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1.
Am J Trop Med Hyg ; 96(4): 876-884, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28138054

RESUMO

AbstractWe describe 70 cases of monocled cobra (Naja kaouthia) bite admitted to Chittagong Medical College Hospital, Bangladesh. The biting snakes were identified by examining the dead snake and/or detecting N. kaouthia venom antigens in patients' serum. Bites were most common in the early morning and evening during the monsoon (May-July). Ligatures were routinely applied to the bitten limb before admission. Thirty-seven patients consulted traditional healers, most of whom made incisions around the bite site. Fifty-eight patients experienced severe neurotoxicity and most suffered swelling and pain of the bitten limb. The use of an Indian polyvalent antivenom in patients exhibiting severe neurotoxicity resulted in clinical improvement but most patients experienced moderate-to-severe adverse reactions. Antivenom did not influence local blistering and necrosis appearing in 19 patients; 12 required debridement. Edrophonium significantly improved the ability of patients to open the eyes, endurance of upward gaze, and peak expiratory flow rate suggesting that a longer-acting anticholinesterase drug (neostigmine) could be recommended for first aid. The study suggested that regionally appropriate antivenom should be raised against the venoms of the major envenoming species of Bangladesh and highlighted the need to improve the training of staff of local medical centers and to invest in the basic health infrastructure in rural communities.


Assuntos
Antivenenos/uso terapêutico , Elapidae/fisiologia , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antivenenos/administração & dosagem , Bangladesh/epidemiologia , Criança , Pré-Escolar , Edrofônio , Venenos Elapídicos/toxicidade , Feminino , Primeiros Socorros , Humanos , Masculino , Pessoa de Meia-Idade , Mordeduras de Serpentes/patologia , Adulto Jovem
2.
Toxicon ; 42(1): 35-41, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12893059

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 Saúde
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