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越南蛇伤负担评估、蛇伤临床特征及改善蛇伤管理策略。

Assessment of snakebite burdens, clinical features of envenomation, and strategies to improve snakebite management in Vietnam.

机构信息

Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India.

Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India; Institute of Advanced Study in Science and Technology, Vigyan Path Garchuk, Paschim Boragaon, Guwahati, Assam 781035, India.

出版信息

Acta Trop. 2021 Apr;216:105833. doi: 10.1016/j.actatropica.2021.105833. Epub 2021 Jan 22.

Abstract

The sheer paucity of scientific documentation of herpetofauna in Vietnam and the rudimentary healthcare response to snakebite have stimulated this review. Over six decades of data culled from public data bases and search engines, have been used to assess snakebite burdens, clinical features of envenomation, and strategies for snakebite management in Vietnam. In addition, biochemical and proteomic analyses to decipher venom composition, rapid analytical techniques to be used for clinical diagnosis of snakebite in Vietnam have been discussed in detail. The assessment of efficacy, safety, and quality of commercial antivenom produced in Vietnam and improvement of antivenom production to meet the national requirement has been critically examined. It is apparent that snake bite incidence in Vietnam is exacerbated by mismatch in demand and supply of antivenom therapy, insufficient medical facilities, preference for traditional healers and poor management of clinical records. The impediments arising from geographical and species-specific variation in venom composition can be overcome by the 'Omics approach', and scientific documentation of pathophysiological manifestations post envenomation. The development of next generation of therapeutics, encouraging clinical research, novel approaches and social awareness against snakebite and its treatments have been suggested to significantly reduce the snakebite mortality and morbidity in this region.

摘要

越南对爬行动物的科学文献记录匮乏,对蛇伤的基本医疗反应也很原始,这激发了本次综述。六十多年来,从公共数据库和搜索引擎中收集的数据被用于评估越南的蛇伤负担、蛇伤的临床特征以及蛇伤管理策略。此外,还详细讨论了用于解析蛇毒成分的生化和蛋白质组学分析、用于越南蛇伤临床诊断的快速分析技术。还对在越南生产的商业抗蛇毒血清的疗效、安全性和质量进行了评估,并对提高抗蛇毒血清的生产以满足国家需求进行了严格审查。显然,由于抗蛇毒血清治疗的需求和供应不匹配、医疗设施不足、偏爱传统治疗者以及临床记录管理不善,越南的蛇咬伤发病率加剧。通过“组学方法”以及对蛇伤后病理生理表现的科学记录,可以克服毒液成分的地理和物种特异性差异所带来的障碍。建议开发下一代治疗方法、鼓励临床研究、采用新方法和提高社会对蛇伤及其治疗的认识,以显著降低该地区的蛇伤死亡率和发病率。

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