1887
Volume 2012, Issue 1
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

Abstract

Abstract

Snakebites are a common environmental hazard in many regions of the world. The objectives were to study the epidemiology, clinical, laboratory features of snakebites, the pattern of management with its outcome, and studying the association between the presenting clinical and initial laboratory findings with the outcome.

: a retrospective, hospital-based study was conducted from March 1997–April 2001 at the Saudi Hospital in the Hajjah governorate, Yemen Republic. The demographics, clinical, laboratory, management, outcome data and selected variables were collected for detecting any association between the degree of acuity of snakebites and the outcome.

The data of 186 patients was collected over the period of 4 years. Eighty three percent of snakebite victims were below 40 years of age and males made up 73.7% of all cases. The average incidence was 43 cases per year, with the highest number of cases recorded in July–October. Local swelling then redness was the most common clinical features and the systemic hematological manifestations were double the neurological signs. Lower limbs were involved in 55% of cases. Anemia, leukocytosis, leucopenia and thrombocytopenia were recorded in 34%, 28%, 11% and 8% of cases respectively. Abnormal coagulation was seen in 30% of patients. Admission was necessitated for one third of patients. Surgical assessment was required for 15% of patients. Antivenom was administered for 80% but only 31.7% received this within the first 8 h. Blood products were used for 42% of patients. The complications from the snakebites were recorded in 26% of all cases. There was a statistically significantly association between the rate of complications and the presence of more than three clinical and laboratory findings on arrival. The overall mortality rate was 3.7%.

Snakebites are an important public health problem with a relatively high rate of mortalities and other complications associated with delay in the administration of antivenom. Acknowledging more than three clinical and/or laboratory manifestations on arrival to hospital might help in anticipating clinically important complications.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2012.2
2012-05-07
2019-08-22
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2012/1/jemtac.2012.2.html?itemId=/content/journals/10.5339/jemtac.2012.2&mimeType=html&fmt=ahah

