[Situation of the envenomations by snakebites in Congo-Brazzaville: epidemiological, clinical and therapeutic approaches].

A retrospective study was carried out in six areas of Congo and in the town of Brazzaville for the period between 2000 and 2004 in order to evaluate the incidence, lethality, treatments and the used drugs in cases of snakebites. We associated a retrospective survey using health centre registers (11 centres) and a retrospective survey based on the staff statements of village communities (42) and private pharmacies and drug centrals. The questionnaire related to the snakebites (identification of victims, place of bite, symptoms and treatment) was used in communities. The total case fatality rate was relatively low (3,11%). The incidence of the estimated snakebites was higher in villages (221) than in health centres (165). But, lethality was equal in the two study clusters (6 cases versus 6 cases). There was no difference of cases rate between male and female subjects. Around urban areas, many victims consulted health centre and in rural area, many victims resorted systematically to traditional practitioners. In drug centrals and private pharmacies of Brazzaville, drugs against envenomations were proposed, respectively, by one and two structures. In health centres these drugs were not available. This evaluation could be underestimated as many victims consulted traditional practitioners. This explains why collecting data from health centre registers is not sufficient to evaluate the importance of envenomations in our study area.