RESUMO
Os acidentes por animais peçonhentos, especialmente os acidentes ofídicos, foram incluídos pela Organização Mundial da Saúde (OMS) na lista das doenças tropicais negligenciadas que acometem, na maioria das vezes, populações pobres que vivem em áreas rurais, devido à gravidade constituem um problema de saúde pública. O sucesso no tratamento do paciente para que os mesmos não gerem sequelas graves, podendo chegar ao óbito, requer atendimento de forma rápida, com o uso adequado do soro específico quando necessário para cada espécie de serpentes e na quantidade recomendada. Em Goiás as principais serpentes que causam acidente são dos gêneros: Bothrops (jararacas), Crotalus (cascavéis) e Micrurus (coral), são considerados acidentes graves que demandam o uso de soros antivenenos específicos
Accidents by venomous animals, especially snakebites, were included by the World Health Organization (WHO) in the list of neglected tropical diseases that affect, most of the time, poor people living in rural areas, due to the seriousness of a public health problem. . Successful treatment of the patient so that they do not generate serious sequelae, which can lead to death, requires quick care, with the appropriate use of specific serum when necessary for each species of snakes and in the recommended amount. In Goiás, the main snakes that cause accidents are of the genera: Bothrops (jararacas), Crotalus (rattlesnakes) and Micrurus (coral), are considered serious accidents that require the use of specific antivenom serums
Assuntos
Humanos , Masculino , Feminino , Mordeduras de Serpentes/classificação , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/terapia , Venenos de Crotalídeos/classificaçãoRESUMO
Abstract Snakebite is one of the major health issues posing considerable morbidity and mortality. According to an estimate of World Health Organization (WHO) (World health organization, 2021) approximately 5 million people are bitten by several species of snakes resulting in up to 2.5 million envenomation cases annually. The mainstay of treatment for envenomation is intravenous administration of anti-snake venom. Although antivenom neutralizes the systemic effects but it does not relieve the symptoms such as venom-induced hemorrhage, necrosis and nephrotoxicity. Moreover, the use of antivenoms is associated with hypersensitivity reactions including urticaria, anaphylaxis, or serum sickness due to their heterologous property. Furthermore, stringent storage conditions and narrow specificity of antivenoms limit their use in both developed as well as developing countries. In this context, researchers have been searching for natural products and plant extracts to explore their antivenom activity along with anti-myotoxic, anti-hemorrhagic and anti-inflammatory properties. Plant remedies may prove to be an effective alternate for antivenom sera with less adverse events and better tolerability. To the best of our knowledge, this is the first comprehensive review of medicinal plants possessing anti-snake venom activities against certain species of snakes. The current review highlights the investigated plants with their phytochemical analysis to integrate the available information for future research and development of antivenom sera.
Assuntos
Plantas Medicinais/efeitos adversos , Venenos de Serpentes/análise , Antivenenos/análise , Venenos Elapídicos/isolamento & purificação , Compostos Fitoquímicos/agonistas , Mordeduras de Serpentes/classificação , Organização Mundial da Saúde , Extratos Vegetais , Administração Intravenosa/instrumentaçãoRESUMO
Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. Methods This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. Results During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Conclusion Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.
