Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa
Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and...
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ftdoajarticles:oai:doaj.org/article:a37da65ce4734024b29b4a80648f5ec0 2023-05-15T15:08:35+02:00 Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa Mamadou C Baldé Jean-Philippe Chippaux Mamadou Y Boiro Roberto P Stock Achille Massougbodji 2013-03-01T00:00:00Z https://doi.org/10.1186/1678-9199-19-6 https://doaj.org/article/a37da65ce4734024b29b4a80648f5ec0 EN eng SciELO http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304&lng=en&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1186/1678-9199-19-6 https://doaj.org/article/a37da65ce4734024b29b4a80648f5ec0 Journal of Venomous Animals and Toxins including Tropical Diseases, Vol 19, Iss 0 (2013) Elapid Neurotoxins Treatment Antivenom Guinea Africa Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 article 2013 ftdoajarticles https://doi.org/10.1186/1678-9199-19-6 2022-12-31T09:08:52Z Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and two other groups that received either 2 or 4 initial vials of Antivipmyn® Africa renewed as necessary. CFR was 27.3%, 15.4% and 17.6%, respectively. Although antivenom treatment was likely to reduce CFR, it didn’t seem to have an obvious clinical benefit for the patients, suggesting a low treatment efficacy. Mean delay to treatment or clinical stages were not significantly different between the patients who recovered and the patients who died, or between groups. Interpretation of these results is complicated by the lack of systematic studies under comparable conditions. Of particular importance is the absence of assisted ventilation, available to patients in all the other clinical studies of neurotoxic envenomation. Conclusion The apparent lack of clinical benefit may have several causes. The hypothesis of a limited therapeutic window, i.e. an insufficient formation of antigen-antibody complexes once toxins are bound to their targets and/or distributed beyond the reach of antivenom, should be explored. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Journal of Venomous Animals and Toxins including Tropical Diseases 19 1 6 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Elapid Neurotoxins Treatment Antivenom Guinea Africa Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
spellingShingle |
Elapid Neurotoxins Treatment Antivenom Guinea Africa Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 Mamadou C Baldé Jean-Philippe Chippaux Mamadou Y Boiro Roberto P Stock Achille Massougbodji Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
topic_facet |
Elapid Neurotoxins Treatment Antivenom Guinea Africa Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
description |
Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and two other groups that received either 2 or 4 initial vials of Antivipmyn® Africa renewed as necessary. CFR was 27.3%, 15.4% and 17.6%, respectively. Although antivenom treatment was likely to reduce CFR, it didn’t seem to have an obvious clinical benefit for the patients, suggesting a low treatment efficacy. Mean delay to treatment or clinical stages were not significantly different between the patients who recovered and the patients who died, or between groups. Interpretation of these results is complicated by the lack of systematic studies under comparable conditions. Of particular importance is the absence of assisted ventilation, available to patients in all the other clinical studies of neurotoxic envenomation. Conclusion The apparent lack of clinical benefit may have several causes. The hypothesis of a limited therapeutic window, i.e. an insufficient formation of antigen-antibody complexes once toxins are bound to their targets and/or distributed beyond the reach of antivenom, should be explored. |
format |
Article in Journal/Newspaper |
author |
Mamadou C Baldé Jean-Philippe Chippaux Mamadou Y Boiro Roberto P Stock Achille Massougbodji |
author_facet |
Mamadou C Baldé Jean-Philippe Chippaux Mamadou Y Boiro Roberto P Stock Achille Massougbodji |
author_sort |
Mamadou C Baldé |
title |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_short |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_full |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_fullStr |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_full_unstemmed |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_sort |
use of antivenoms for the treatment of envenomation by elapidae snakes in guinea, sub-saharan africa |
publisher |
SciELO |
publishDate |
2013 |
url |
https://doi.org/10.1186/1678-9199-19-6 https://doaj.org/article/a37da65ce4734024b29b4a80648f5ec0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Venomous Animals and Toxins including Tropical Diseases, Vol 19, Iss 0 (2013) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304&lng=en&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1186/1678-9199-19-6 https://doaj.org/article/a37da65ce4734024b29b4a80648f5ec0 |
op_doi |
https://doi.org/10.1186/1678-9199-19-6 |
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Journal of Venomous Animals and Toxins including Tropical Diseases |
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19 |
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