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 ,Revised 12 November 2007 ,Accepted 12 November 2007.

References 

  1. Ashton, J., 2000. Monitoring the Quality of Hospital Care. Center for Human Services, University Research Co., LCC, Bethesda, MD. http://www.urc-chs.com [accessed 7 November 2007].
  2. Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Trans. R. Soc. Med. Hyg. 2002;96:79–84
  3. Chippaux JP, Lang J, Eddine SA, Fagot P, Rage V, Peyrieux JC, et al. Clinical safety of a polyvalent F(ab’)2 equine antivenom in 223 African snake envenomations: a field trial in Cameroon. VAO (Venin Afrique de l’Ouest) Investigators. Trans. R. Soc. Trop. Med. Hyg. 1998;92:657–662
  4. Chippaux JP, Rage-Andrieux V, Le Mener-Delore V, Charrandiere M, Sagot P, Lang J. Epidemiology of snake envenomations in northern Cameroon. Bull. Soc. Pathol. Exot. 2002;95:184–187[in French]
  5. Einterz EM, Bates ME. Snake bite in northern Cameroon: 134 victims of bites by the saw-scaled or carpet viper, Echis ocellatus. Trans. R. Soc. Trop. Med. Hyg. 2003;97:693–696
  6. Fry BG, Winkel KD, Wicramaratna JC, Hodgson WC, Wüster W. Effectiveness of snake antivenom: species and regional venom variation and its clinical impact. J. Toxicol. Toxin Rev. 2003;22:23–34
  7. Gutierrez JM, Rojas E, Quesada L, Leon G, Nunez J, Laing GD, et al. Pan-African polyspecific antivenom produced by caprylic acid purification of horse IgG: an alternative to the antivenom crisis in Africa. Trans. R. Soc. Trop. Med. Hyg. 2005;99:468–475
  8. Habib AG. Tetanus complicating snake bite in northern Nigeria: clinical presentation and public health implications. Acta Trop. 2003;85:87–91
  9. Laing GD, Harrison RA, Theakston RD, Renjifo JM, Nasidi A, Gutierrez JM, et al. Polyspecific snake antivenom may help in antivenom crisis. BMJ. 2003;326:447–448
  10. Massougbodji M, Chobli M, Assouto P, Lokossou T, Sanoussi H, Sossou A, et al. Geoclimatology and severity of snake bite envenomations in Benin. Bull. Soc. Pathol. Exot. 2002;95:175–177[in French]
  11. Mebs D, Kornalik F. Schlangengiftseren—Probleme ihrer Wirksamkeit, untersucht am Beispiel von Echis carinatus. Salamandra (Frankf.). 1981;17:89–98
  12. Meyer WP, Habib AG, Onayade AA, Yakubu A, Smith DC, Nasidi A, et al. First clinical experiences with a new ovine Fab Echis ocellatus snake bite antivenom. Am. J. Trop. Med. Hyg. 1997;56:291–300
  13. Muguli GI, Marimba A, Washaya CT. Snake bites in Zimbabwe: a clinical study with emphasis on the need for antivenom. Centr. Afr. J. Med. 1994;40:83–88
  14. Nasidi, A., 2007. Snakebite as a serious public health problem for Nigeria and Africa. http://www.who.int/entity/bloodproducts/animal_sera/A.Nasidi.pdf [accessed 7 November 2007].
  15. Sano-Martins IS, Fan HW, Castro SC, Tomy SC, Franca FO, Jorge MT, et al. Reliability of the simple 20 minute whole blood clotting test (20WBCT) as an indicator of low plasma fibrinogen concentration in patients envenomed by Bothrops snakes. Butantan Institute Antivenom Study Group. Toxicon. 1994;32:1045–1050
  16. Snow RW, Bronzan R, Roques T, Nyamawi C, Murphy S, Marsh K. The prevalence and morbidity of snake bite and treatment-seeking behaviour among a rural Kenyan population. Ann. Trop. Med. Parasitol. 1994;88:665–671
  17. Swiecicki AW. Snakes and snake bite in the Western Region, Ghana. J. Trop. Med. Hyg. 1965;68:300–304
  18. Theakston RD, Warrell DA, Griffiths E. Report of a WHO workshop on the standardization and control of antivenoms. Toxicon. 2003;41:541–557
  19. Visser LE, Kyei-Faried S. Snake bites: a simple treatment protocol for rural areas. Ghana Med. J. 2003;37:57–61
  20. Visser LE, Kyei-Faried S, Belcher DW. Protocol and monitoring to improve snake bite outcomes in rural Ghana. Trans. R. Soc. Trop. Med. Hyg. 2004;98:278–283
  21. Warrell DA. Venomous bites and stings in the tropical world. Med. J. Aust. 1993;159:773–779
  22. Warrell DA. Clinical toxicology of snakebite in Africa and the Middle East/Arabian Peninsula. In:  Meier J,  White J editor. Handbook of Clinical Toxicology of Animal Venoms and Poisons. New York: CRC Press; 1995;p. 435–489
  23. Warrell DA, Arnett C. The importance of bites by the saw-scaled or carpet viper (Echis carinatus): epidemiological studies in Nigeria. Acta Trop. 1976;33:307–341
  24. Warrell DA, Warrell MJ, Edgar W, Prentice CRM, Mathieson J. Comparison of Pasteur and Behringwerke antivenoms in envenoming by the carpet viper (Echis carinatus). Br. Med. J. 1980;280:607–609
  25. WHO, 1998. The Clinical Management of Snakebites in the South East Asian Region. World Health Organization, Regional Office for South-East Asia. http://www.searo.who.int/ [accessed 7 November 2007].

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

Article Tools