Transactions of the Royal Society of Tropical Medicine and Hygiene · 2014
Epidemiology of snakebite and use of antivenom in Argentina.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Dolab Jorge Adrián, de Roodt Adolfo Rafael, de Titto Ernesto Horacio, García Susana Isabel, Funes Raúl, Salomón Oscar Danie, Chippaux Jean-Philippe
Аннотация
BACKGROUND: The incidence and case fatality rate of snakebite in Argentina are poorly known.
METHODS: The authors used questionnaires provided with antivenoms by the primary manufacturer of anti-venoms in Argentina.
RESULTS: A total of 8083 completed questionnaires was collected between 1978 and 1998. The annual incidence of snakebite was 1.8 bites per 100,000 inhabitants, with a high geographical heterogeneity; in the northern provinces of the country, the incidence can exceed 150 snakebites per 100,000 people per year. Bothrops (pit viper) bites predominated, accounting for 96.6% (6720/6957) of envenomations, bites from Crotalus (rattlesnake) accounted for 2.8% (195/6957), and bites from Micrurus (coral snake) for 0.6% (42/6957). Most patients were young men, who were generally bitten during agricultural activities, i.e. while working in the fields. Most snakebites (78.9%, 5852/7419) were to the lower limb, including 58.3% (4322/7419) to the foot. The case fatality rate was <0.04% (3/8083). Most envenomations (90%, 7275/8083) were treated with specific antivenom during the first 4 h after the bite. The median dose of antivenom was two vials for viper bites (Bothrops and Crotalus) and three vials for Micrurus bites.
CONCLUSION: These preliminary results should enable manufacturers to increase the availability of appropriate antivenom and health authorities to improve the management of snakebites where they are most common.
METHODS: The authors used questionnaires provided with antivenoms by the primary manufacturer of anti-venoms in Argentina.
RESULTS: A total of 8083 completed questionnaires was collected between 1978 and 1998. The annual incidence of snakebite was 1.8 bites per 100,000 inhabitants, with a high geographical heterogeneity; in the northern provinces of the country, the incidence can exceed 150 snakebites per 100,000 people per year. Bothrops (pit viper) bites predominated, accounting for 96.6% (6720/6957) of envenomations, bites from Crotalus (rattlesnake) accounted for 2.8% (195/6957), and bites from Micrurus (coral snake) for 0.6% (42/6957). Most patients were young men, who were generally bitten during agricultural activities, i.e. while working in the fields. Most snakebites (78.9%, 5852/7419) were to the lower limb, including 58.3% (4322/7419) to the foot. The case fatality rate was <0.04% (3/8083). Most envenomations (90%, 7275/8083) were treated with specific antivenom during the first 4 h after the bite. The median dose of antivenom was two vials for viper bites (Bothrops and Crotalus) and three vials for Micrurus bites.
CONCLUSION: These preliminary results should enable manufacturers to increase the availability of appropriate antivenom and health authorities to improve the management of snakebites where they are most common.