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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Real life condition evaluation of Inoserp PAN-AFRICA antivenom effectiveness in Cameroon
PLoS Neglected Tropical Diseases, Volume 17, No. 11, Article e0011707, Year 2023
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Description
Background Snakebites is a serious public health issue but remains a neglected tropical disease. Data on antivenom effectiveness are urgently needed in Africa. We assessed effectiveness of Inoserp PAN-AFRICA (IPA), the recommended antivenom available in Cameroon. Methodology/Principal findings We enrolled 447 patients presenting with snakebite in 14 health facilities across Cameroon. At presentation, cytotoxicity, coagulation troubles and neurotoxicity were graded. We administered two to four vials of antivenom to patients based on hemotoxic or neurotoxic signs. We renewed antivenom administration to patients with persistence of bleedings or neurotoxicity 2 hours after each injection. We defined early improvement as a reduction of the grade of envenomation symptoms 2 hours after first injection. Medium-term effectiveness was investigated looking at disappearance of symptoms during hospitalization. After hospital discharge, a home visit was planned to assess long-term outcomes. Between October 2019 and May 2021, we enrolled 447 (93.7%), including 72% from the savannah regions. The median [IQR] age was 25 [14–40]. Envenomation was diagnosed in 369 (82.6%) participants. The antivenom was administered to 356 patients (96.5%) of whom 256 (71.9%) received one administration. Among these patients, cytotoxic symptoms were observed in 336 (94.4%) participants, coagulation disorders in 234 (65.7%) participants and neurotoxicity in 23 (6.5%) participants. Two hours after the first administration of antivenom, we observed a decrease in coagulation disorders or neurotoxicity in 75.2% and 39.1% of patients, respectively. Complete cessation of bleedings and neurotoxicity occurred in 96% and 93% of patients within 24 hours, respectively. Sequelae have been observed in 9 (3%) patients at the home visit 15 days after hospital admission and 11 (3%) died including one before antivenom injection. Conclusions/Significance We confirmed good effectiveness of the IPA and highlighted the rapid improvement in bleed-ing or neurotoxicity after the first administration. Sequential administrations of low doses of antivenom, rigorously assessed at short intervals for an eventual renewal, can preserve patient safety and save antivenom. © 2023 Chippaux et al.
Authors & Co-Authors
Chippauxid, Jean Philippe
France, Marseille
Ird Institut de Recherche Pour le Developpement
France, Paris
Institut Pasteur, Paris
Ntonè, Rodrigue
France, Paris
Epicentre
Madec, Yoann
France, Paris
Institut Pasteur, Paris
Amta, Pierre
Cameroon, Tokombéré
Hôpital de Tokombéré
Matchim, Lucrece
France, Paris
Epicentre
Eteki, Lucrèce
France, Paris
Epicentre
Ndifon, Mark
France, Paris
Epicentre
Boum, Yap I.
France, Paris
Epicentre
Nkwescheu, Armand Séraphin
Cameroon, Yaounde
Cameroon Society of Epidemiology Case
Taieb, Fabien Nicolas
France, Paris
Institut Pasteur, Paris
Statistics
Citations: 1
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pntd.0011707
ISSN:
19352727
Research Areas
Health System And Policy
Study Approach
Qualitative
Study Locations
Cameroon