A comparison between adult and paediatric snakebites and their outcomes in North Eastern South Africa

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

“…One study in India reported an odds ratio of 2.97 for a poor outcome (mortality, ventilation, or renal replacement therapy) in children under 5 years of age [ 13 ]. In this study, snakebite-related mortality was unusually high at 11.7%, while in South Africa, despite an increased risk of severity, the recorded mortality rates in children remained low, with few reported deaths [ 12 , 20 , 40 ].…”

“…The clinical signs and symptoms following SBE are similar for children and adults [ 20 ]. However, the envenomation dose delivered by snakes is not discriminatory, exposing children to a larger venom dose-to-weight ratio than adults [ 11 ].…”

“…However, the envenomation dose delivered by snakes is not discriminatory, exposing children to a larger venom dose-to-weight ratio than adults [ 11 ]. This has a direct impact on the clinical severity and complication risk for children [ 19 , 20 , 40 , 41 ].…”

“…One study from South Africa reported an odds ratio of 2.13 for children requiring antivenom or a surgical procedure, while another cited a relative risk of 4.75 for a surgical intervention when compared to adults [ 15 , 20 ]. Overall, young children and toddlers carry a higher risk of poor outcomes [ 13 , 38 ].…”

“…A study from Nigeria reported that children with cytotoxic SBE are more likely to need an amputation, blood transfusion, and antivenom than adults [ 19 , 40 ]. Antivenom is more commonly prescribed for children with snakebite than adults in sub-Saharan Africa, with the proportion ranging from 15–85% [ 13 , 15 , 18 , 19 , 20 ]. One study in India reported an odds ratio of 2.97 for a poor outcome (mortality, ventilation, or renal replacement therapy) in children under 5 years of age [ 13 ].…”