References

  1. [1]. Paul   V.., , Partibha   S.., , Prahlad   K.A.., , Earali   J.., , Francis   S.., and Lewis   F..   High-dose anti-snake venom in the treatment of poisonous snake bites—a criticalstudy. . J Assoc Physicians India . 2004; ;52: : 14– 17 .
    [Google Scholar]
  2. [2]. Ertem   K.., , Esenkaya   I.., , Kaygusuz   M.A.., and Turan   C..   Our clinical experience in the treatment of snakebites. . Acta Orthop Traumatol Turc . 2005; ;39: : 1 , 548 .
    [Google Scholar]
  3. [3]. Bawaskar   H.S.., and Bawaskar   PH..   Envenoming by the common krait (Bungarus caeruleus) and Asian cobra (Najanaja): clinical manifestations and their management in a rural setting. . WildernessEnviron Med . 2004; ;15: : 4 , 257– 266 .
    [Google Scholar]
  4. [4]. Kidmas   A.T.., , Nwadiaro   C.H.., and Igun   G.O..   Lower limb amputation in Jos, Nigeria. . East Afr Med J . 2004; ;81: : 8 , 427– 429 .
    [Google Scholar]
  5. [5]. Tchoua   R., , Raouf   A.O., , Ogandaga   A., , Mouloungui   C., , Loussou   J.B., , Kombula   M.   et al. Analysis of snake bite envenomations in Gabon. . Bull Soc Pathol Exot . 2002; ;95: : 3 , 188– 190 .
    [Google Scholar]
  6. [6]. Moreno   E., , Queiroz-Andrade   M., , Lira-da-Silva   RM., and Tavares-Neto   J..   Clinical and eidemiological characteristics of snakebites in Rio Branco. . Acre. Rev SocBras Med Trop . 2005 Jan–Feb; ;38: : 1 , 15– 21 .
    [Google Scholar]
  7. [7]. Currie   B.J..   Snakebite in tropical Australia: a prospective study in the Top End of the NorthernTerritory. . Med J Aust . 2004; ;181: : 11–12 , 693– 697 .
    [Google Scholar]
  8. [8]. Sharma   N.., , Chauhan   S.., , Farugi   S.., , Bhat   P.., and Varma   S..   Snake envenomation in a north Indian hospital. . Emerg Med J . 2005; ;22: : 2 , 118– 120 .
    [Google Scholar]
  9. [9]. Eayomi   B.., , Massougbodji   A.., and Chobli   M..   Epidemilogical data on snake bite cases reported in Benin from 1994 to 2000. . BullSoc Pathol Exot . 2002; ;95: : 3 , 178– 180 .
    [Google Scholar]
  10. [10]. Ribeiro   L.A.., and Torge   M.T..   Epidemiology and clinical picture of accidents by adult and young snakes Bothropsjaraca. . Rev Inst Med Trop Sao Paulo . 1990; ;32: : 6 , 436– 442 .
    [Google Scholar]
  11. [11]. Lallo   D.G.., , Trevett   A.J.., , Saweri   A.., , Naragi   S.., , Theakston   R.D.., and Warrell   D.A..   The epidemiology of snake bite in Central Province and National CapitalDistrict, Papua New Guinea. . Trans R Soc Trop Med Hyg . 1995; ;89: : 2 , 178– 182 .
    [Google Scholar]
  12. [12]. Morgan   B.W.., , Lee   C.., , Damiano   L.., , whitlow   K.., and Geller   R..   Reptile envenomation 20-year mortality as reported by US medical examiners. . SouthMed J . 2004; ;97: : 7 , 642– 644 .
    [Google Scholar]
  13. [13]. Pinho   F.M.., , Oliveira   E.S.., and Faleiros   F..   Snakebites in the State of Goias. . Brazil Rev Assoc Med Bras . 2004; ;50: : 1 , 93– 96 .
    [Google Scholar]
  14. [14]. Hanssens   Y.., , Deleu   D.., and Taqi   A..   Etiologic and demographic charactrestics of poisoning: a prospective hsopital-basedstudy in Oman. . J toxicol Clin Toxicol . 2001; ;39: : 4 , 371– 380 .
    [Google Scholar]
  15. [15]. Al Harbi   N..   Epidemiological and clinical differences of snake bites among children andadults in south western Saudi Arabia. . J Accid Emerg Med . 1999; ;16: : 6 , 428– 30 .
    [Google Scholar]
  16. [16]. Chippaux   J.P.., , Rage-Anderieux   V.., , Le Mener-Delore   V.., , Charrondiere   M.., , Sagot   P.., and Lang   J..   Epidemiology of snake envenomations in northern Cameroon. . Bull Soc Pathol Exot . 2002; ;95: : 3 , 184– 187 .
    [Google Scholar]
