The questionnaire was self-administered (unless people were unable to read/understand whereupon additional support was provided by one of the team members by reading the questions and recording their answers) and completed anonymously (no personal details were collected). ), most sparsely populated countries in the world, List of cities in Australia by population, List of population demographics of New South Wales by local government area, "Aussie Beer Drinking Market Goes Flat, Slumping to 65-Year Low", "Australia's population to hit 28 million by 2031: report", "Migration—Australian migration flows and population", "3302.0.55.001 – Life Tables, States, Territories and Australia, 2015–2017", "3218.0 - Regional Population Growth, Australia, 2018-19", "Indigenous rock shelter in Top End pushes Australia's human history back to 65,000 years", "When did Australia's earliest inhabitants arrive? [citation needed]. We are able to translate a wide range of languages including Tamil, Indonesia, Slovak, Italian, French, Chinese, German, Spanish, Portuguese, Japanese, and Vietnamese, etc. We thank Dr Malathi, Dr Chandrasekar, and Mr Hussain and all other friends, relatives and colleagues in various educational institutions in Tamil Nadu who provided their support at various levels during this campaign. e0008911. Overall, our approach provides a framework on how to educate rural communities about the dangers of SBE and thereby, mitigate delayed SBE treatment leading to an overall reduction in SBE-induced mortality, morbidity, treatment costs and other socio-economic ramifications. This will prevent the significant socio-economic burden on poor agricultural families caused by SBE. Trichy SRM Medical College Hospital & Research Centre, Tamil Nadu, India, Affiliation: A previous study gauged the awareness of essential first aid measures for SBE among medical students in Nepal [43]. [35][36] About 110 others are spoken exclusively by older people. It is based on fairly good data for the entire period. For example, time was a critical factor during these activities as we aimed to reach a significant number of locations within a short period. The data were analysed anonymously in order to categorise them for different parameters as discussed in the results section. The governments of India and Tamil Nadu have used this medium to disseminate information about the risk of smoking tobacco, cancer, cardiovascular diseases and, more recently, COVID-19. The specific actions are written in Tamil, and English translation is as provided in Fig 4 legend (from 1–14). And this quotient is higher than what any other country possesses (U.K: ⦠This exhaustive programme has also encountered some challenges. Moreover, views of the documentary reached around 14,000 on YouTube within two weeks of broadcasting [19]. Three best posters (judging criteria being the inclusion of key messages as well as creativity) were awarded with cash prizes (Rs 2,000 for first, Rs 1,500 for second and Rs 1,000 for third prize) in each institution. The hospital data were collected from 20th January until 31st December 2019. In 2012, the total fertility rate of Australian-born women was 1.94, while for overseas-born women, it was 1.81,[72] while in 2013, it was 1.91 and 1.79 respectively. The core public health message that we wanted to convey was that rapid action saves lives. This is of concern as women make up around 47% of agricultural labourers in rural India, and they are therefore noticeably not being reached via Facebook. By providing appropriate awareness about snakes and SBE among the rural population through a variety of approaches, we should be able to reduce SBE-induced complications and the resulting disabilities and deaths. The study locations were selected to cover a wide range of geographical regions (such as coastal, terrestrial, forest, dry and humid areas) across the state where agriculture is the predominant occupation. Captain James Cook claimed the east coast for Great Britain in 1770, the west coast was later settled by Britain also. Although Australia has no official language, English has always been entrenched as the de facto national language. Another factor is urbanisation, with 89% of its population living in a handful of urban areas, Australia is one of the world's most urbanised countries. Although the population as a whole is aware of the danger of snakes and snakebites (including venomous and dry bites), the majority of people, including some healthcare professionals, were not aware of how to respond to snakes or snakebites. B, age-wise classification of total number of victims admitted in the hospital in 2019 and 2018. All the prior arrangements (e.g. The population of Australia is estimated to be 25,741,800 as of 3 February 2021. A, the total number of victims admitted into the study hospital in 2019 (blue) and 2018 (red), and classification of numbers based on the offending snake species. Arumugam says that his organisation, with a dozen other Tamil associations, played an active role in getting Tamils in Australia to ⦠doi:10.1371/journal.pntd.0008911, Editor: José María Gutiérrez, Universidad de Costa Rica, COSTA RICA, Received: May 22, 2020; Accepted: October 22, 2020; Published: December 31, 2020. [19][21] Most immigrants are skilled,[22] but the immigration quota includes categories for family members and refugees.