RESUMO
Currently there is a crisis in the supply of antivenom for treatment of snake bite in sub-Saharan Africa. Commercial pressures have resulted in the reduction or even cessation of production of antivenom by European manufacturers while continued production of antivenom in Africa has been threatened by the privatisation of the only remaining company based in Africa. As a consequence, there has been an increase in snake bite morbidity and mortality in many African countries. Two Latin American antivenom manufacturers have agreed to produce antivenom suitable for Africa, using venoms from the species which are of the greatest medical importance in sub-Saharan Africa. Preclinical in vivo assays of neutralising potency demonstrated that a new Pan African antivenom produced in Colombia compared favourably with the existing commercial monospecific and polyspecific antivenoms. This new antivenom, and a similar product being manufactured in Costa Rica, are now candidates for clinical testing at an appropriate site in Africa.
Assuntos
Antivenenos , Indústria Farmacêutica/economia , Emergências , Mordeduras de Serpentes , África Subsaariana , Animais , Antivenenos/biossíntese , Antivenenos/economia , Antivenenos/imunologia , Antivenenos/farmacologia , Avaliação Pré-Clínica de Medicamentos , Eletroforese em Gel de Poliacrilamida , Serviços Médicos de Emergência , Cavalos/imunologia , Dose Letal Mediana , Testes de Neutralização , Mordeduras de Serpentes/terapia , Venenos de Serpentes/química , Venenos de Serpentes/imunologia , Especificidade da Espécie , Organização Mundial da SaúdeRESUMO
Morbidity and mortality due to envenoming by the carpet viper (Echis ocellatus) in northern Nigeria remains unacceptably high and constitutes a severe economic and public health problem to the local farming community in particular. The only effective treatment of systemic envenoming is antivenom, but supplies are very limited as the little that is available is either too expensive, ineffective or both. Here, we describe a new ovine antivenom, designed both to be effective and to be available at low cost. The antivenom, a polyclonal ovine Fab preparation, provides superior protection, both in vivo and in vitro, to the best alternatives, the monospecific South African Institute of Medical Research antivenom and the polyspecific Pasteur Isper Africa antivenom. Fab fragments, which have the advantages of large volumes of distribution and, theoretically, low immuno-reactivity, are produced by a reusable solid-phase papain matrix which eliminates enzyme contamination of the product and reduces cost. The antivenom is lyophilised for increased stability and extended shelf-life in tropical climates where it is often impossible to keep such products cool.