Menon Jaideep C, Sreekrishnan T P, Nair Sabarish B, Pillay Vijay V, Kanungo Srikanta, Aravind M S, Bharti Omesh K, Joseph Joseph K, Pati Sanghamitra
Adult Cardiology and Public Health, Amrita Institute of Medical Sciences, Kochi 682041, India.
Emergency Medicine, Amrita Institute of Medical Sciences, Kochi 682041, India.
Trans R Soc Trop Med Hyg. 2025 Sep 2;119(9):1016-1022. doi: 10.1093/trstmh/traf042.
India faces substantial challenges from snakebite envenoming secondary to the high morbidity, mortality and financial burden, particularly in rural communities. While concentrated on the 'Big Four' venomous species, recent research indicates a necessity to expand the focus to encompass additional medically relevant species. This review emphasizes the geographic heterogeneity in venom among these snakes, which impacts antivenom effectiveness and necessitating region-specific formulations. This analysis highlights the shortcomings of current antivenoms and identifies non-Big Four species involved in snakebite envenoming, advocating for an urgent shift to inclusive antivenom strategies that integrate local venom profiles to enhance treatment effectiveness and thereby reduce snakebite-related morbidity and mortality. Improved training for healthcare providers and enhancements in anti-snake venom quality are essential for meeting the World Health Organization's 2030 Sustainable Development Goal objective of halving snakebite-related fatalities and disabilities. Incorporating snakebite management into national health programs and conducting epidemiological research systematically are crucial to mitigating this preventable health concern.
由于高发病率、死亡率和经济负担，印度在蛇咬伤中毒方面面临重大挑战，特别是在农村社区。虽然重点关注“四大”有毒物种，但最近的研究表明有必要扩大关注范围，将其他具有医学相关性的物种纳入其中。本综述强调了这些蛇毒的地理异质性，这影响了抗蛇毒血清的有效性，因此需要特定区域的配方。该分析突出了当前抗蛇毒血清的缺点，并确定了参与蛇咬伤中毒的非“四大”物种，主张迫切转向包容性抗蛇毒血清策略，整合当地毒液特征以提高治疗效果，从而降低与蛇咬伤相关的发病率和死亡率。改善医疗服务提供者的培训和提高抗蛇毒血清质量对于实现世界卫生组织2030年可持续发展目标中与蛇咬伤相关的死亡和残疾减半的目标至关重要。将蛇咬伤管理纳入国家卫生计划并系统地开展流行病学研究对于减轻这一可预防的健康问题至关重要。
