Persistent spatial hotspots and socioeconomic inequalities of snakebite envenoming in Peru: A nationwide spatiotemporal analysis, 2010–2025

Background: Snakebite envenoming remains a major neglected tropical disease worldwide, disproportionately affecting rural and socioeconomically vulnerable populations in tropical and subtropical regions. In Peru, snakebite burden is strongly concentrated in Amazonian territories, yet nationwide evidence on its long-term spatial dynamics and socioeconomic determinants remains limited. Methodology: This study provides the first multiscale spatiotemporal assessment of snakebite envenoming incidence in Peru between 2010 and 2025. National surveillance data were analyzed at departmental and district levels to evaluate temporal trends, spatial clustering, hotspot persistence, ecological suitability, and socioeconomic associations. Spatial autocorrelation was assessed using Global Moran’s I and Local Indicators of Spatial Association (LISA), while associations between Human Development Index (HDI) and snakebite envenoming incidence were evaluated across Peruvian macroregions. Findings: A total of 32,942 snakebite envenoming cases were reported during the study period, with more than 60% concentrated in Amazonian departments, particularly Loreto, San Martín, and Ucayali. Snakebite incidence exhibited significant spatial autocorrelation throughout the study period (Moran’s I = 0.53–0.61; p