  17. [17]. De Sousa   L., , Vasques   D., , Salzar   D., , Valecillos   R., , Vasquez   D., , Rojas   M.   et al. Human mortality due to invertebrate and vertebrate envenomation in Monagas State,Venezuela. . Invest Clin . 2005; ;46: : 3 , 241– 254 .
    [Google Scholar]
  18. [18]. Malik   G.M..   Snake bites in adults from the Asir region of southern Saudi Arabia. . Am J Trop MedHyg . 1995; ;52: : 4 , 314– 317 .
    [Google Scholar]
  19. [19]. Suleman   M.M.., , Shahab   S.., and Rab   M.A..   Snake bite in the Thar Desert. . J Pak Med Assoc . 1998; ;48: : 10 , 306– 308 .
    [Google Scholar]
  20. [20]. Dumavibhat   B..   A study of epidemiology, risk factors and preventive measures against snake bites. . JMed Assoc Thai . 1997; ;80: : 9 , 547– 556 .
    [Google Scholar]
  21. [21]. Hati   A.K.., , Mandal   M.., , De   M.K.., , Mukherjee   H.., and Hati   R.N..   Epidemiolgy of snake bite in the district of Burdwan, West Bengal. . J Indian MedAssoc . 1992; ;90: : 6 , 145– 147 .
    [Google Scholar]
  22. [22]. Morandi   N.., and Williams   J..   Snakebite injuries: contributing factors and intentionality of exposure. . WildernessEnviron Med . 1997; ;8: : 3 , 152– 155 .
    [Google Scholar]
  23. [23]. Dabo   A.., , Diawara   S.I.., , Dicko   A.., , Katile   A.., , Diallo   A.., and Doumbo   O..   Evaluation and treatment of snake bites in Bancomana village in Mali. . Bull SocPathol Exot . 2002; ;95: : 3 , 160– 162 .
    [Google Scholar]
  24. [24]. Snow   R.W.., , Bronzan   R.., , Roques   T.., , Nyamawi   C.., , Murphy   S.., and Marsh   K..   The prevalence and morbidity of snake bite and treatment-seeking behaviouramong a rural Kenyan population. . Ann Trop Med parasitol . 1994; ;88: : 6 , 665– 671 .
    [Google Scholar]
  25. [25]. Jamieson   R.., and Pearn   J..   An epidemiological and clinical study of snake-bites in childhood. . Med J Aus . 1989; ;150: : 12 , 698– 702 .
    [Google Scholar]
  26. [26]. Seddik   S.S.., , Wanas   S.., , Helmy   M.H.., and Hashem   M..   Cross neutralization of dangerous snake venoms in Africa and Middle East using theVACSERA polyvalent antivenom. Egyptian Organization for Biological Products &vaccines. . J Nat Toxins . 2002; ;11: : 4 , 329– 335 .
    [Google Scholar]
  27. [27]. Barrett   R.., and Little   M..   Five years of snake envenoming in north Queensland. . Emerg Med (Fremantle) . 2003; ;15: : 5–6 , 500– 510 .
    [Google Scholar]
  28. [28]. Al-Sadoon   M.K.., and Al-Farraj   S.A..   Poisonous snakes in the Kingdom of Saudi Arabia: Species, Distribution andPrevention . , Third edition. , 1997; ; 21 .
    [Google Scholar]
  29. [29]. Jamaiah   I.., , Rohela   M.., , Roshalina   R.., and Undan   R.C..   Prevalence of snake bites in Kangar District Hospital, Perlis, West Malaysia: aretrospective study (January 1999–December 2000). . Southeast Asian J Trop MedPublic Health . 2004; ;35: : 4 , 962– 965 .
    [Google Scholar]
  30. [30]. Bubalo   P.., , Curic   I.., and Fister   K..   Characterstics of venomous snakebites in Herzegovina. . Croat Med J . 2004; ;45: : 1 , 50– 53 .
    [Google Scholar]
  31. [31]. Wierzbicka   I.., , Prokopowicz   D.., , Kolakowska   R.., and Panasiuk   A..   Snake bites. . Prezegl Epidemiology . 1997; ;51: : 3 , 359– 362 .
    [Google Scholar]
  32. [32]. Mahaba H.M. SnakeBite: Epidemiology, Prevention, Clinical Presentation and Management. http://www.kfshrc.edu.sa/annals/201/99-108.htm.
  33. [33]. Chen   J.C.., , Liaw   S.J.., , Bullard   M.J.., and Chiu   T.F..   Treatment of poisonous snakebites in northern Taiwan. . J Formos Med Assoc . 2000; ;99: : 2 , 135– 139 .
    [Google Scholar]
  34. [34]. Handsdak   S.G.., , Lallar   K.S.., , Pokharel   P.., , Shyangwa   P.., , Karki   P.., and Koirala   S..   A clinicoepidemiological study of snake bite in Nepal. . Trop Doct . 1998; ;28: : 4 , 223– 226 .
    [Google Scholar]
