Snakebite burden in Sub-Saharan Africa: estimates from 41 countries

Halilu, Sadiq; Iliyasu, Garba; Hamza, Muhammad; Chippaux, Jean-Philippe; Kuznik, Andreas; Habib, Abdulrazaq G.

doi:10.1016/j.toxicon.2018.12.002

Cited by 71 publications

(68 citation statements)

References 11 publications

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“…Our analysis illustrates that venoms used for preclinical testing have tended to be sourced from regional "hot spots" (Fig 1B). This results in an absence of antivenom efficacy data for large swathes of sub-Saharan Africa, particularly central and southern countries suspected of having substantial snakebite burdens [58,59]. It is therefore important that the scientific community expands preclinical testing of antivenoms to include venoms from different medicallyrelevant regions.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

An analysis of preclinical efficacy testing of antivenoms for sub-Saharan Africa: Inadequate independent scrutiny and poor-quality reporting are barriers to improving snakebite treatment and management

et al. 2020

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Background The World Health Organization's strategy to halve snakebite mortality and morbidity by 2030 includes an emphasis on a risk-benefit process assessing the preclinical efficacy of antivenoms manufactured for sub-Saharan Africa. To assist this process, we systematically collected, standardised and analysed all publicly available data on the preclinical efficacy of antivenoms designed for sub-Saharan Africa. Methodology/Principal findings Using a systematic search of publication databases, we focused on publicly available preclinical reports of the efficacy of 16 antivenom products available in sub Saharan Africa. Publications since 1999 reporting the industry standard intravenous pre-incubation method of murine in vivo neutralisation of venom lethality (median effective dose [ED 50 ]) were included. Eighteen publications met the criteria. To permit comparison of the several different reported ED 50 values, it was necessary to standardise these to microlitre of antivenom resulting in 50% survival of mice challenged per milligram of venom (μl/mg). We were unable to identify publicly available preclinical data on four antivenoms, whilst data for six polyspecific antivenoms were restricted to a small number of venoms. Only four antivenoms were tested against a wide range of venoms. Examination of these studies for the reporting of key metrics required for interpreting antivenom ED 50 s were highly variable, as evidenced by eight different units being used for the described ED 50 values. Conclusions/Significance There is a disturbing lack of (i) preclinical efficacy testing of antivenom for sub Saharan Africa, (ii) publicly available reports and (iii) independent scrutiny of this medically important data. Where reports do exist, the methods and metrics used are highly variable. This

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

An analysis of preclinical efficacy testing of antivenoms for sub-Saharan Africa: Inadequate independent scrutiny and poor-quality reporting are barriers to improving snakebite treatment and management

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A recent estimate of SBE burden comprising years of life lost (YLL) due to premature deaths and years of life lived (YLD) with disability from amputation and posttraumatic stress disorder (PTSD) yielded 1.03 million disability-adjusted life years (DALYs) annually in SSA [7,10]. The WHO Roadmap targets halving snakebites and the resulting deaths and disabilities by the year 2030 [4].…”

Section: Potential Public Health Impact and Costs Of Providing Antivementioning

confidence: 99%

“…This will be achieved at costs of $11.85 million, $118.5 million, and $711 million, respectively. Overall, our analysis yielded conservative estimates, as relatively lower number of SB cases, deaths, minimal AV wastage and higher weighted DALYs were used as inputs [9,10].…”

Section: Potential Public Health Impact and Costs Of Providing Antivementioning

confidence: 99%

“…As an NTD, global funding has been suboptimal for SBE, particularly when compared to other communicable NTDs despite its substantially higher burden [7]. Furthermore, as a noncommunicable disease (with no development of herd immunity) that recurs annually at more than 270,000 envenomings in SSA [1,10], there is the need for annual provision of large stock of AV therapies to be acquired and sustained.…”

Section: Challenges and Lessons Towards Sustaining The Programmentioning

confidence: 99%

“…In this Policy Appraisal, the challenges of AV supply are explored using the parameters of "security of supply," a concept traditionally applied to food, energy, military, weapons, and, recently, medicines (e.g., insulin supply) [5,6]. The potential impact of expanding AV availability and supply in SSA is also be explored, building on our previous findings and cognizant of WHO Roadmap targets [4,7,8,9,10]. The financial resources needed to sustain AV supplies to achieve WHO Roadmap goals is estimated.…”

Section: Introductionmentioning

confidence: 99%

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