Snake bites: One million Africans are victims yearly- Report

THE PUNCH Newspaper- Hamed Shobiye

A new report released on Sunday by the World Health Organisation has revealed that globally, about five million people suffer from snake bite annually. This, WHO disclosed, resulted in deaths and brought permanent disabilities to some victims.

The report pointed out that most of the deaths occurred in the developing countries that were characterised by weak health systems and sparse medical resources.

WHO said, “Snake bite is a neglected public health issue in many tropical and sub-tropical countries. Most of these occur in Africa, Asia and Latin America. In Africa alone, there are an estimated one million snake bites annually, with about half needing treatment. This type of injury is often found among women, children and farmers in poor, rural communities in low- and middle-income countries. It is mainly in countries where health systems are weakest and medical resources sparse.

“An estimated five million people are bitten each year, resulting in up to 2.5 million enve-noming, at least 100,000 deaths and around three times as many amputations and other permanent disabilities each year.

“Bites by venomous snakes can cause paralysis that may prevent breathing, bleeding disorders that can lead to fatal haemorrhage, irreversible kidney failure and severe tissue damage that can cause permanent disability and may result in limb amputation.”

The victims, according to the group, are mostly women, children and farmers living in poor, rural communities crippled by little or no access to adequate health facilities.

“Agricultural workers and children are the most affected. Children often suffer more severe effects than adults, due to their smaller body mass,” WHO stated.

Venomous snakes abound in many regions of the world and constitute great threat to public health, especially in the rural tropics where they are most abundant. Out of more than 3,000 species of snakes, over 600 are venomous and over 200 are considered to be medically important.

There are four families of venomous snakes, namely, Viperidae, Elapidae, Colubridae and Actraspididae in Nigeria, where only 8.5 per cent of the victims attend hospitals.

Among these families, three species: carpet viper (Echis ocellatus), black-necked spitting cobra (Naja nigricollis) and puff adder (Bitis arietans), are the most important snakes associated with envenoming in Nigeria.

Health systems in other countries where snake bites are common lack the infrastructure and resources to collect robust statistical data on the problem. Assessing the true impact is further complicated by the fact that cases reported to health ministries by clinics and hospitals are often only a small proportion of the actual burden, because many victims don’t visit primary care facilities, and are therefore unreported.

In Nepal, for example, where 90 per cent of the population lives in rural areas, the Ministry of Health reported 480 snake bites resulting in 22 deaths for the year 2000; yet figures for the same year collected in a community based study of one region (Eastern Nepal) detailed 4,078 bites and 396 deaths.

On the shortage of anti-venoms among member countries, WHO disclosed that low demand for anti-venoms had forced several manufacturers to cease production, leading to increase in price and making treatment unaffordable for the majority of those in desperate situation.

It also identified Africa and some countries in Asia as some of the areas where anti-venom supply failure is imminent.

WHO said, “Today, countries face a critical global shortage of appropriate, safe and effective snake anti-venoms. A combination of factors has led to the present situation: poor data on the number and type of snake bites, difficulty to estimate the needs and define markets, combined with deficient distribution policies, all of which have contributed to manufacturers stopping production or increasing prices of anti-venoms.

“Poor regulation and marketing of inappropriate anti-venoms have led to a loss of confidence in the available anti-venoms by clinicians, public health officials and patients. Effective and safe anti-venoms require international collaboration. WHO urges regulators, producers, researchers, clinicians, national and regional health authorities, international organisations and community organisations to work together to improve the availability of reliable epidemiological data on snake bites, the regulatory control of anti-venoms and their distribution policies,” the body added.

The WHO Assistant Director-General, Carissa Etienne, while speaking on the issue, called for increase in the supply of anti-venoms to member countries.

She said, “Many countries have no access to the anti-venoms they need. Others use anti-venoms that have never been tested against their target snake venoms. So often, when people get bitten, they can’t get the treatment they need.

“With snake bites killing at least 100,000 people a year and countries facing a shortage of appropriate anti-venoms, access to health facilities and information about available anti-venoms are increasingly important. The World Health Organisation is publishing new guidelines for the production, regulation and control of snake anti-venoms and a website with details on where the venomous snakes are located, what they look like, which anti-venoms are appropriate, and where they can be obtained,” she added.


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