Incidence of snakebites in Can Tho Municipality, Mekong Delta, South Vietnam—Evaluation of the responsible snake species and treatment of snakebite envenoming

Autor: Ralf Krumkamp, Nguyen Hai Dang, Le Hoang Hai, Truong Quy Quoc Bao, Cao Minh Chu, Joerg Blessmann, Vo Van Thang, Hoang Dinh Tuyen
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
RC955-962
Antivenom
Snake Bites
Pediatrics
Medical care
Geographical Locations
0302 clinical medicine
Antibiotics
Arctic medicine. Tropical medicine
Surveys and Questionnaires
Medicine and Health Sciences
Medicine
Snakebite
Snake antivenom
Child
Aged
80 and over
Family Characteristics
Ecology
Antivenins
Antimicrobials
Incidence
Incidence (epidemiology)
Eukaryota
Drugs
Snakes
Middle Aged
Squamates
Anti-Bacterial Agents
Infectious Diseases
Vietnam
Child
Preschool
Vertebrates
Delta Ecosystems
Female
Public aspects of medicine
RA1-1270
Mekong delta
Research Article
Neglected Tropical Diseases
Adult
Asia
Adolescent
Vipers
030231 tropical medicine
Person years
Microbiology
Ecosystems
Wetland Ecosystems
Young Adult
03 medical and health sciences
Microbial Control
Environmental health
Animals
Humans
Community survey
Aged
Pharmacology
Treatment Guidelines
Health Care Policy
business.industry
Ecology and Environmental Sciences
Background data
Organisms
Public Health
Environmental and Occupational Health
Infant
Biology and Life Sciences
Reptiles
Tropical Diseases
Health Care
Cross-Sectional Studies
030104 developmental biology
Amniotes
People and Places
business
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 14, Iss 6, p e0008430 (2020)
ISSN: 1935-2735
DOI: 10.1371/journal.pntd.0008430
Popis: Background Data on incidence of snakebites and the responsible snake species are largely missing in Vietnam and comprehensive national guidelines for management of snakebite envenoming are not yet available. They are needed to estimate the scope of this health problem, to assess the demand for snake antivenom and to ensure the best possible treatment for snakebite victims. Methodology/Principle findings A cross-sectional community-based survey was conducted from January to April 2018. Multistage cluster sampling was applied and snakebite incidence in Can Tho municipality, excluding two central districts of Can Tho city, was calculated at 48 (95%-confidence interval (CI): 20.5–99.8) snakebites per 100,000 person-years. Seven snakebite victims found during the survey reported 3 bites from green pit vipers and 4 bites from non-venomous snakes. In 2017 two treatment centres for snakebite envenoming in Can Tho city, the Military Hospital 121 and the Paediatric Hospital, received 520 admissions of snakebite victims. Two hundred sixty-seven came from Can Tho Municipality and 253 from neighbouring provinces. According to these data, the incidence of snakebites for Can Tho municipality was calculated at 21 (95%-CI: 18.5–23.7) snakebites per 100,000 person-years. Incidence was 14 (95%-CI: 12–17) snakebites per 100,000 person years in those 7 districts of the municipality which were part of the community survey. Green pit vipers were responsible for 92% of snakebite envenoming. Antivenom, antibiotics and corticosteroids were administered to 405 (90%), 379 (84%), and 310 (69%) out of 450 patients, respectively. Conclusions Incidence of snakebites in Can Tho Municipality is relatively low and green pit vipers are responsible for the vast majority of bites. Approximately one third of snakebite patients sought medical care in hospitals and although hospital data still underestimate the real incidence of snakebites, these statistics are valuable and can be obtained fast and inexpensively. Evaluation of patients’ records indicates the need for development of guidelines for management of snakebite envenoming in Vietnam to ensure a rational use of antivenom and ancillary treatments.
Author summary The World Health Organization included snakebite envenoming into the list of neglected tropical diseases in 2017 and launched a strategy for prevention and control of snakebite envenoming in 2019 in order to reduce the number of deaths and cases of disability by 50% before 2030. The neglect includes first and foremost epidemiology of snakebites, knowledge about management of snakebite envenoming and the medically relevant snake fauna, and access to life saving treatment with snake antivenom. In Vietnam reliable data on snakebite incidence and on snake species responsible for envenoming are largely missing. The present community-based survey showed that incidence of snakebites in Can Tho Municipality in the Mekong Delta in South Vietnam is significantly lower than in neighbouring countries and lower poverty rates among others are most likely the principal reason. Green pit vipers are responsible for the vast majority of snakebites. Treatment practices need to be reviewed and national guidelines are needed to achieve the best outcome for snakebite patients.
Databáze: OpenAIRE
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