Parents' challenges in identifying offending snakes during paediatric snakebites in Sri Lanka: a qualitative study.

Accurate identification of the offending snake can support clinical decision-making in snakebite management, particularly in settings without venom detection facilities. A qualitative exploratory study was conducted among parents of children admitted with suspected or confirmed snakebites to three high-incidence hospitals in Sri Lanka. From August 2024 to July 2025, 64 in-depth interviews were carried out. The interviews were audio-recorded, transcribed, translated, and analysed thematically using Braun and Clarke's six-phase approach. Parents described considerable uncertainty and limited knowledge of local snake species. Identification was hindered by poor visibility, rapid snake movement, conflicting eyewitness accounts, and confusion during emergencies. Fear, panic, and emotional distress often overrode systematic observation. Misidentification was frequent and contributed to elevated community fear and unnecessary killing of snakes. Parents relied heavily on elders and informal social media groups due to a lack of structured educational resources. Many expressed a clear need for practical, community-based training and visual tools to support accurate recognition. Parents face multiple challenges in identifying snakes during paediatric bite incidents, shaped by limited knowledge, situational constraints, emotional overload, and systemic gaps in preventive education. Strengthening community-level snake identification training and incorporating visual educational tools into child health programmes may reduce misidentification and support timely, appropriate care-seeking.