The 6th international conference on envenomation by Snakebites and Scorpion Stings in Africa: a crucial step for the management of envenomation

Chippaux, Jean-Philippe; Akaffou, Marc Hermann; Allali, Bernard; Dosso, Mireille; Massougbodji, Achille; Barraviera, Benedito

doi:10.1186/s40409-016-0062-y

Cited by 19 publications

(24 citation statements)

References 6 publications

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“…Mortality data on snakebite is scarce in Cameroon, majority of which are obtained from hospital-based sources [ 10 ]. Consequently, the values obtained usually underestimate the true burden of this neglected health problem in most communities [ 12 – 14 ]. This is worrisome because mortality is an important health indicator [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series

Tianyi

Agbor²,

Tochie

et al. 2018

BMC Res Notes

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BackgroundSnakebites are a major cause of mortality and morbidity worldwide with the highest mortality burden in poor rural areas of sub-Saharan Africa. Inadequate surveillance systems result in loss of morbidity and mortality data in these settings. Although rarely reported in these resource-constraint environments, community-based audits are recognised pivotal tools which could help update existing data and indicate key public health interventions to curb snakebite-related mortality. Herein, we present two cases of snakebite-related deaths in a rural Cameroonian community.Case presentationsThe first case was a 3-year-old female who presented at a primary care health centre and was later referred due to absence of antivenom serum (AVS). However, she had an early fatal outcome before getting to the referral hospital. The second case was an 80-year-old traditional healer who got bitten while attempting to kill a snake. He died before hospital presentation.ConclusionCommunity-based audits help identify key intervention points to curb snakebite mortality in high-risk rural areas like ours. From our audits, we note a remarkable absence of affordable AVS in rural health facilities in Cameroon. We recommend frequent community health education sessions on preventing snakebites; continuous training modules for health personnel from high-risk areas; training traditional healers on the importance of AVS in managing cases of snakebite envenoming, and the need for timely hospital presentation; and setting up context-specific approaches to rapidly transport snakebite victims to hospitals.

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Section: Discussionmentioning

confidence: 99%

“…In the absence of affordable snake AVS in some rural areas in Cameroon [ 1 , 12 , 23 ], it is important to seek alternative means to decrease morbidity and mortality from snakebites [ 9 , 10 , 20 ]. One of such ways is to invest in community education and prevention of snakebites [ 13 , 14 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series

Tianyi

Agbor²,

Tochie

et al. 2018

BMC Res Notes

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“…Some years later, antiserum began to be used in humans. Since that time, such products have always proven to be highly effective in the treatment of infections and envenomations [ 1 , 4 – 7 ]. However, in their initial applications, antivenoms did not exhibit good safety results and could even cause life-threatening side effects [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Antivenom therapy: efficacy of premedication for the prevention of adverse reactions

Morais

2018

J Venom Anim Toxins Incl Trop Dis

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Antivenoms or antitoxins have been effectively used for more than a century. During this time, these products have always proven to be highly effective in the treatment of infections and envenomations. However, antivenoms did not exhibit good safety results in their initial applications. After many improvements, antivenoms have substantially better safety profiles but still have some side effects. Due to the occurrence of adverse reactions, the practice of using premedication with the intent to decrease side effects has become accepted or mandatory in many countries. The drugs used for premedication belong to the histamine H1 antagonist, glucocorticoid and catecholamine groups. Currently, this practice is being questioned due to low or controversial efficacies in clinical assays. In this article, we discuss the causes of adverse reactions, the mechanisms of drugs that block the undesired effects and the results obtained in clinical trials. Although these three families of drugs could have positive effects on reducing adverse reactions, only adrenaline has demonstrated positive results in clinical assays.

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“…In developing countries, particularly in sub-Saharan Africa, most envenomations occur in rural areas and are managed in peripheral health centers lacking the capability to perform automated laboratory tests for diagnosis or monitoring of envenomed patients [ 1 , 2 ]. Venom-induced consumption coagulopathies (VICC) are present in more than two-thirds of African snake envenomations [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation

Benjamin

Chippaux

Sambo

et al. 2018

J Venom Anim Toxins Incl Trop Dis

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BackgroundThe whole blood clotting test (WBCT) is a simple test of coagulation that is often used in the assessment, diagnosis, and therapeutic monitoring of snakebite patients in sub-Saharan Africa. WBCT requires only a clean glass tube and several milliliters of venous blood and is ideal for use in poorly equipped health centers throughout the rural areas where 95% of snakebites occur. However, questions surrounding the accuracy and reliability of the test remain unanswered due to variations in testing conditions and a lack of comparative research with which to validate them. This is the first study to evaluate WBCT results at both 20-min (WBCT20) and 30-min (WBCT30) reading times in the same group of snakebite patients.MethodsIn order to define the best reading time, the authors compared the results of serial WBCT evaluation at both 20 and 30 min after collection in 23 patients treated for snake envenomation in Bembèrèkè, northern Benin.ResultsWBCT results were identical at both reading times in patients without coagulopathy or when coagulation was restored permanently following a single dose of antivenom. Out of 17 patients with coagulopathy, 14 showed discrepancies between WBCT20 and WBCT30 results in at least one pair of serial evaluations. These could be completely contradictory results (e.g. normal clot at WBCT20 and no clot at WBCT30) or a marked difference in the quality of the clot (e.g. no clotting activity at WBCT20 and an unstable partial clot at WBCT30). WBCT discrepancies were encountered most frequently in three situations: initial normalization of hemostasis following antivenom therapy, detection of a secondary resumption of coagulopathy, or final restoration of hemostasis after a secondary resumption had occurred.ConclusionsThis study suggests that the WBCT is robust and that a sequential reading should improve the diagnosis and monitoring of venom-induced coagulopathies. It also indicates the possibility of discrepancies in the sensitivity of WBCT20 and WBCT30 for detecting the resolution or reoccurrence of coagulopathy and identifies how these findings, if confirmed, may be used to increase the efficacy and efficiency of antivenom treatment in the field.

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The 6th international conference on envenomation by Snakebites and Scorpion Stings in Africa: a crucial step for the management of envenomation

Cited by 19 publications

References 6 publications

Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series

Community-based audits of snake envenomations in a resource-challenged setting of Cameroon: case series

Antivenom therapy: efficacy of premedication for the prevention of adverse reactions

Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation

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