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. 2013 Oct 17;19(1):27.
doi: 10.1186/1678-9199-19-27.

Public health aspects of snakebite care in West Africa: perspectives from Nigeria

Abdulrazaq G Habib  1
Affiliations

Public health aspects of snakebite care in West Africa: perspectives from Nigeria

Abdulrazaq G Habib. J Venom Anim Toxins Incl Trop Dis. .

Abstract

Snakebite envenoming is a major public health problem among rural communities of the Nigerian savanna. The saw-scaled or carpet viper (Echis ocellatus) and, to a lesser extent, the African cobras (Naja spp.) and puff adders (Bitis arietans) have proved to be the most important cause of mortality and morbidity. The main clinical features of E. ocellatus envenoming are systemic hemorrhage, incoagulable blood, shock, local swelling, bleeding and, occasionally, necrosis. Bites may be complicated by amputation, blindness, disability, disfigurement, mutilation, tissue destruction and psychological consequences. Antivenom remains the hallmark and mainstay of envenoming management while studies in Nigeria confirm its protection of over 80% against mortality from carpet-viper bites. However, the availability, distribution and utilization of antivenom remain challenging although two new antivenoms (monospecific EchiTab G and trispecific EchiTab ICP-Plus) derived from Nigerian snake venoms have proven very effective and safe in clinical trials. A hub-and-spoke strategy is suggested for broadening antivenom access to endemic rural areas together with instituting quality assurance, standardization and manpower training. With the advent of antivenomics, national health authorities must be aided in selecting and purchasing antivenoms appropriate to their national needs while manufacturers should be helped in practical ways to improve the safety, efficacy and potential coverage against snake venoms and pricing of their products.

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Figures

Figure 1
Figure 1
Carpet viper, African spitting cobra and puff adder.
Figure 2
Figure 2
Hub-and-spoke model for snakebite care. Full meaning of acronyms: ADR: Adverse Drug Reactions; ASV: Anti-Snake Serum AntiVenom; CHC: Comprehensive Health Centre; CHEW: Community Health Extension Worker; MD: Medical Doctors; PCV: Packed Cell Volume; QA-QC: Quality Assurance Quality Control; TOT: Training of Trainers; 20WBCT: 20 minute Whole Blood Clotting Test.
See this image and copyright information in PMC

References

    1. Warrell DA, Arnett C. The importance of bites by the saw-scaled or carpet viper (Echis carinatus): epidemiological studies in Nigeria and a review of the world literature. Acta Trop. 1976;33(4):307–341. - PubMed
    1. Chippaux JP, Lang J, Amadi Eddine S, Fagot P, Le Mener V. Treatment of snake envenomations by a new polyvalent antivenom composed of highly purified F(ab’)2: results of a clinical trial in northern Cameroon. Am J Trop Med Hyg. 1999;61(6):1017–1018. - PubMed
    1. Chippaux JP, Massougbodji A, Stock RP, Alagon A. Investigators of African antivipmyn in Benin: clinical trial of an F(ab’)2 polyvalent equine antivenom for African snake bites in Benin. Am J Trop Med Hyg. 2007;77(3):538–546. - PubMed
    1. Visser LE, Kyei-Faried S, Belcher DW. Protocol and monitoring to improve snake bite outcomes in rural Ghana. Trans R Soc Trop Med Hyg. 2004;98(5):278–283. doi: 10.1016/S0035-9203(03)00065-8. - DOI - PubMed
    1. Kasturiratne A, Wickremasinghe AR, De Silva NR, Gunawardena NK, Pathmeswaran A, Premaratna R. et al.The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5(11):e218. doi: 10.1371/journal.pmed.0050218. - DOI - PMC - PubMed

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