[22]. Only countries with 100,000 or more are listed here. Together, these data demonstrate the significance of using both traditional and social media to increase the reach of the campaign within a short period of time. Population by sex, states and territories, 30 June 1901 onwards", "Total Fertility Rate around the world over the last centuries", "3105.0.65.001 - Australian Historical Population Statistics, 2006.Table 42. In a selection of 20 participating institutions, poster competitions (prizes were announced for 3 best posters) were organised so that students could visually illustrate the knowledge that they had gained from our activities to their families, friends and relatives. [1] Australia is the 52nd most populous country in the world and the most populous Oceanian country. At the end of each session, our leaflets were distributed to all participants. Where the victims were minor (under 18 years old), the written consents were obtained from their parents or legal guardians. In 2018, this hospital received a total of 223 patients, which is significantly lower than in 2019. Also due to immigration, the European component's share of the population rose sharply in the late 18th and 19th centuries, but is now declining as a percentage. Over 250 Indigenous Australian languages are thought to have existed at the time of first European contact, of which less than 20 are still in daily use by all age groups. This study wouldn’t have been possible without the significant support from a number of people at various stages. Likewise, the age of SBE patients varied little between 2018 and 2019 (Fig 6B) with the majority of admissions observed in people of working age: 76.6% and 77.2% in 2018 and 2019 respectively were in people aged between 21 and 60. Contacts with media outlets were established through phone calls and emails, building on existing links with local journalists. Through direct public engagement activities, we aimed to reach around 0.5% (i.e. Aboriginal population density ranged from approximately one person per 3 km2 (1 sq mi) along the coasts to one person per 90 km2 (35 sq mi) in the arid interior. Furthermore, 303 questionnaires were collected from students in 10 selected institutions where previous activities had been conducted. [25][26] Australia has become a religiously diverse country with 22% being Catholic, 30% having no religion and there are significant numbers of Muslims, Buddhists, Hindus and others. 5–10 year-old children in primary schools, 11–15 year-old students in secondary schools, 16–18 year-old students in higher secondary schools, and 18 or above in colleges/universities. SBE is a disease of poor communities, predominantly affecting the lives of people living in rural areas of developing countries [3,36,37]. Historically the percentage has been far higher and the religious landscape of Australia is changing and diversifying. Snakebite envenomation (SBE) is a major neglected tropical disease that primarily affects poor communities living in rural areas of developing countries. We also analysed the recall of key messages of participants after only one year and this indicated that they still remember the majority of the information provided. The total number of bite victims admitted in 2019 was significantly (X2 = 8.9, df = 1, p = 0.003) higher than those admitted in 2018. Repeated and continuing activities (either directly through physical activities or indirectly via traditional and social media) in collaboration with local NGOs, healthcare professionals and relevant government officials will significantly enhance awareness about the dangers of SBE and essential first aid and protective measures. Furthermore, student responses to the study questionnaire after 12 months (n = 303) (green) were recorded. A similar ratio of bite admissions by gender was observed in 2018 with 58.7 to 41.2% male to female respectively. Among the contributing factors, lack of awareness of snakes and SBE was identified as the most critical factor in exacerbating SBE-induced complications, deaths, disabilities and/or increased treatment costs [8,12,13]. Venomtech Limited, Sandwich, United Kingdom, Affiliation: Our sincere thanks to all the media and social media who supported our campaign, specifically to Hameed from Puthiya Thalaimurai TV, Vinoth from The Federal, Soundar from Update News 360, Prashant from BBC Tamil and Veeramani from Puthiya Thalaimurai magazine. Interestingly, we noted that nearly 99% of the adverts’ impressions were via mobile phones. Covaimail, the Kovaiherald, and Kovai Media 24/7 [23]), state-level (e.g. While 40% students knew that Indian rat snakes (Ptyas mucosa) are non-venomous, around 60% students thought that rat snake would bite and inject venom using its tail. Notably, a popular Tamil television channel, Puthiya Thalaimurai, developed a 25-minute-long documentary by interviewing a scientist (SV) and clinicians (SPS, SC and Dr Ragunanthanan from Madras Medical College, India) [19]. Australia does not generally collect data on "race" as such. We are very grateful to Caroline Cross, Caroline Knowles, Katie Cooper, Tim Watkins, Pete Castle, and Tim Mayo at the University of Reading for their valuable guidance and support during the design of this study and preparation of leaflets and posters. In Australia, several first aid protocols and efficient SBE management protocols for emergency nurses/healthcare professionals have been produced [45] and they will no doubt play a key role in keeping Australia’s SBE mortality at its current, low level. Written informed consent was obtained from all the victims prior to data collection. In addition to lectures covering the clinical challenges faced by healthcare professionals treating SBE, workshops were held in order to answer the diverse questions from participants and to share current best practice. Numerous newspapers (both in Tamil and English), magazines, television and YouTube channels have disseminated the campaign’s key messages (e.g. A considerable proportion of first- and second-generation migrants are bilingual. These details will provide further evidence on the impact of our activities and actual changes in treatment seeking behaviour for SBE in the community. The videos, information leaflets and key messages were also shared via WhatsApp to numerous users in Tamil Nadu. The 2019 hospital admissions data subsequently recorded that 60% of the people arriving at this hospital with suspected snakebites were aware of our activities, all of whom had arrived