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乌干达蛇咬伤中毒的治疗及治疗结果:一项回顾性分析

Treatment and treatment outcomes of snakebite envenoming in Uganda: a retrospective analysis.

作者信息

Nanyonga Stella Maris, Matafwali Scott Kaba, Kibira Denis, Kitutu Freddy Eric

机构信息

The Pharmaceutical Society of Uganda, Plot 1847 Kyambogo House, P. O. Box 3774 Kampala, Uganda.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LG, UK.

出版信息

Trans R Soc Trop Med Hyg. 2025 Jul 1;119(7):796-803. doi: 10.1093/trstmh/trae112.

Abstract

BACKGROUND

Snakebite envenoming is a neglected tropical disease that causes significant morbidity and mortality in rural sub-Saharan Africa. However, there is a notable lack of data concerning the management and treatment outcomes for those affected. This study addresses this gap by examining the management and treatment outcomes of snakebite victims in Uganda.

METHODS

We reviewed retrospective data of 532 snakebite cases attending 16 Ugandan health facilities from January 2017 to December 2021. Demographic characteristics and clinical data were extracted from patient records and summarized using descriptive statistics.

RESULTS

The snakebite victims had a median age of 26 y, most were male (55.3%) and had bites of unidentified snake species (92.3%). Among the 465 treated patients, 71.6% received antibiotics, 66.0% hydrocortisone, 36.3% analgesics and only 6.9% antivenom. No adverse antivenom reactions were documented. The majority (89.5%) were discharged; 1.3% died and 5.5% had unknown outcomes.

CONCLUSIONS

These results suggest that snakebite envenoming affects vulnerable Ugandans, particularly young males and children. Treatment is primarily supportive, with antibiotic overuse and infrequent antivenom administration. Health provider training on appropriate snakebite management is needed to optimize outcomes.

摘要

背景

蛇咬伤中毒是一种被忽视的热带疾病,在撒哈拉以南非洲农村地区导致了严重的发病和死亡。然而,关于受影响者的管理和治疗结果的数据明显缺乏。本研究通过调查乌干达蛇咬伤受害者的管理和治疗结果来填补这一空白。

方法

我们回顾了2017年1月至2021年12月期间在乌干达16家医疗机构就诊的532例蛇咬伤病例的回顾性数据。从患者记录中提取人口统计学特征和临床数据,并使用描述性统计进行总结。

结果

蛇咬伤受害者的中位年龄为26岁,大多数为男性(55.3%),被咬蛇种不明(92.3%)。在465例接受治疗的患者中,71.6%接受了抗生素治疗,66.0%接受了氢化可的松治疗,36.3%接受了镇痛药治疗,只有6.9%接受了抗蛇毒血清治疗。未记录到抗蛇毒血清的不良反应。大多数(89.5%)患者出院;1.3%死亡,5.5%结局不明。

结论

这些结果表明,蛇咬伤中毒影响易受影响的乌干达人,特别是年轻男性和儿童。治疗主要是支持性的,存在抗生素过度使用和抗蛇毒血清使用不频繁的情况。需要对卫生保健人员进行适当蛇咬伤管理方面的培训,以优化治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ab/12212200/d2f38e516a6e/trae112fig1.jpg

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