Bawe L D, Kotosso A, Nemi K D, Abaltou B, Moukaïla A R, Blatome T, N'Djao A, Patassi A A, M I Wateba
Service de médecine générale, CHR de Sokodé, Togo.
Centre hospitalier des Armées de Lomé, Togo.
Bull Soc Pathol Exot. 2020;113(4):215-221. doi: 10.3166/bspe-2020-0145.
Snakebite envenomation (SBE) is a public health issue in Africa, unfortunately neglected and underestimated. SBE is a medical emergency that can be devastating and lifethreatening. A retrospective study was performed from January 1, 2016 to December 31, 2016 in the general medicine department of the Regional Hospital Center (CHR), Sokodé. We included 91 SBE accounting for 5.7% of the whole hospitalizations in the general medicine department at the CHR of Sokodé. The median age of the patients was 34 [23.5-42] with male predominance (59%). Farming activities (75%) and walking (24%) were the most frequent activities when SBE happened, and they occurred mostly in rural areas (80%) during the dry season (56%). Echis genus (37%) belonging to the Viperidae family was the king of snake most often identified. Hospital admission time after a bite often exceeded 24 hours (44%). Clinical manifestations resulted in 76 cases of viper syndrome (83%) and 7 cases of dry bites (8%). Antivenom was administered in 84 cases (92%) within 12 hours (54%) after the bite with a minimum dose of 20 mL (43%). Observed complications were severe anemia (19 cases) and diffuse hemorrhage (32 cases). Case fatality rate was 9%. Antivenom is critical in cases of obvious SBE. High cost and poor access of antivenom, in addition to delayed care due to traditional treatment seeking behavior, are factors of poor prognosis.
蛇咬伤中毒（SBE）是非洲的一个公共卫生问题，不幸的是被忽视和低估了。SBE是一种医疗紧急情况，可能具有毁灭性并危及生命。2016年1月1日至2016年12月31日在索科德地区医院中心（CHR）的综合内科进行了一项回顾性研究。我们纳入了91例SBE病例，占索科德CHR综合内科全部住院病例的5.7%。患者的中位年龄为34岁[23.5 - 42岁]，男性占主导（59%）。SBE发生时，农业活动（75%）和行走（24%）是最常见的活动，且大多发生在旱季（56%）的农村地区（80%）。蝰蛇科的锯鳞蝰属（37%）是最常被识别出的蛇类。咬伤后入院时间通常超过24小时（44%）。临床表现导致76例出现蝰蛇综合征（83%）和7例干性咬伤（8%）。84例（92%）在咬伤后12小时内（54%）接受了抗蛇毒血清治疗，最小剂量为20毫升（43%）。观察到的并发症有严重贫血（19例）和弥漫性出血（32例）。病死率为9%。在明显的SBE病例中，抗蛇毒血清至关重要。抗蛇毒血清成本高昂且难以获取，再加上因寻求传统治疗行为导致的治疗延误，都是预后不良的因素。
