Climatic and Social Drivers of Snakebite Incidence in Pará State, Brazilian Amazon

Background Snakebite envenoming is a neglected public health issue influenced by both environmental and socioeconomic variables. In Pará, the Brazilian state with the highest number of cases, knowledge gaps remain regarding the relationship between these factors and the temporal and geospatial distribution of accidents. This study investigates the influence of the El Niño–Southern Oscillation (ENSO), rainfall, river levels and socioeconomic indicators on snakebite incidence over nearly two decades (2007–2023). Methods Data were obtained from official public health, environmental and socioeconomic databases. A Generalized Additive Model (GAM) was used to assess social variables, cross‐correlation analyses evaluated associations with rainfall and river levels and wavelet analysis was applied to explore temporal patterns linked to ENSO variability. Results A total of 87,267 cases were recorded during the study period, with the highest incidence in northeastern Pará, particularly in the municipality of Santarém. Snakebite occurrence showed positive correlations with poor sanitation, rural population density and illiteracy rates. Temporal associations were also observed with river levels, rainfall and ENSO variability. Conclusions The most affected municipalities should be prioritised for preventive education and improved antivenom distribution. The association with poverty indicators underscores the need for structural improvements in health and social assistance systems. Climatic influences highlight the role of environmental variability in shaping snakebite incidence in the Amazon and raise concerns about potential impacts of ongoing climate change on snakebite risk.