Assuntos
Animais , Mordeduras de Serpentes/classificação , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/prevenção & controleRESUMO
Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. Methods This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. Results During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Conclusion Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.(AU)
Assuntos
Animais , Mordeduras de Serpentes/prevenção & controle , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/classificaçãoRESUMO
OBJECTIVES: In low-income countries, snakebites are frequently managed in rural areas in health centers with severely constrained resources. Many healthcare providers in these settings have limited access to the numerous and relatively expensive laboratory studies used to diagnose envenomation. The relatively simple and inexpensive 20-minute whole blood clotting test (WBCT) has been recommended by several international organizations for the diagnosis of certain venomous snakebites. This study proposes to confirm the utility of the WBCT as the sole laboratory diagnostic tool to determine systemic envenomation in hematotoxic snakebite management in severely resource-constrained areas of the world. METHODS: The authors reviewed all 110 cases of snakebite during a 6-year period in a small hospital in rural Ecuador using the WBCT. RESULTS: All cases presented within 24 hours of snakebite. Twenty cases revealed normal coagulation with no clinical evidence of systemic envenomation. Ninety cases had no evidence of clot formation (positive WBCT) at 20 minutes, suggesting systemic envenomation. Of these 90 cases, according to a classification scale, 54 were mild, 26 were moderate, and 10 were severe envenomations requiring transfer to tertiary care. All mild and moderate systemic envenomations were successfully treated at the rural hospital. All severe envenomations were treated initially with antivenom before transfer to tertiary care. One patient with severe envenomation died in tertiary care. CONCLUSIONS: The WBCT was predictive of the presence or absence of systemic envenomation from snakebite in our region. The WBCT guided the successful management of mild and moderate systemic envenomation, and spared patients with no evidence of systemic envenomation from potential side effects of antivenom.
Assuntos
Antivenenos/uso terapêutico , Coagulação Sanguínea , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/terapia , Equador , Humanos , Estudos Retrospectivos , Saúde da População Rural/economia , Mordeduras de Serpentes/classificaçãoRESUMO
OBJETIVO: caracterizar o perfil clínico-epidemiológico dos acidentes ofídicos no estado da Paraíba, Brasil, no período 2005-2010. MÉTODOS: estudo transversal descritivo sobre dados obtidos do Sistema de Informação de Agravos de Notificação da Secretaria de Estado de Saúde. RESULTADOS: foram notificados 3.033 casos no período, com média de 505,5 casos/ano; a incidência anual do período foi de 13,7 casos/100 mil habitantes; a maior frequência de casos foi no sexo masculino (76,0 por cento); a faixa etária que apresentou maior risco foi a dos 60-64 anos (18,9 casos/100 mil hab.); a maioria dos casos ocorreu entre maio e agosto (43,1 por cento), em grande parte causados pelo gênero Bothrops (jararaca) (83,0 por cento); 122 (4,0 por cento) foram classificados como casos graves e 18 (0,6 por cento) evoluíram para óbito. CONCLUSÃO: os meses de maior índice pluviométrico (maio a agosto) foram os que apresentaram maior número de casos; a evolução para cura foi o desfecho mais comum; os acidentes de grau leve predominaram.
OBJECTIVE: to characterize clinical and epidemiological profile of snakebites in the state of Paraíba, Brazil, in the period 2005-2010. METHODS: a cross-sectional descriptive study based on data obtained in the Information System for Notifiable Diseases, of the State Health Secretariat. RESULTS: 3,033 cases were reported in the period, with an average of 505.5 cases/year; the annual incidence of the period was 13.7 cases per 100,000 inhabitants; the higher frequency of cases was in male gender (76.0 per cent); the age group with highest risk was 60-64 years (18.9 cases per 100,000 inhab.); most cases occurred between May and August (43.1 per cent) and the genus Bothrops (pit viper) caused most of these (83.0 per cent); 122 were classified as severe cases (4.0 per cent) and 18 (0.6 per cent) died. CONCLUSION: months of greatest rainfall (May to August) presented highest number of cases; cure was the most common outcome; accidents of mild degree predominated.
Assuntos
Humanos , Masculino , Feminino , Epidemiologia , Epidemiologia Descritiva , Bothrops , Mordeduras de Serpentes/classificaçãoRESUMO
Acute renal failure is one of the most serious complications of envenoming resulting from Crotalus durissus terrificus bites. This study evaluated the relevance of hyperuricemia and oxidative stress and the effects of allopurinol and probenecid in renal dysfunction caused by direct nephrotoxicity of C. d. terrificus venom.
