Abstract
The deliberations and conclusions of a Hinxton Retreat convened in September 2015, entitled “Mechanisms to reverse the public health neglect of snakebite victims” are reported. The participants recommended that the following priority actions be included in strategies to reduce the global impact of snake envenoming: (a) collection of accurate global snakebite incidence, mortality and morbidity data to underpin advocacy efforts and help design public health campaigns; (b) promotion of (i) public education prevention campaigns; (ii) transport systems to improve access to hospitals and (iii) establishment of regional antivenom-efficacy testing facilities to ensure antivenoms’ effectiveness and safety; (c) exploration of funding models for investment in the production of antivenoms to address deficiencies in some regions; (d) establishment of (i) programs for training in effective first aid, hospital management and post-treatment care of victims; (ii) a clinical network to generate treatment guidelines and (iii) a clinical trials system to improve the clinical management of snakebite; (e) development of (i) novel treatments of the systemic and local tissue-destructive effects of envenoming and (ii) affordable, simple, point-of-care snakebite diagnostic kits to improve the accuracy and rapidity of treatment; (f) devising and implementation of interventions to help the people and communities affected by physical and psychological sequelae of snakebite.
Highlights
Snakebite is a medical emergency that annually kills over 95,000 people residing in some of the world’s most disadvantaged subsistence farming communities, and leaves over 300,000 surviving victims with permanent physical disabilities, stigmatising disfigurements and chronic mental morbidity [1,2,3]
Rural snakebite victims typically gain access to health centres many hours (6+) after the bite [5,6], which increases both the severity of pathology and complexity of treatment. The causes of this delay vary significantly but often include (i) remoteness and lack of road infrastructure; (ii) poor ambulance services; (iii) expense of transport, when it is available and (iv) cultural norms dictating that snakebite victims often first seek assistance of traditional healers—whose administrations are lengthy, often harmful and rarely effective; and, (v) there is often a loss of confidence in local health facilities because of a frequent lack of affordable and effective antivenom, which regrettably reinforces the importance of traditional healers in these communities
In addition to a sustained international cooperative effort in the preclinical testing of antivenom efficacy being performed in Latin America for many years (e.g., [28]), it was reported to the workshop that several research groups have been/are performing preclinical efficacy assessment of several antivenoms distributed in sub-Saharan Africa
Summary
Snakebite is a medical emergency that annually kills over 95,000 people residing in some of the world’s most disadvantaged subsistence farming communities, and leaves over 300,000 surviving victims with permanent physical disabilities, stigmatising disfigurements and chronic mental morbidity [1,2,3]. It is the rural impoverished African, Asian and Latin American communities [4], and the most economically-important and educationally-vulnerable 10–30-year-olds that suffer disproportionally high rates of snakebite mortality and morbidity. Poverty and limited government investment in snakebite management were described as ever-present themes at each level that snakebite affects its victims
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