Epidemiology of snakebite and use of antivenom in Argentina

• Autores: Dolab, Jorge A.; de Roodt, Adolfo R.; de Titto, Ernesto Horacio; García, Susana Isabel; Funes, Raúl F; Salomón, Oscar Daniel; Chippaux, Jean-Philippe
• Año de publicación: 2014
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: Transactions of The Royal Society of Tropical Medicine and Hygiene 2014 ; 108(5):269-276
• Materia: Argentina; Bothrops; Crotalus; Serpientes de Coral; Mordeduras de Serpientes; Animales; Antivenenos; Esquema de Medicación; Servicio de Urgencia en Hospital; Femenino; Humanos; Masculino; Estaciones del Año; Encuestas y Cuestionarios; Resultado del Tratamiento; Elapidae
• Institución: Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"

Fil: Dolab, Jorge Adrián. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Producción de Biológicos; Argentina.
Fil: de Roodt, Adolfo Rafael. Universidad de Buenos Aires. Facultad de Medicina. Centro de Patología Experimental y Aplicada. Laboratorio de Toxinopatología; Argentina.
Fil: de Titto, Ernesto Horacio. Ministerio de Salud. Dirección Nacional de Determinantes de la Salud e Investigación; Argentina.
Fil: García, Susana Isabel. Ministerio de Salud. Dirección Nacional de Determinantes de la Salud e Investigación; Argentina.
Fil: Funes, Raúl. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Producción de Biológicos; Argentina.
Fil: Salomón, Oscar Danie. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Medicina Tropical; Argentina.
Fil: Chippaux, Jean-Philippe. Institut de Recherche pour le Développement; Francia.
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.