Assuntos
Masculino , Feminino , Humanos , Animais , Crotalus cascavella , Mordeduras de Serpentes/classificação , Mordeduras de Serpentes/complicações , Serpentes/classificação , Insuficiência RenalRESUMO
Accidents caused by snakes, especially in tropical and subtropical countries, still constitute a serious public health problem due to the lack of knowledge of health professionals and the precariousness of health systems in the regions where most accidents occur. Snake venoms contain a range of molecules that may provoke local swelling, pain, renal and respiratory insufficiencies. The study of the effects of each molecule on humans can help the development of complementary therapy. Similarly, the knowledge of clinical aspects of envenomations provides a better identification and implementation of appropriate treatment. In addition, to understand Bothrops envenomations and improve the therapeutic strategy, it is necessary to understand and study the role of important inflammatory mediators, particularly nitric oxide (NO), cytokines and the complement system.(AU)
Assuntos
Humanos , Resultado do Tratamento , Alergia e Imunologia/tendências , Mordeduras de Serpentes/classificação , Bothrops/classificação , Óxido Nítrico/químicaRESUMO
The aim of this study was to describe the epidemiological profile of snakebite accidents in the healthcare macroregion of the north of the State of Minas Gerais, Brazil. Database information on snakebite accidents covering the period from January 2002 to December 2006 was analyzed. It was found that 10,553 cases were notified, and that the samples were noticeably larger in the months of hot and rainy weather, in urban areas (54.1%), at ages less then 20 years (39.7%) and among men and students (53.1% and 29.1%) respectively. The lower limbs (feet, toes, legs and thighs) were the locations most affected (35.9%). The most prevalent snakes were in the genus Bothrops (82.9%) and most of the accidents were mild (66.2%). In this study, it was seen that the seasonality, urbanization and undernotification of the species involved in these accidents had a notable impact, along with seeking walk-in care. It is expected that the new data obtained from this sample may serve as the substrate for planning and implementing measures for healthcare surveillance.
Assuntos
Mordeduras de Serpentes/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil/epidemiologia , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estações do Ano , Índice de Gravidade de Doença , Distribuição por Sexo , Mordeduras de Serpentes/classificação , Adulto JovemRESUMO
O objetivo deste estudo foi descrever o perfil epidemiológico dos acidentes ofídicos da macrorregião de saúde do Norte do Estado de Minas Gerais, Brasil. Foram analisadas informações sobre os acidentes ofídicos relativos ao período compreendido entre janeiro de 2002 a dezembro de 2006, por meio de bancos de dados. Os resultados demonstraram 10.553 casos notificados, com ênfase para a maior casuística em meses de tempo quente e chuvoso, em áreas urbanas (54,1 por cento), faixa etária menor de 20 anos (39,7 por cento), acometendo mais homens e estudantes (53,1 por cento e 29,1 por cento) respectivamente. Os membros inferiores (pé, dedo do pé, perna e coxa) foram os locais mais afetados (35,9 por cento), as serpentes prevalentes foram do gênero Bothrops (82,9 por cento) e a gravidade da maioria dos acidentes foi leve (66,2 por cento). Observou-se nesse estudo um importante impacto da sazonalidade, urbanização, subnotificação das espécies envolvidas nesses acidentes e busca rápida pelo pronto atendimento. Espera-se que os dados inéditos da casuística obtida possam servir de substrato para o planejamento e execução de medidas voltadas para vigilância em saúde e atendimento.
The aim of this study was to describe the epidemiological profile of snakebite accidents in the healthcare macroregion of the north of the State of Minas Gerais, Brazil. Database information on snakebite accidents covering the period from January 2002 to December 2006 was analyzed. It was found that 10,553 cases were notified, and that the samples were noticeably larger in the months of hot and rainy weather, in urban areas (54.1 percent), at ages less then 20 years (39.7 percent) and among men and students (53.1 percent and 29.1 percent) respectively. The lower limbs (feet, toes, legs and thighs) were the locations most affected (35.9 percent). The most prevalent snakes were in the genus Bothrops (82.9 percent) and most of the accidents were mild (66.2 percent). In this study, it was seen that the seasonality, urbanization and undernotification of the species involved in these accidents had a notable impact, along with seeking walk-in care. It is expected that the new data obtained from this sample may serve as the substrate for planning and implementing measures for healthcare surveillance.