In Sudan, as in many African countries, no local specific antivenom is manufactured resulting in snake bite victims being treated by antivenoms imported from abroad. In the present work we measured the cytotoxic effect of the recently described spitting cobra (Naja nubiae) and the carpet viper (Echis ocellatus) snake venoms using a cell based assay. We also investigated the efficacy of four antivenoms CSL (Australia), SAIMR (South Africa), snake venom antiserum (India), and EchiTAb-Plus-ICP (Cost Rica) to neutralize the cytotoxic effect of the two venoms. The venoms resulted in a remarkable inhibition of cell viability with N. nubiae being more cytotoxic than E. ocellatus. The four antivenoms studied were effective in neutralizing N. nubiae cytotoxicity. However, only partial efficacy in neutralizing the cytotoxic effect of E. ocellatus was achieved using CSL (Australia) and SVA (India) antivenoms. Based on the cross neutralization by the four antivenoms, the Sudanese N. nubiae venom most likely has homologous epitopes with similar snakes from Australia, South Africa, India, and Cost Rica, while E. ocellatus venom from Sudan shares little homology with similar snakes from other countries.
Background Snakebite statistics are lacking in Sudan despite the high estimated burden. In this study we aimed to describe the incidence of snakebite envenomation and death in Sudan and to show the state-wise distribution of snakebite episode. Methods We retrospectively analyzed hospital-based data on snakebite for 2014–2018. Data were obtained from the annual health statistical reports of the Ministry of Health. Descriptive statistics were used to illustrate the results. Results A total of 63 160 people were envenomed during 2014–2018 with an average of 12 632 cases/year. The death rate between inpatient cases was 2.5%. The annual incidence was 18– 47 cases/100 000 population. Gadarif state recorded the highest incidence (132/100 000 population) of snakebite envenomation in Sudan whereas Northern state had the least incidence (5/100 000 population). The 15–24 y age group experienced the highest risk of snakebite and males were more exposed to snakebites than females. Conclusions Although hospital-based records underestimate the burden of snakebite, they can still provide an insight regarding the actual numbers. Here, we highlight the at-risk states in Sudan to be targeted for further questionnaire-based epidemiological studies and to guide health authorities to reduce the burden of snakebite envenomation by insuring proper antivenom distribution to the highly affected areas.
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