Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 102, Issue 5 , Pages 445-450, May 2008

Failure of a new antivenom to treat Echis ocellatus snake bite in rural Ghana: the importance of quality surveillance

  • L.E. Visser

      Affiliations

    • Mathias Hospital, P.O. Box 43, Yeji B/A, Ghana
    • Corresponding Author InformationCorresponding author. Present address: Holy Family Hospital, P.O. Box 21, Berekum B/A, Ghana. Tel.: +233 20 815 7857.
    • ,
  • S. Kyei-Faried

      Affiliations

    • Regional Health Directorate, P.O. Box 99, Tamale, Northern Region, Ghana
    • ,
  • D.W. Belcher

      Affiliations

    • Department of Community Health, University of Ghana School of Medicine, Accra, Ghana
    • ,
  • D.W. Geelhoed

      Affiliations

    • ICRH, Tete Province, Mozambique
    • ,
  • J. Schagen van Leeuwen

      Affiliations

    • St Antonius Hospital, Nieuwegein, The Netherlands
    • ,
  • J. van Roosmalen

      Affiliations

    • Leiden University Medical Centre, Leiden, The Netherlands
    • Free University Amsterdam, The Netherlands

Received 21 August 2007; received in revised form 12 November 2007; accepted 12 November 2007.

Summary 

This study compares two antivenoms used to treat Echis ocellatus snake bite patients at Mathias Hospital, Yeji, central Ghana. FAV-Afrique™ antivenom (Aventis Pasteur) was given to 278 patients during 2001–2003, whilst Asna Antivenom C (Bharat Serum and Vaccines Ltd) was used in 2004 to treat 66 patients. The two groups had comparable patient attributes, time from snake bite to treatment and staff adherence to the tested treatment protocol. The antivenom C group required more repeat doses and twice the amount of antivenom to treat coagulopathy. Of greater concern, the antivenom C mortality rate was 12.1%, a marked rise from the 1.8% rate in the earlier FAV-Afrique™ antivenom group. In this study, antivenom C was ineffective as treatment for West African E. ocellatus snake venom. This illustrates the absolute need for regional pilot tests to assess the effectiveness of a new antivenom against local snake venoms before its sole and general distribution in a region is initiated.

Keywords: Snake bite, Envenomation, Antivenom, Carpet viper, Evaluation, Ghana

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PII: S0035-9203(07)00396-3

doi:10.1016/j.trstmh.2007.11.006

Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 102, Issue 5 , Pages 445-450, May 2008

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