Every year 2 million or more people fall victim to snakebite envenoming, mostly in poor, rural communities of Africa, Asia and Latin America. Between 83,000—138,000 of them die, while hundreds of thousands more suffer debilitating long-term complications or disabilities.
Although some antivenom medicines are highly effective when used promptly and appropriately, many snakebite victims get no treatment at all. Those who do may receive antivenoms which don’t work against the type of snake that bit them, or were not rigorously tested for safety and effectiveness.
To mark World Snakebite Awareness Day on September 19th, the Collection linked below brings together recent MSF work on this highly neglected disease. Several articles and conference presentations help fill evidence gaps on the burden of disease and its impacts or on treatment outcomes with specific antivenoms in specific regions. Others examine how to tackle the formidable challenges of availability and affordability, the absence of regulatory oversight for making, testing and registering antivenoms, and the anemic R&D pipeline for new products—all of which impede access for patients to safe, effective treatment tailored to local snake species.
Snakes responsible for bites are rarely identified, resulting in a loss of information about snakebites from venomous species whose venom effects are poorly understood. A prospective clinical study including patients bitten by a snake was conducted in Cameroon between 2019 and 2021 to evaluate the efficacy and tolerability of a marketed polyvalent antivenom. Clinical presentation during the first 3 days of hospitalization was recorded following a standardized protocol. This ancillary study aimed to assess the frequency of bites by the different species encountered in Cameroon and to describe the symptoms of bites by formally identified species. Of the 447 patients included in the study, 159 (35.6%) brought the snake that caused the bite that was identified by a specialist. Out of these, 8 specimens could not be identified due to poor condition, 19 were non-venomous species, and 95 belonged to Echis romani—formerly E. ocellatus—species. The remaining 37 specimens included 2 Atheris squamigera, 12 Atractaspis spp., 2 Bitis arietans, 11 Causus maculatus, 1 Dendroaspis jamesoni, 1 Naja haje, 1 N. katiensis, 5 N. melanoleuca complex, and 2 N. nigricollis. Symptoms, severity of envenomation, and post-treatment course are described. Symptoms and severity of bites are consistent with cases described in the literature, but some specific features are highlighted.