The WHO strategy for prevention and control of snakebite envenoming: a sub-Saharan Africa plan

Abstract

Snakebite is a critical public health issue in tropical countries, particularly in Africa, where 20% of snakebites globally occur. In 2017, the WHO added snakebite envenoming to the category A of neglected tropical diseases. In 2019, thanks to broad institutional and international NGO support, including strong mobilization of African experts and governments, WHO launched a strategy for prevention and control of snakebite envenoming with more ambitious goals. In sub-Saharan Africa, accessibility of antivenoms and symptomatic, adjuvant or replacement therapy is a priority. Several antivenoms are available but their evaluation has not been properly carried out and they remain expensive. To date, there are no manufacturers of antivenom in sub-Saharan Africa (except in South Africa), which requires their importation from other continents. The lack of experience in antivenom choice and its use by health authorities, health personnel and population largely explains the shortage in sub-Saharan Africa. The deficiency of epidemiological data does not allow the implementation of appropriate and efficient care. It is crucial to strengthen the health system which does not have the necessary means for emergency management in general and envenoming in particular. Providing peripheral health centers with antivenoms would decrease complications and deaths. The motivation of communities at risk, identified through the epidemiological data, would be to reduce the delay in consultation that is detrimental to the efficiency of treatment. Partnerships need to be coordinated to optimize resources from international institutions, particularly African ones, and share the burden of treatment costs among all stakeholders. We propose here a project of progressive implementation of antivenom manufacturing in sub-Saharan Africa. The various steps, from the supply of appropriate venoms to the production of purified specific antibodies and vial filling, would be financed by international, regional and local funding promoting technology transfer from current manufacturers compensated by interest on the sale of antivenoms.

Prise en charge des envenimations par morsure de serpent à l’Institut de recherche en biologie appliquée de Guinée

“…This reinforces the strategy of bringing the AAS as close as possible to populations at greatest risk, particularly in peripheral health centers [ 6 ].…”

Prise en charge des envenimations par morsure de serpent à l’Institut de recherche en biologie appliquée de Guinée

“…This reinforces the strategy of bringing the AAS as close as possible to populations at greatest risk, particularly in peripheral health centers [ 6 ].…”

Healthcare Worker Preparedness for Snakebite Management in Selected Zambian Hospitals: An Exploratory Study

“…A key finding was the limited access to formal snakebite management training. More than one-third of participants reported never having received any training related to snakebite management [5,9,11,17,21]. Similar findings have been reported in several African countries where healthcare workers frequently encounter snakebite patients but receive little or no formal instruction on diagnosis, antivenom administration, and management of complications [7,22].…”

Persistence of venom-induced consumption coagulopathy (VICC) associated with the late application of antivenom after snakebite by Bothrops complex: a retrospective cohort study

“…The findings in the present study could contribute to the development of strategies for improving the timeliness of care, specifically in the administration of antivenom to patients with a snakebite in the Colombian context [26].…”

Prise en charge des envenimations par morsure de serpent à l’Institut de recherche en biologie appliquée de Guinée

“…This reinforces the strategy of bringing the AAS as close as possible to populations at greatest risk, particularly in peripheral health centers [ 6 ].…”

Healthcare Worker Preparedness for Snakebite Management in Selected Zambian Hospitals: An Exploratory Study

“…A key finding was the limited access to formal snakebite management training. More than one-third of participants reported never having received any training related to snakebite management [5,9,11,17,21]. Similar findings have been reported in several African countries where healthcare workers frequently encounter snakebite patients but receive little or no formal instruction on diagnosis, antivenom administration, and management of complications [7,22].…”

Persistence of venom-induced consumption coagulopathy (VICC) associated with the late application of antivenom after snakebite by Bothrops complex: a retrospective cohort study

“…The findings in the present study could contribute to the development of strategies for improving the timeliness of care, specifically in the administration of antivenom to patients with a snakebite in the Colombian context [26].…”

Prise en charge des envenimations par morsure de serpent à l’Institut de recherche en biologie appliquée de Guinée

“…This reinforces the strategy of bringing the AAS as close as possible to populations at greatest risk, particularly in peripheral health centers [ 6 ].…”

Healthcare Worker Preparedness for Snakebite Management in Selected Zambian Hospitals: An Exploratory Study

“…A key finding was the limited access to formal snakebite management training. More than one-third of participants reported never having received any training related to snakebite management [5,9,11,17,21]. Similar findings have been reported in several African countries where healthcare workers frequently encounter snakebite patients but receive little or no formal instruction on diagnosis, antivenom administration, and management of complications [7,22].…”

Persistence of venom-induced consumption coagulopathy (VICC) associated with the late application of antivenom after snakebite by Bothrops complex: a retrospective cohort study

“…The findings in the present study could contribute to the development of strategies for improving the timeliness of care, specifically in the administration of antivenom to patients with a snakebite in the Colombian context [26].…”