26.
clothing such as boots and long pants should be worn
27.
when doing (27) ____The removal of (28) ____and
(29)____ from the surroundings of human dwellings
28.
can also help reduce snake populations.
29.

TOTAL SCORE

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 Reading Part A
 
Part A
Time Limit: 15 minutes
Instructions
• Complete the summary on the answer page using the information in the four
texts below.
• Skim and scan the texts to find the information required.
• Write your answers in the appropriate space in the column on the right hand
side.
• Make sure your spelling is correct.

Snake Bite in South Asia

Source: Public Library of Open Science
Authors: Alirol et al
Text 1

Background

There are more snake bites in the South Asia region than any where else in the world.
This is due to its high population density, widespread agricultural activities, numerous
venomous snake species and lack of functional snake bite control programs. However,
since ancient times, snakes have been worshipped and feared, in South Asia. Cobras
appear in many tales and myths and are regarded as sacred by both Hindus and
Buddhists. Unfortunately, snakes remain a painful reality in the daily life of millions
of villagers in this region. Indeed, although antivenom is produced in sufficient
quantities by several public and private manufacturers, most snake bite victims don’t
have access to quality care, and in many countries, both morbidity and mortality due
to snake bites are high.

Text 2

First aid

Most experts agree that snake bite victims should be transported as quickly as
possible to a medical centre where they can be clinically evaluated by qualified
medical staff, and where antivenoms are available. In fact, time of transport was
shown to be a crucial determinant of snake bite mortality in eastern Nepal, and studies
in southern India confirmed that delayed antivenom administration was associated
with an increased risk of complications. The bite victim should be reassured, the
bitten limb immobilized with a makeshift splint or sling, and the patient transported.
Walking is contraindicated, because muscular contractions promote venom
absorption. These traditional measures are strongly contraindicated as they are
ineffective and in most cases deleterious. For example, tourniquets cannot be safely
left on for long without risking severe local damage including ischemia, necrosis, and
gangrene

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Text 3
Table 1. Characteristics of snake bite victims in South Asia
Characteristic Detail
Age The mean age of snake bite victims is around 30 years.
Three-quarters of the victims are in the 10- to 40-year age
group, broadly in agreement with demography.
Gender There is a clear preponderance of males among snake bite
victims. A 2:1 male to female ratio is frequently observed.
Occupation Farmers account for more than half of the victims.
Students and housewives are also frequently bitten.
Time of Bite The time of bite depends on the relative abundance of
diurnal and nocturnal snakes. Krait bites generally occur
at night, whereas viper and cobra bites mostly occur
during daytime.
Site of bite 60%–80% of bites occur on the foot, ankle, or leg. Bites
on the head and trunk are mostly due to nocturnal species
biting sleeping people.
Delay between bite and The bite-to-treatment delay varies greatly, ranging from
treatment 30 minutes to 15 days. Most studies show that at least
60% of victims reach a health centre within six hours but
very few in less than one hour.
First aid methods In eight out of 15 studies, more than 50% of snake bite
victims used inappropriate and harmful first aid methods.
Tourniquets are used by up to 98% of patients, and cannot
be left on for too long without risking severe local damage
including ischemia, necrosis, and gangrene.
Mortality Mortality rates are highly variable, ranging from 0.5% to
58%. Most fatalities occur before reaching treatment
centres.

Text 4

Control and Prevention

In practice, strategies to control snake populations and to prevent snake bites are
nonexistent in South Asian countries. Many bites could be avoided by educating the
population at risk. Sleeping on a cot (rather than on the floor) and under bed nets
decreases the risk of nocturnal bites in Nepal. Rubbish and firewood, which attract
snakes, can be removed from the vicinity of human dwellings. Attempts can be made
to prevent the proliferation of rodents in the domestic and peridomestic area.
Thatched roofs, and mud and straw walls are favoured hiding places for snakes and
should be checked frequently. Many bites occur when people walking barefoot or
wearing only sandals accidentally step on a snake. Using a torch/ flashlight while
walking on footpaths at night, and wearing boots and long trousers during
agricultural activities, could significantly reduce the incidence of bites.

