Épidémiologie des envenimations par morsure de vipère en unité de réanimation pédiatrique à l’hôpital d’Enfants de Rabat au Maroc

Abstract

The snakebite is the most severe form of envenomation. The aim of this retrospective study was to describe the epidemiological, diagnostic, therapeutic and evolutionary snakebites in Children in paediatric intensive care unit of the children's hospital of Rabat. The criteria of severity were studied in four grades : grade 0 (traces of hooks at the bite, no swelling or local reaction), grade 1 (local oedema, absence of constitutional symptoms), grade 2 (swelling of regional member and/or moderate symptoms), grade 3 (extensive swelling up the trunk and/or severe symptoms). The number of patients included was 17 between January 2004 and December 2009. The male predominance (59%), bites by snakes (76%), bites during the afternoons (76%) and summer (53%), bites to the lower limb (65%) were net, corroborating the data from the literature on the subject. The median period of treatment was 9.5 hours, 53% of cases of severe grade 2 and 3 versus 47% in grades 0 and 1. The median duration of hospitalization was five days. One child died (6%). No child received antivenin treatment. Our analysis calls for the availability of specific immunotherapy in local health institutions in high-risk areas, such as ours.