Review Article: Snake Envenomation in Africa

Benjamin, Jordan Max; Abo, Benjamin N.; Brandehoff, Nicklaus

doi:10.1007/s40475-020-00198-y

Cited by 23 publications

(15 citation statements)

References 65 publications

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“…Cobras are common causes of snakebite envenomation in Sub-Saharan Africa, causing two distinctive toxic manifestations. The African non-spitting cobras ( N. haje , N. nivea , N. senegalensis , N. annulifera ) and the forest cobra ( N. melanoleuca ) cause systemic neurotoxic envenomation, while the African spitting cobras ( N. nigricollis , N. katiensis , N. mossambica , N. pallida , N. ashei ) cause predominantly local cytotoxic envenomation (tissue necrosis) [ 65 ]. Due to the limited local capacity for antivenom production in Africa, currently, various antivenom products are imported and marketed in Sub-Saharan Africa; these include SAIMR polyvalent antivenom produce from South Africa, Antivipmyn-Africa from Mexico, VACSERA from Egypt, EchiTAb-Plus-ICP from Costa Rica, VINS Pan Africa antivenom and ASNA antivenom from India, and Inoserp Pan Africa from Mexico with limited information regarding their clinical effectiveness [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

A Neurotoxic Snake Venom without Phospholipase A2: Proteomics and Cross-Neutralization of the Venom from Senegalese Cobra, Naja senegalensis (Subgenus: Uraeus)

Wong

Tan

et al. 2021

Toxins

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The Senegalese cobra, Naja senegalensis, is a non-spitting cobra species newly erected from the Naja haje complex. Naja senegalensis causes neurotoxic envenomation in Western Africa but its venom properties remain underexplored. Applying a protein decomplexation proteomic approach, this study unveiled the unique complexity of the venom composition. Three-finger toxins constituted the major component, accounting for 75.91% of total venom proteins. Of these, cardiotoxin/cytotoxin (~53%) and alpha-neurotoxins (~23%) predominated in the venom proteome. Phospholipase A2, however, was not present in the venom, suggesting a unique snake venom phenotype found in this species. The venom, despite the absence of PLA2, is highly lethal with an intravenous LD50 of 0.39 µg/g in mice, consistent with the high abundance of alpha-neurotoxins (predominating long neurotoxins) in the venom. The hetero-specific VINS African Polyvalent Antivenom (VAPAV) was immunoreactive to the venom, implying conserved protein antigenicity in the venoms of N. senegalensis and N. haje. Furthermore, VAPAV was able to cross-neutralize the lethal effect of N. senegalensis venom but the potency was limited (0.59 mg venom completely neutralized per mL antivenom, or ~82 LD50 per ml of antivenom). The efficacy of antivenom should be further improved to optimize the treatment of cobra bite envenomation in Africa.

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Section: Resultsmentioning

confidence: 99%

A Neurotoxic Snake Venom without Phospholipase A2: Proteomics and Cross-Neutralization of the Venom from Senegalese Cobra, Naja senegalensis (Subgenus: Uraeus)

Wong

Tan

et al. 2021

Toxins

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“…3 In Africa, some snakes, such as spitting cobras, have a dry bite rate of 50%. 4 Conservative management is recommended as an initial treatment for snakebite victims.…”

Section: Introductionmentioning

confidence: 99%

Delayed Splenic Rupture: A Rare Complication of Snakebites

Kim

Roh

Cha

et al. 2021

Wilderness & Environmental Medicine

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Bites by venomous snakes can cause fatal systemic and coagulation disorders. Rare complications, such as compartment syndrome and hemoperitoneum, may also require surgical intervention. Here, we describe our experience with an unusual case of snakebite-induced delayed splenic rupture. A 54-yold male with no specific medical history visited a local hospital for a bite by an unidentified snake. He had been bitten on the left thumb and was administered antivenom. He was discharged from the local hospital after 3 d when his symptoms had improved. However, he revisited our emergency medical center 2 d later, reporting dizziness with diaphoresis. Focused abdominal ultrasonography and computed tomography revealed large amounts of intraperitoneal fluid collection and hemoperitoneum with splenic rupture, respectively. The patient underwent immediate blood transfusion and received antivenom treatment in our emergency department and, subsequently, emergency splenectomy. Histopathologic findings at the time of surgery revealed multifocal lacerations on the external surface of the spleen, with fresh hemorrhage. He recovered 7 d after surgery without any complication.