within 4 hours. Note that population estimates in the table below do not include the Aboriginal population before 1961. Our analysis of key message inclusion in 50 posters indicated that all the students have emphasised the necessity to seek immediate medical attention following a snakebite. they seek hospital treatment only when the situation has become an emergency) [14,15]. To determine the efficacy of our activities in changing the behaviour of SBE victims and their relatives for seeking prompt hospital treatment, data from 291 patients who were admitted with suspected snakebites during 2019 at TCR Multispeciality Hospital were collected (Fig 6A). TCR Multispeciality Hospital, Krishnagiri, Tamil Nadu, India, Affiliation: The multidimensional activities reported in this study can be used as a framework to educate more people in rural areas of Tamil Nadu, and more widely in India and other developing countries where SBE is a major concern. Without our efficient team members, this programme would not have been possible to achieve within a year, and therefore manpower is another critical factor in designing and executing this type of study. PLOS Neglected Tropical Diseases is the top Open Access tropical medicine journal, featuring an International Editorial Board and increased support for developing country authors. Of the 223 admissions in 2018, 77 (34.5%) bites were from Russell’s vipers, 17 (7.6%) from cobras, 7 (3.1%) from kraits and 10 (4.5%) from saw-scaled vipers, 22 (9.9%) from non-venomous snakes, 3 (1.3%) from centipedes and 87 (39%) from unknown species. As it was practically impossible to achieve direct engagement with the entire rural population of Tamil Nadu during this study, support was sought from local and national media to further disseminate the campaign’s key messages over the same time period (January-December 2019). In 2017, TFR was 1.68 for overseas women (overseas father 1.73) and 1.78 for native women (native father 1.69). Significant differences were observed in arrival times at the hospital between the 2018 and 2019 data (Fig 6C) with 276 (95%) arriving in under four hours in 2019, compared to the corresponding figure of 135 (60.5%) in 2018. Nearly 90% of students thought that prompt medical treatment was unnecessary, that panicking is required, and that leaving the bite site undisturbed is incorrect. PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US. Since healthcare professionals play a critical role in saving lives after SBE, in all countries experiencing high levels of SBE they need to have adequate access to reliable information and appropriate training about SBE, specifically in terms of first aid and standard treatment protocols. Harry F. Williams, Moreover, in some areas, the Q&A session took much longer than anticipated because of the number of questions that people asked. Interestingly, nearly 50% students were confused between the physical characteristics of the Russell’s viper (Daboia russelii) and Indian python (Python molurus). A rate plateau of over 13.0 persons per 1,000 population occurred for every year from 1946 to 1962. The demography of Australia covers basic statistics, most populous cities, ethnicity and religion. This data suggests that the community education approaches that we have used in this study were effective in changing treatment seeking behaviour of SBE victims or their relatives. BCCI on Thursday wrote to Cricket Australia seeking relaxation in hard quarantine protocol of Brisbane for the fourth Test to go ahead, reminding the host board that the visitors are done with the strict isolation that was agreed upon at the beginning of the tour. The number of bites based on snake species was not (p = 0.098) significantly different between 2018 and 2019 as determined by the Fisher’s Exact Test for Count Data with simulated p-value (based on 10,000 replicates). Stephen Paul Samuel, Finally, we would like to thank everyone else who directly or indirectly supported this project at many different stages. [24], In an optional question on the 2016 Census, 52.1% of the Australian population declared some variety of Christianity. Hence, SBE and its socio-economic ramifications are continuing to alter the lives of thousands of rural people every year [8]. We also cannot rule out the possibilities of numerous other factors such as increased access to transport and unavailability of traditional healers influencing these numbers in 2019. [19], Australia's population has quadrupled since the end of World War I,[20] much of this increase from immigration. However, the ‘Big Four’ snakes [Russell’s viper (Daboia russelii), Indian cobra (Naja naja), Indian krait (Bungarus caeruleus) and saw-scaled viper (Echis carinatus)] are responsible for the vast majority of deaths and disabilities in this country [6,8–10]. Malaysia: 1,800,000 Since 1901, the crude death rate has fallen from about 12.2 deaths per 1,000 population, to 6.4 deaths per 1,000 population in 2006. The treatment costs in private hospitals are another major concern, although free SBE treatment is available in government hospitals. setting the assembly hall, arranging students and necessary facilities such as access to electricity) were performed by the institutions and our team organised the audio-visual tools, displayed posters and distributed the leaflets. For example, SBE treatment (with antivenom) in wards (Rs 5,400), in high dependency units (HDU) (Rs 8,100) and in intensive care units (ICU) (Rs 10,800), and SBE treatment requiring ventilatory support (up to a maximum of Rs 31,500) is covered under this scheme [46]. [58][59][60][61], Median age of the Australia population through history. Evaluation of community-based assemblies indicated that at least 90% of attendees were able to recall the key messages at the end of the events, and at least 85% were able to recall the key messages even after 12 months. 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