Current challenges for confronting the public health problem of snakebite envenoming in Central America

ABSTRACT

Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 casesoccur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe,cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally known as ‘terciopelo’, ‘barba amarilla’ or‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significantand successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenommanufacture and quality control, training of health professionals in the diagnosis and clinical management of bites,and prevention of snakebites, much remains to be done in order to further reduce the impact of this medicalcondition. This essay presents seven challenges for improving the confrontation of snakebite envenoming inCentral America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholdersthough inter-sectorial and inter-programmatic interventions.