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“…Subcutaneous or intramuscular injection of venom, via a snakebite, into the victim's body, elicits local and systemic toxic effects with profound sequela [ 5 , 6 ]. Local effects associated with SBE include haemorrhage, oedema, myonecrosis, and extracellular matrix (ECM) degradation.…”

Section: Introductionmentioning

confidence: 99%

“…Local effects associated with SBE include haemorrhage, oedema, myonecrosis, and extracellular matrix (ECM) degradation. Also, neurotoxicity, myotoxicity, cardiotoxicity, and hemotoxic syndrome are associated with systemic SBE sequelae [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, most antivenoms are ineffective due to geographic variation in venom composition and antigenic reactivity, attributable to the taxonomic diversity of venomous snake types [ 10 , 11 ]. Besides, the high cost of antivenoms, especially in economically deprived settings, unavailability of enough antivenom stocks in various healthcare facilities, and inaccessibility of hospitals impede timely antivenom access, thereby leading to high morbidity and mortality rates [ 6 , 8 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Ethnobotanical Documentation, Phytochemical Screening, and Cytotoxicity Evaluation of Medicinal Plants Used to Manage Snakebite Envenomation in Mwingi West Subcounty, Kenya

Mokua

Mbaria

Maitho

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Snakebite envenomation (SBE) is a life-threatening global public health problem affecting over 2.7 million persons annually, with a bigger burden lying in the developing world. Despite the successful management of SBE by antivenom therapy in conventional medicine, it is of low efficacy due to the diverse venom composition across snake types, which limits its usefulness. As a result, inhabitants of the sub-Sahara region, where SBE incidence is high, utilise medicinal plants as an alternative remedy for SBE. However, most plants have not been ethnobotanically documented and validated empirically and hence this study is needed. An ethnobotanical survey to document medicinal plants used to manage SBE in Migwani ward, Mwingi West Subcounty, Kitui County, was conducted between January and February, 2021. Ethnobotanical data were collected from 45 purposefully sampled respondents from Migwani ward using semistructured questionnaires, field walks, and oral interviews. In this study, 14 medicinal plants which are used to manage SBE were documented. Four plants with the highest Relative Frequency of Citation (RFC) (Entada leptostachya Harms-stem bark (0.58), Senna singueana-roots (0.53), Securidaca longipendunculata-roots (0.36), and Strychnos henningsii-stem bark (0.46)) were selected and extracted using water, methanol, and dichloromethane according to the standard procedures. Qualitative phytochemical analysis of the plant extracts and their cytotoxic effects on brine shrimp nauplii (brine shrimp lethality assay) was conducted according to the standard techniques. Qualitative phytochemical screening revealed the presence of anti-SBE-associated phytochemicals, such as alkaloids, saponins, tannins, phenols, and flavonoids, in the aqueous and methanolic extracts of the studied plant extracts. However, the tested phytochemicals were not detected in dichloromethane extracts of all the studied extracts. The anti-SBE effects of the documented plants could be attributable to these associated bioactive phytocompounds, which are synthesized by the studied plants and transfered to humans when consumed. Furthermore, the aqueous and methanolic extracts of Entada leptostachya and Senna singueana had high LC50 of >1000 µg/ml and were considered noncytotoxic. However, Securidaca longipendunculata had an LC50 of <1000 µg/ml and was considered slightly cytotoxic. Further empirical investigations to characterise the bioactive phytochemicals and their safety should be done.

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Review Article: Snake Envenomation in Africa

Cited by 23 publications

References 65 publications

A Neurotoxic Snake Venom without Phospholipase A2: Proteomics and Cross-Neutralization of the Venom from Senegalese Cobra, Naja senegalensis (Subgenus: Uraeus)

A Neurotoxic Snake Venom without Phospholipase A2: Proteomics and Cross-Neutralization of the Venom from Senegalese Cobra, Naja senegalensis (Subgenus: Uraeus)

Delayed Splenic Rupture: A Rare Complication of Snakebites

Ethnobotanical Documentation, Phytochemical Screening, and Cytotoxicity Evaluation of Medicinal Plants Used to Manage Snakebite Envenomation in Mwingi West Subcounty, Kenya

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