Snakebite in Angola

• Autor(a) principal: Simões de Oliveira, Paula Regina
• Data de Publicação: 2024
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25761/anaisihmt.461

Introduction: Snakebites are still a neglected public health problem, affecting tropical countries in Africa, Asia and Latin America. The World Health Organization (WHO) estimates that each year there are 5.4 million snake bites, responsible for 1.8 to 2.7 million poisonings, causing between 81 thousand and 138 thousand deaths and three times more amputations, and other permanent disabilities. In Africa, it is estimated that over 500,000 accidents and 20,000 deaths occur annually. The epidemiological scenario in Angola is, to date, unknown. Patients, especially in rural areas, do not seek or have access to health services, making it difficult to officially register cases and consequently to provide serum, which is also non-existent in public hospitals and, when available, is of dubious safety and effectiveness. The snakes that cause the most accidents in the country are Naja spp, Bitis arietans and Dendroaspis spp. Objectives: Address the clinical spectrum of poisonings by snakes of greatest medical importance in Angola. Materials and methods: This is a descriptive and retrospective study of three cases of snake bites of greatest medical importance in Angola with outcomes from different clinicians. Results: In the clinical case involving the snake of the species Bitis arietans, it was necessary to perform a fasciotomy, due to the compartment syndrome that developed nine surgeries and was hospitalized for 92 days. In the clinical case caused by naja nigricollis, the 2-year-old child died after 4 days of hospitalization, due to necrotizing fasciitis of the neck and right leg, septic shock and severe anemia. The clinical case caused by the species Dendroaspis polylepis, the patient with delayed neurotoxic poisoning, due to the self-inflicted blow shortly after the bite, developed a serious clinical condition, which was corrected with the administration of 6 antivenom units and clinical handling with expertise from the medical team of intensive care. Conclusion: The multivariate spectrum of clinical complications developed in the three clinical cases demonstrates that snakebites have unique characteristics that make their prevention and control challenging, so it is important to continue to educate our populations regarding the disbelief in the use of traditional therapy. It is imperative to make serum available in health units for the timely and effective treatment of poisonings, thus avoiding prolonged hospitalizations, amputations and increased morbidity and mortality, which constitute high expenses for the country.