Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | The Journal of venomous animals and toxins including tropical diseases (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304 |
Resumo: | Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and two other groups that received either 2 or 4 initial vials of Antivipmyn® Africa renewed as necessary. CFR was 27.3%, 15.4% and 17.6%, respectively. Although antivenom treatment was likely to reduce CFR, it didn’t seem to have an obvious clinical benefit for the patients, suggesting a low treatment efficacy. Mean delay to treatment or clinical stages were not significantly different between the patients who recovered and the patients who died, or between groups. Interpretation of these results is complicated by the lack of systematic studies under comparable conditions. Of particular importance is the absence of assisted ventilation, available to patients in all the other clinical studies of neurotoxic envenomation. Conclusion The apparent lack of clinical benefit may have several causes. The hypothesis of a limited therapeutic window, i.e. an insufficient formation of antigen-antibody complexes once toxins are bound to their targets and/or distributed beyond the reach of antivenom, should be explored. |
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The Journal of venomous animals and toxins including tropical diseases (Online) |
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Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan AfricaElapidNeurotoxinsTreatmentAntivenomGuineaAfrica Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and two other groups that received either 2 or 4 initial vials of Antivipmyn® Africa renewed as necessary. CFR was 27.3%, 15.4% and 17.6%, respectively. Although antivenom treatment was likely to reduce CFR, it didn’t seem to have an obvious clinical benefit for the patients, suggesting a low treatment efficacy. Mean delay to treatment or clinical stages were not significantly different between the patients who recovered and the patients who died, or between groups. Interpretation of these results is complicated by the lack of systematic studies under comparable conditions. Of particular importance is the absence of assisted ventilation, available to patients in all the other clinical studies of neurotoxic envenomation. Conclusion The apparent lack of clinical benefit may have several causes. The hypothesis of a limited therapeutic window, i.e. an insufficient formation of antigen-antibody complexes once toxins are bound to their targets and/or distributed beyond the reach of antivenom, should be explored. Centro de Estudos de Venenos e Animais Peçonhentos (CEVAP/UNESP)2013-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304Journal of Venomous Animals and Toxins including Tropical Diseases v.19 2013reponame:The Journal of venomous animals and toxins including tropical diseases (Online)instname:Universidade Estadual Paulista (UNESP)instacron:UNESP10.1186/1678-9199-19-6info:eu-repo/semantics/openAccessBaldé,Mamadou CChippaux,Jean-PhilippeBoiro,Mamadou YStock,Roberto PMassougbodji,Achilleeng2018-08-17T00:00:00Zoai:scielo:S1678-91992013000100304Revistahttp://www.scielo.br/jvatitdPUBhttps://old.scielo.br/oai/scielo-oai.php||editorial@jvat.org.br1678-91991678-9180opendoar:2018-08-17T00:00The Journal of venomous animals and toxins including tropical diseases (Online) - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
spellingShingle |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa Baldé,Mamadou C Elapid Neurotoxins Treatment Antivenom Guinea Africa |
title_short |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_full |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_fullStr |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_full_unstemmed |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
title_sort |
Use of antivenoms for the treatment of envenomation by Elapidae snakes in Guinea, Sub-Saharan Africa |
author |
Baldé,Mamadou C |
author_facet |
Baldé,Mamadou C Chippaux,Jean-Philippe Boiro,Mamadou Y Stock,Roberto P Massougbodji,Achille |
author_role |
author |
author2 |
Chippaux,Jean-Philippe Boiro,Mamadou Y Stock,Roberto P Massougbodji,Achille |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Baldé,Mamadou C Chippaux,Jean-Philippe Boiro,Mamadou Y Stock,Roberto P Massougbodji,Achille |
dc.subject.por.fl_str_mv |
Elapid Neurotoxins Treatment Antivenom Guinea Africa |
topic |
Elapid Neurotoxins Treatment Antivenom Guinea Africa |
description |
Background In Guinea Elapids are responsible for 20% of envenomations. The associated case fatality rate (CFR) ranged 15-27%, irrespective of treatment. Results We studied 77 neurotoxic envenomations divided in 3 groups: a set of patients that received only traditional or symptomatic treatments, and two other groups that received either 2 or 4 initial vials of Antivipmyn® Africa renewed as necessary. CFR was 27.3%, 15.4% and 17.6%, respectively. Although antivenom treatment was likely to reduce CFR, it didn’t seem to have an obvious clinical benefit for the patients, suggesting a low treatment efficacy. Mean delay to treatment or clinical stages were not significantly different between the patients who recovered and the patients who died, or between groups. Interpretation of these results is complicated by the lack of systematic studies under comparable conditions. Of particular importance is the absence of assisted ventilation, available to patients in all the other clinical studies of neurotoxic envenomation. Conclusion The apparent lack of clinical benefit may have several causes. The hypothesis of a limited therapeutic window, i.e. an insufficient formation of antigen-antibody complexes once toxins are bound to their targets and/or distributed beyond the reach of antivenom, should be explored. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992013000100304 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1186/1678-9199-19-6 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Centro de Estudos de Venenos e Animais Peçonhentos (CEVAP/UNESP) |
publisher.none.fl_str_mv |
Centro de Estudos de Venenos e Animais Peçonhentos (CEVAP/UNESP) |
dc.source.none.fl_str_mv |
Journal of Venomous Animals and Toxins including Tropical Diseases v.19 2013 reponame:The Journal of venomous animals and toxins including tropical diseases (Online) instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
The Journal of venomous animals and toxins including tropical diseases (Online) |
collection |
The Journal of venomous animals and toxins including tropical diseases (Online) |
repository.name.fl_str_mv |
The Journal of venomous animals and toxins including tropical diseases (Online) - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
||editorial@jvat.org.br |
_version_ |
1748958539549769728 |