  35. [35]. Pozio   E..   Venomous snake bites in Italy: epidemiological and clinical aspects. . Trop MedParasitol . 1988; ;39: : 1 , 62– 66 .
    [Google Scholar]
  36. [36]. Isbister   G.K.., and Currie   B.J..   Suspected snakebite: one year prospective study of emergency departmentpresentations. . Emerg Med (Fremantle) . 2003; ;15: : 2 , 160– 169 .
    [Google Scholar]
  37. [37]. Annobil   S.H..   Complications of Echis colorata snake bites in the Asir region of Saudi Arabia. . AnnTrop Paediatr . 1993; ;13: : 1 , 39– 44 .
    [Google Scholar]
  38. [38]. Ismail   M.., and Memish   Z.A..   Venomous snakes of Saudi Arabia and the Middle East: a keynote for travelers. . Int JAntimicrob Agents . 2003; ;21: : 2 , 164– 169 .
    [Google Scholar]
  39. [39]. LoVecchio   F.., , Klemens   J.., , Welch   S.., and Rodriguez   R..   Antibiotics after rattlesnake envenomation. . J Emerg Med . 2002; ;23: : 4 , 327– 328 .
    [Google Scholar]
  40. [40]. Al-Rohani   M..   Renal failure in Yemen. . Transplant Proc . 2004; ;36: : 6 , 1777– 1779 .
    [Google Scholar]
  41. [41]. Saborio   P.., , Gonzalez   M.., and Cambronero   M..   Snake bite accidents in children in Costa Rica: epidemiology and determination ofrisk factors in the development of abscess and necrosis. . Toxicon . 1998; ;36: : 2 , 359– 366 .
    [Google Scholar]
  42. [42]. Chen   J.C.., , Bullard   M.J.., , Chiu   T.F.., , Ng   C.L.., and Liaw   S.J..   Risk of immediate effects from F(ab)2 bivalent antivenin in Taiwan. . WildernessEnviron Med . 2000; ;11: : 3 , 163– 167 .
    [Google Scholar]
  43. [43]. Yeung   J.M.., , Little   M.., , Murray   L.M.., , Jelinek   G.A.., and Daly   F.F..   Antivenom dosing in 35 patients with severe brown snake (Pseudonaja) envenomingin Western Australia over 10 years. . Med J Aust . 2004; ;181: : 11–12 , 703– 705 .
    [Google Scholar]
  44. [44]. Tariang   D.D., , Philip   P.J., , Alexander   J., , Macaden   S., , Jeyaseelan   L., , Peter   J.V.   et al. Randomized controlled trial on the effective dose of anti-snake venom in cases ofsnake bite with systemic envenomation. . J Assoc Physicians India . 1999; ;47: : 4 , 369– 371 .
    [Google Scholar]
  45. [45]. Jorge   M.T., , Malaque   C., , Ribeiro   L.A., , Fan   H.W., , Cardoso   J.L., , Nishioka   S.A.   et al. Failure of chloramphenicol prohhylaxis to reduce the frequency of abscess formationas a complication of envenoming by Bothrops snakes in Brazil: a double-blindrandomized controlled trial. . Trans R Soc Trop Med Hyg . 2004; ;98: : 9 , 529– 534 .
    [Google Scholar]
  46. [46]. Kalantri   S.., , Singh   A.., , Joshi   R.., , Malamba   S.., , Ho   C.., , Ezoua   J.., and Morgan   M..   Clinical predictors of in-hospital mortality in patients with snake bite: a retrospectivestudy from a rural hospital in central India. . Tropical Medicine and InternationalHealth . 2006; ;11: : 1 , 22– 30 .
    [Google Scholar]
  47. [47]. Moss   StevenT., , Bogdan   Greg., , Dart   Richard C., , Nordt   Seen P., , Williams   Saralyn R., and Clark   Richard F.   Association of rattlesnake bite location with severity of clinical manifestations. . Annals of Emergency Medicine . 1997; ;30: : 1 , 58– 61 .
    [Google Scholar]
  48. [48]. Elizabeth   J.., , Scharman   V.., and Dalton   N..   Copperhead snakebites: clinical severity of local effects. . Annals of emergencyMedicine . 2001; ;38: : 1 , 55– 61 .
    [Google Scholar]
  49. [49]. Dart   R.C.., , Hurlbut   K.M.., , Garcia   R.., and Boren   J..   Validation of a Severity Score for the Assessment of Crotalid Snakebite. . Annals ofEmergency Medicine . 1996; ;27: : 3 , 321– 326 .
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2012.2
Loading
/content/journals/10.5339/jemtac.2012.2
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error