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喀麦隆的蛇伤:在现实条件下对一种蛇抗毒血清(Inoserp™ PAN-AFRICA)在非洲的耐受性。

Snakebites in Cameroon: Tolerance of a Snake Antivenom (Inoserp™ PAN-AFRICA) in Africa in Real-Life Conditions.

机构信息

Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris Cité University, F-75015 Paris, France.

MERIT Unit, Institut de Recherche pour le Développement, Paris Cité University, F-75006 Paris, France.

出版信息

Toxins (Basel). 2024 Mar 22;16(4):165. doi: 10.3390/toxins16040165.

DOI:10.3390/toxins16040165
PMID:38668590
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11053651/
Abstract

Snakebite envenomation (SBE) is a public health issue in sub-Saharan countries. Antivenom is the only etiological treatment. Excellent tolerance is essential in managing SBE successfully. This study aimed to evaluate tolerance of Inoserp PAN-AFRICA (IPA). It was conducted on fourteen sites across Cameroon. IPA was administered intravenously and repeated at the same dose every two hours if needed. Early and late tolerance was assessed by the onset of clinical signs within two hours and at a visit two weeks or more after the first IPA administration, respectively. Over 20 months, 447 patients presenting with a snakebite were included. One dose of IPA was administered to 361 patients and repeated at least once in 106 patients. No significant difference was shown between the proportion of adverse events in patients who received IPA (266/361, 73.7%) and those who did not (69/85, 81.2%) ( = 0.95). Adverse reactions, probably attributable to IPA, were identified in four (1.1%) patients, including one severe (angioedema) and three mild. All these reactions resolved favorably. None of the serious adverse events observed in twelve patients were attributed to IPA. No signs of late intolerance were observed in 302 patients. Tolerance appears to be satisfactory. The availability of effective and well-tolerated antivenoms would reduce the duration of treatment and prevent most disabilities and/or deaths.

摘要

蛇伤(SBE)是撒哈拉以南非洲国家的一个公共卫生问题。抗蛇毒血清是唯一的病因治疗方法。成功管理 SBE 必须具有良好的耐受性。本研究旨在评估 Inoserp PAN-AFRICA(IPA)的耐受性。它在喀麦隆的十四个地点进行。IPA 静脉内给药,如果需要,每两小时重复相同剂量。早期和晚期耐受性分别通过在两小时内出现临床症状和首次 IPA 给药后两周或更长时间的就诊来评估。在 20 个月的时间里,共有 447 名蛇咬伤患者入组。361 名患者给予了 IPA 单剂量,106 名患者至少重复了一次。接受 IPA 的患者(266/361,73.7%)和未接受 IPA 的患者(69/85,81.2%)( = 0.95)不良事件的比例没有显著差异。在 4 名(1.1%)患者中发现了可能归因于 IPA 的不良反应,包括 1 例严重(血管性水肿)和 3 例轻度。所有这些反应都得到了良好的解决。在 12 名患者中观察到的 12 例严重不良事件均与 IPA 无关。在 302 名患者中未观察到晚期不耐受的迹象。耐受性似乎令人满意。有效的、耐受性良好的抗蛇毒血清的可用性将缩短治疗时间,并预防大多数残疾和/或死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc17/11053651/7c6e86e31b3e/toxins-16-00165-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc17/11053651/3d6970bc62fc/toxins-16-00165-g0A1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc17/11053651/7c6e86e31b3e/toxins-16-00165-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc17/11053651/3d6970bc62fc/toxins-16-00165-g0A1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc17/11053651/7c6e86e31b3e/toxins-16-00165-g001.jpg

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