Snakebites notified to the poison control center of Morocco between 2009 and 2013

Abstract

BackgroundSnakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013.MethodsThis retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone.ResultsDuring the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %).ConclusionDespite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.

Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana

“…We consistently found that young to middle-aged men (age group = 15-44 years) were most at risk of snakebites, corroborating similar findings from Ghana [22, 23, 24], other parts of West Africa [15, 25, 26, 27, 44, 46, 47] and Africa in general [30, 34, 48, 49, 50]. Adolescent and young men in their twenties are among the most active and adventurous, albeit least cautious, section of rural African people [24, 27, 44, 51].…”

Snake bites in morocco: Progress and challenges

“…According to the study of Chafi q, et al, the majority of victims were young, with a mean age of 26.8±17.2 years and a male/female sex ratio of 1.67 [7]. The highest annual incidence was observed in the region of Tangier-Tetouan followed by the region of Meknes-Tafi lalet.…”

“…This region is known to be agricultural and has a large population, a diverse fauna of snakes and a semiarid to arid climate. Regarding mortality, the studies of both Chafi q, et al, and Arfaoui, et al, revealed that the current annual mortality rate from snakebites reaches 3.9% [5,7], while a retrospective study between 1980 and 2008 revealed a higher rate of 7.2% [7]. The studies also showed that females aged more than 60 and less than 20 present a signifi cantly higher specifi c lethality [5].…”

“…The spring and summer are the seasons when most snake bites happen with a bit of a peak in June, resulting from a higher activity of both snakes and humans. Snakebites are mainly infl icted on the feet or ankles, most frequently during the evening when there is a greater probability of accidentally treading on a snake and sometimes at night while it is sleeping or moving [5][6][7].…”

Snakebites in Africa and Europe: a military perspective and update for contemporary operations

“…Haemolysis, coagulopathy and AKI have also been observed 22. The blunt-nosed viper ( Macrovipera lebetina ) and the Moorish viper ( Macrovipera mauritanica ), the most common cause of snakebite in Morocco,23 are larger snakes, reaching 100–180 cm in length, greyish or reddish brown, with distinctive dorsal markings. Bites result in local envenoming and coagulopathy.…”