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 Reading Part A
 
Snake bite

Answer Sheet
1. worshipped
2. feared
3. Buddhists
4. sacred
5. more snake bites
6. high population density
7. venomous
8. males (must be plural)
9. females (must be plural)
10. 30(years)
11. students
12. housewives
13. time of bite
14. daytime/day
15. Krait bites
16. 60 to 80%
17. is agreed (use passive verb form)
18. evaluation (change adjective to noun)
19. Southern India
20. Is/was delayed (use passive verb form)
21. very few
22. inappropriate
23. harmful
24. too long
25. barefoot
26. accidentally
27. agricultural activities
28. rubbish
29. firewood

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Highlighted Answers

Snake Bite in South Asia

Source: Public Library of Open Science
Authors: Alirol et al
Text 1

Background

There are (5)more snake bites in the South Asia region than any where else in the
world. This is due to its (6)high population density, widespread agricultural activities,
numerous (7) venomous snake species and lack of functional snake bite control
programs. However, since ancient times, snakes have been (1)worshipped and
(2)feared, in South Asia. Cobras appear in many tales and myths and are regarded as
(4) sacred by both Hindus and (3) Buddhists. Unfortunately, snakes remain a painful
reality in the daily life of millions of villagers in this region. Indeed, although
antivenom is produced in sufficient quantities by several public and private
manufacturers, most snake bite victims don’t have access to quality care, and in many
countries, both morbidity and mortality due to snake bites are high.

Text 2

First aid

Most experts (17) agree that snake bite victims should be transported as quickly as
possible to a medical centre where they can be clinically (18)evaluated by qualified
medical staff, and where antivenoms are available. In fact, time of transport was
shown to be a crucial determinant of snake bite mortality in eastern Nepal, and studies
in (19)southern India confirmed that (20)delayed antivenom administration was
associated with an increased risk of complications. The bite victim should be
reassured, the bitten limb immobilized with a makeshift splint or sling, and the patient
transported. Walking is contraindicated, because muscular contractions promote
venom absorption. These traditional measures are strongly contraindicated as they are
ineffective and in most cases deleterious. For example, tourniquets cannot be safely
left on for long without risking severe local damage including ischemia, necrosis, and
gangrene

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 Reading Part A
 
Text 3
Table 1. Characteristics of snake bite victims in South Asia (2009)
Characteristic Detail
Age The mean age of snake bite victims is around (10)30 years.
Three-quarters of the victims are in the 10- to 40-year age
group, broadly in agreement with demography.
Gender There is a clear preponderance of (8)males among snake bite
victims. A 2:1 male to (9)females ratio is frequently observed.
Occupation Farmers account for more than half of the victims. (11)Students
and (12)housewives are also frequently bitten.
Time of Bite The (13)time of bite depends on the relative abundance of
diurnal and nocturnal snakes. (15)Krait bites generally occur at
night, whereas viper and cobra bites mostly occur during
(14)daytime.
Site of bite (16)60–80% of bites occur on the foot, ankle, or leg. Bites on
the head and trunk are mostly due to nocturnal species biting
sleeping people.
Delay between bite and The bite-to-treatment delay varies greatly, ranging from 30
treatment minutes to 15 days. Most studies show that at least 60% of
victims reach a health centre within six hours but (21)very few
in less than one hour.
First aid methods In eight out of 15 studies, more than 50% of snake bite victims
used (22)inappropriate and (23)harmful first aid methods.
Tourniquets are used by up to 98% of patients, and cannot be
left on for (24) too long without risking severe local damage
including ischemia, necrosis, and gangrene
Mortality Mortality rates are highly variable, ranging from 0.5% to 58%.
Most fatalities occur before reaching treatment centres.

Text 4

Control and Prevention

In practice, strategies to control snake populations and to prevent snake bites are
nonexistent in South Asian countries. Many bites could be avoided by educating the
population at risk. Sleeping on a cot (rather than on the floor) and under bed nets
decreases the risk of nocturnal bites in Nepal. (28)Rubbish and (29) firewood, which
attract snakes, can be removed from the vicinity of human dwellings. Attempts can be
made to prevent the proliferation of rodents in the domestic and peridomestic area.
Thatched roofs, and mud and straw walls are favoured hiding places for snakes and
should be checked frequently. Many bites occur when people walking (25)barefoot
and (26)accidentally step on a snake. Using a torch/ flashlight while walking on
footpaths at night, and wearing boots and long trousers during (27)agricultural
activities, could significantly reduce the incidence of bites.
 

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