Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, Malaysia.
BMJ Glob Health. 2022 Mar;7(3). doi: 10.1136/bmjgh-2021-007639.
Snakebite envenoming is a neglected tropical disease posing public health challenges globally. The Association of Southeast Asian Nations (ASEAN) countries are among the tropical regions with disproportionately high incidence of snakebite. Hence, this study aimed to review the situation of snakebite, antivenom market and access to antivenoms in ASEAN.
This mixed-methods study included comprehensive literature review and in-depth interviews with key informants to assess the situation of management system of snakebite, antivenom market and access to antivenoms in seven ASEAN countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR and Myanmar. Data were analysed by a framework method.
ASEAN have developed various strategies to improve outcomes of snakebite victims. Five domestic antivenom manufacturers in the region produce up to 288 375 vials of antivenoms annually with the value of US$13 058 053 million which could treat 42 213 snakebite victims. However, there remain challenges to be addressed especially the lack of snakebite-related informatics system, inadequate antivenoms at the healthcare facilities and when the majority of snakebite victims seek traditional healers instead of conventional treatment.
Improving the situation of snakebite and antivenom is not only about the availability of antivenom, but the whole landscape of surrounding management and supporting system. The assessment of the situation of snakebite and antivenom is crucial for countries or regions where snakebites are prevalent to recognise their current standpoint to inform the development of strategies to achieve the goal set by the WHO of halving the global burden of snakebite by 2030.
蛇伤是一种被忽视的热带病，在全球范围内对公共卫生构成挑战。东南亚国家联盟（东盟）国家是热带地区中蛇伤发病率过高的国家之一。因此，本研究旨在综述东盟国家的蛇伤情况、抗蛇毒血清市场和抗蛇毒血清的可及性。
本混合方法研究包括全面的文献回顾和对 7 个东盟国家（马来西亚、泰国、印度尼西亚、菲律宾、越南、老挝人民民主共和国和缅甸）的关键信息者进行深入访谈，以评估蛇伤管理系统、抗蛇毒血清市场和抗蛇毒血清可及性的情况。数据采用框架方法进行分析。
东盟制定了各种战略来改善蛇伤受害者的结局。该地区有 5 家国产抗蛇毒血清制造商，每年生产多达 288375 支抗蛇毒血清，价值 1305.8053 亿美元，可治疗 42213 名蛇伤受害者。然而，仍存在一些需要解决的挑战，特别是缺乏与蛇伤相关的信息系统、医疗保健机构缺乏抗蛇毒血清，以及大多数蛇伤患者寻求传统治疗而非常规治疗。
改善蛇伤和抗蛇毒血清的情况不仅涉及抗蛇毒血清的可及性，还涉及整个周边管理和支持系统的情况。对蛇伤和抗蛇毒血清情况进行评估，对于蛇伤流行的国家或地区至关重要，这有助于了解其当前状况，为实现世卫组织到 2030 年将全球蛇伤负担减半的目标制定策略提供信息。
