Snakebite in northern Cameroon: 134 victims of bites by the saw-scaled orcarpet viper, Echis ocellatus

Einterz, Ellen M.; Bates, Myra E.

doi:10.1016/s0035-9203(03)80105-0

Cited by 26 publications

(17 citation statements)

References 14 publications

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“…The literature on snake envenoming is, like global poverty, rich with references associating rural agriculture with high incidence of disease and death. Taking West Africa as a detailed example, farmers and children in rural communities are consistently identified as being the highest snakebite risk groups in Senegal [12], the Gambia [13], Mali [14], Cote D-Ivoire [15], Ghana [16], Benin [17], Niger [18], Nigeria [19]–[21], Cameroon [22], Gabon [23] and the Congo [24]. The numerous epidemiological reports conducted in Asia and Latin America similarly emphasise that rural subsistent farming communities in these regions also suffer snakebite as a daily occupational hazard (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Snake Envenoming: A Disease of Poverty

et al. 2009

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BackgroundMost epidemiological and clinical reports on snake envenoming focus on a single country and describe rural communities as being at greatest risk. Reports linking snakebite vulnerability to socioeconomic status are usually limited to anecdotal statements. The few reports with a global perspective have identified the tropical regions of Asia and Africa as suffering the highest levels of snakebite-induced mortality. Our analysis examined the association between globally available data on snakebite-induced mortality and socioeconomic indicators of poverty.Methodology/Principal FindingsWe acquired data on (i) the Human Development Index, (ii) the Per Capita Government Expenditure on Health, (iii) the Percentage Labour Force in Agriculture and (iv) Gross Domestic Product Per Capita from publicly available databases on the 138 countries for which snakebite-induced mortality rates have recently been estimated. The socioeconomic datasets were then plotted against the snakebite-induced mortality estimates (where both datasets were available) and the relationship determined. Each analysis illustrated a strong association between snakebite-induced mortality and poverty.Conclusions/SignificanceThis study, the first of its kind, unequivocally demonstrates that snake envenoming is a disease of the poor. The negative association between snakebite deaths and government expenditure on health confirms that the burden of mortality is highest in those countries least able to deal with the considerable financial cost of snakebite.

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Section: Discussionmentioning

confidence: 99%

Snake Envenoming: A Disease of Poverty

et al. 2009

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“…While it is the intent of the EchiTAb Study Group to expand the geographical delivery of its antivenoms, the current scarcity of effective antivenom in the region has resulted in victims undertaking long and expensive journeys to attend these hospitals, with some victims reportedly travelling from as far as Cameroon in the East and Niger in the North-West (personal observation, AN and ND). These observations indicate the paucity of effective and affordable antivenom in West Africa where snakebite, and particularly E. ocellatus , is a medical problem in most countries (Burkina Faso [26], Mali [27] Côte d'-Ivoire [28], Ghana [29], Benin [30], Niger [31] and Cameroon [32]). EchiTAbG therefore offers a therapeutic benefit in many countries other than Nigeria for which it was designed.…”

Section: Discussionmentioning

confidence: 99%

Pre-Clinical Assays Predict Pan-African Echis Viper Efficacy for a Species-Specific Antivenom

et al. 2010

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BackgroundSnakebite is a significant cause of death and disability in subsistent farming populations of sub-Saharan Africa. Antivenom is the most effective treatment of envenoming and is manufactured from IgG of venom-immunised horses/sheep but, because of complex fiscal reasons, there is a paucity of antivenom in sub-Saharan Africa. To address the plight of thousands of snakebite victims in savannah Nigeria, the EchiTAb Study Group organised the production, testing and delivery of antivenoms designed to treat envenoming by the most medically-important snakes in the region. The Echis saw-scaled vipers have a wide African distribution and medical importance. In an effort to maximise the clinical utility of scarce antivenom resources in Africa, we aimed to ascertain, at the pre-clinical level, to what extent the E. ocellatus-specific EchiTAbG antivenom, which was designed specifically for Nigeria, neutralised the lethal activity of venom from two other African species, E. pyramidum leakeyi and E. coloratus.Methodology/Principal FindingsDespite apparently quite distinctive venom protein profiles, we observed extensive cross-species similarity in the immuno-reactivity profiles of Echis species-specific antisera. Using WHO standard pre-clinical in vivo tests, we determined that the monospecific EchiTAbG antivenom was as effective at neutralising the venom-induced lethal effects of E. pyramidum leakeyi and E. coloratus as it was against E. ocellatus venom. Under the restricted conditions of this assay, the antivenom was ineffective against the lethal effects of venom from the non-African Echis species, E. carinatus sochureki.Conclusions/SignificanceUsing WHO-recommended pre-clinical tests we have demonstrated that the new anti-E. ocellatus monospecific antivenom EchiTAbG, developed in response to the considerable snakebite-induced mortality and morbidity in Nigeria, neutralised the lethal effects of venoms from Echis species representing each taxonomic group of this genus in Africa. This suggests that this monospecific antivenom has potential to treat envenoming by most, perhaps all, African Echis species.

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“…In a study conducted on children with snakebite, it is seen that about only 1% (Lahori et al, 1981) in their study. When the delay in the time for treatment is delayed, obviously, the snake bite becomes mortal in some cases of the patient (Einterz and Bates, 2003;Muguti et al, 1994). This is because, like the time-lapse, the anti-venom action becomes ineffective (Snow et al, 1994;Habib, 2003).…”

Section: Resultsmentioning

confidence: 99%

Retrospective analysis of symptoms and outcomes of snakebite cases

Ismail

Ahamed

2020

ijrps

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Usually, every part of the globe is found with snakes, varying with the species or variety of snakes found in a particular region. It is scientifically known that about 3000 types of snakes are prevalent in all parts of the globe. Among these 300, only 10% of the snakes are reportedly venomous, giving life-threatening risks in human beings. Depending upon the snake group, neurotoxic or hemotoxic venom of the snake is manifested. Symptoms of swelling or without swelling at the site of the bite, flank bite marks, local pain are seen in moderate cases, and the severe cases may manifest with shock, renal failure, and/or coagulopathy. The retrospective data were collected from one tertiary care hospital in Nellore district, Andhra Pradesh, India. A further retrospective analysis was carried out using snakebite victims or patients. About 20 patients among these were excluded from the study based on incorrect labeling of snake bite. Therefore, complete data for the study was collected from 72 patients for the study who were admitted into the general medical ward. When the duration time of the treatment is delayed, obviously, the snake bite becomes mortal in the case of the patient. This is because, like the time-lapse, the anti-venom action becomes ineffective. However, despite the above findings like clinical presentation, demographic characteristics, and timelines in both the groups. The overall mortality rate in the present study was reportedly 2%. It could be concluded from the study that by rapid administration of anti-venin in appropriate doses, the snakebite cases can be managed successfully. Thus, we suggest developing an inter-disciplinary approach to reducing the mortality rate of snakebite.

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Snakebite in northern Cameroon: 134 victims of bites by the saw-scaled orcarpet viper, Echis ocellatus

Cited by 26 publications

References 14 publications

Snake Envenoming: A Disease of Poverty

Snake Envenoming: A Disease of Poverty

Pre-Clinical Assays Predict Pan-African Echis Viper Efficacy for a Species-Specific Antivenom

Retrospective analysis of symptoms and outcomes of snakebite cases

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