Department of Chemical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India.
J Epidemiol Glob Health. 2024 Sep;14(3):586-612. doi: 10.1007/s44197-024-00247-z. Epub 2024 Jun 10.
The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.
蛇伤（SBE）的唯一治疗方法——抗蛇毒血清（ASV），存在着严重的缺陷，包括副作用和有限的物种特异性。此外，尽管 ASV 已经存在了一个多世纪，但高质量的 ASV 还没有普及。本综述描述了一位 SBE 患者的遭遇，强调了 SBE 管理的全球危机。本文还对当前的 ASV 市场进行了详细分析，并介绍了全球范围内的蛇类分布情况。本文还研究了全球范围内特定国家生产的、具有专利的 ASV 及其制造商，并按照蛇种进行了分类。此外，还利用最新文献，对蛇伤抗毒血清制造国的实地情况进行了详细分析。本文还讨论了不同 ASV 的进出口情况，涉及到各国的采购政策、其缺点，以及在物种层面上可能的解决方案。有趣的是，在大多数国家，ASV 的存在要么被忽视，要么被夸大，这意味着它虽然存在，但不适合使用，或者它虽然不存在，但可以从其他国家获得。这凸显了迫切需要进行重大评估和国际合作，不仅是为了开发和生产，还包括采购、分配、供应和意识。本文还引入了一种实用的蛇伤管理方法（PROMISE），提供了简单、经济和易于采用的步骤，以有效地减轻全球 SBE 负担。
