Darryl Wood, Sartorius Benjamin, Hift Richard
Nelson Mandela School of Clinical Medicine (Drs Wood and Hift); Ngwelezane Hospital (Dr Wood), KwaZulu Natal, South Africa.
School of Public Health (Dr Sartorius), University of KwaZulu Natal.
Wilderness Environ Med. 2016 Mar;27(1):53-61. doi: 10.1016/j.wem.2015.11.005.
We propose a formula as a means to estimate the number and incidence of snakebites treated per annum in KwaZulu Natal (KZN), South Africa.
Using an unvalidated formula that includes an antivenom ratio, we crudely estimated the total number of snakebite presentations in KZN. Using antivenom supply data from the central pharmacy, we stratified a sample of 6 hospitals that were surveyed to establish an antivenom ratio, that is, the total number of patients receiving antivenom to the total number of snakebite presentations at hospitals. The antivenom ratio and the average number of antivenom vials for treated snakebites were incorporated into a formula to crudely estimate the number of snakebite presentations. This was then applied to all public hospitals and districts in the region.
Seventy-eight percent of public hospitals were included. The mean antivenom ratio derived from the sample hospitals indicated that 12% (95% CI, 10-14%) of snakebite presentations received antivenom. We estimated an annual total of 1680 (95% CI, 1193-2357) snakebite presentations to hospitals. Two thirds of cases (1109 of 1680) were in the low-lying subtropical coastal region. Few cases were in the higher, cooler regions of KZN (87 of 1680) or the metropolitan city of Durban (93 of 1680). The overall incidence for KZN was 16/100,000. The estimated cost of snakebite in KZN was between $1,156,930 and $2,827,848.
We propose an alternative method to estimate the annual number of snakebite presentations to hospitals.
我们提出一个公式，作为估算南非夸祖鲁-纳塔尔省（KZN）每年治疗的蛇咬伤病例数量及发病率的一种方法。
我们使用一个未经验证的包含抗蛇毒血清比例的公式，粗略估算了KZN蛇咬伤就诊的总数。利用中央药房的抗蛇毒血清供应数据，我们对6家接受调查的医院进行分层，以确定抗蛇毒血清比例，即接受抗蛇毒血清治疗的患者总数与医院蛇咬伤就诊总数之比。将抗蛇毒血清比例和治疗蛇咬伤所用抗蛇毒血清瓶的平均数量纳入一个公式，以粗略估算蛇咬伤就诊数量。然后将其应用于该地区所有公立医院和地区。
纳入了78%的公立医院。样本医院得出的平均抗蛇毒血清比例表明，12%（95%置信区间，10 - 14%）的蛇咬伤就诊患者接受了抗蛇毒血清治疗。我们估计每年医院接收的蛇咬伤就诊病例总数为1680例（95%置信区间，1193 - 2357例）。三分之二的病例（1680例中的1109例）发生在地势低洼的亚热带沿海地区。KZN地势较高、气候较凉爽的地区（1680例中的87例）或德班大都市（1680例中的93例）的病例较少。KZN的总体发病率为16/100,000。KZN蛇咬伤的估计费用在1,156,930美元至2,827,848美元之间。
我们提出了一种估算每年医院蛇咬伤就诊病例数量的替代方法。
