Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;13(4):245-249.
doi: 10.1016/j.afjem.2023.08.002. Epub 2023 Sep 19.

Antivenom supply and demand: An analysis of antivenom availability and utilization in South Africa

Natalie R Neumann  1   2 , Arina du Plessis  3 , Daniël J van Hoving  4 , Christopher O Hoyte  2   5 , Anné Lermer  3 , Stephen Wittels  6 , Carine Marks  3
Affiliations

Antivenom supply and demand: An analysis of antivenom availability and utilization in South Africa

Natalie R Neumann et al. Afr J Emerg Med. 2023 Dec.

Abstract

Introduction: Snakebites are a neglected tropical disease. In many areas, envenoming incidence and antivenom administration rates are unknown. This study compared antivenom (AV) availability to rates of envenoming and recommendations to treat (RTT) in South Africa.

Methods: This retrospective study identified, extracted, and reviewed all cases of envenoming (snake bites and spits) reported to the Poisons Information Helpline of the Western Cape of South Africa (PIHWC) from June 1, 2015 to May 31, 2020 by public hospitals in the Western Cape. A standardized interview was administered to the pharmacies of the 40 hospitals in winter and summer to determine how many vials of monovalent and polyvalent AV they had on hand at the time of the call and their expiration dates. Descriptive analysis was used to compare rates of envenoming and recommendations to treat to antivenom stock in winter and summer and by hospital type and location.

Results: Public hospitals reported 300 envenomings, 122 from snakes. The PIHWC recommended antivenom administration in 26% of cases (N = 32). All hospital pharmacies queried answered our questions. Our study demonstrates urban district hospitals have higher ratios of AV vials compared to mean annual rates of envenoming and RTT than rural district hospitals at both the winter and summer timepoints.

Conclusion: This study evaluates antivenom supply and demand in a province of South Africa. The findings suggest South African urban hospitals have a relative excess of antivenom, and thus more capacity to meet demand, than their rural counterparts. It supports consideration of a redistribution of antivenom supply chains to match seasonal and local rates of envenoming. It indicates a need for higher quality, prospective data characterizing envenoming incidence and treatment.

Keywords: Antidotes; Antivenins; Global health; Snake bites; Toxicology.

PubMed Disclaimer

Conflict of interest statement

The authors declared no conflicts of interest.

Figures

Fig. 1:
Fig. 1
Visual representation of cases reported to the PIHWC from public hospitals in the Western Cape.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization . Report of the tenth meeting of the WHO strategic and technical advisory group for neglected tropical diseases. World Health Organization; Geneva: 2017.
    1. Williams D.J., Faiz M.A., Abela-Ridder B., Ainsworth S., Bulfone T.C., Nickerson A.D., et al. Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming. PLoS Negl Trop Dis. 2019;13 doi: 10.1371/journal.pntd.0007059. - DOI - PMC - PubMed
    1. Wellcome Trust. Snakebite, https://wellcome.org/what-we-do/our-work/snakebite; [Accessed 6 December 2022].
    1. Benjamin J.M., Abo B.N., Brandehoff N. Review article: snake envenomation in Africa. Curr Trop Med Rep. 2020;7:1–10. doi: 10.1007/s40475-020-00198-y. - DOI
    1. World Health Organization . Fourteenth Meeting of the strategic and technical advisory group for neglected tropical diseases. World Health Organization; Geneva: 2021.

LinkOut - more resources