Acción antiofídica de extractos de Myrsine guianensis, Jatropha curcas y Zanthoxylum monogynum / Antiophidic activity of extracts from Myrsine guianensis, Jatropha curcas and Zanthoxylum monogynum

Objetivo: evaluar la inhibición de los venenos de las serpientes Bothrops alternatus y Bothrops moojeni por los extractos vegetales de Jatropha curcas, Myrsine guianensis y Zanthoxylum monogynum, en relación con las actividades coagulante, fosfolipasa y hemorrágica. Métodos: Los extractos vegetales se obtuvieron a partir del liofilizado de hojas de Jatropha curca, Myrsine guianensis y Zanthoxylum monogynum. Se realizaron ensayos de inhibición in vitro con un grupo de control positivo (10 μg de veneno crudo), grupos experimentales que recibieron una mezcla del veneno con cada uno de los extractos, en concentraciones de 5 a 500 μg y un grupo de control negativo (500 μg de extracto). Se realizaron ensayos in vivo con grupos de ratones Balb/c (n = 4). A los ratones del grupo de control positivo se les inyectó solamente el veneno (25 μg); a los de los grupos experimentales, una mezcla del veneno con cada uno de los extractos, en concentraciones de 25 a 500 μg; y a los del grupo de control negativo, solamente extracto (500 μg). Resultados: Jatropha curcas y Myrsine guianensis inhibieron significativamente la actividad fosfolipasa a partir de la proporción 1:0,5 (veneno:extracto). Por otro lado, las actividades coagulante y hemorrágica, fueron inhibidas expresivamente a partir de las proporciones 1:1 y 1:5 con Myrsine guianensis y Jatropha curcas, respectivamente. Las actividades fosfolipasa y coagulante fueron inhibidas con Zanthoxylum monogynum a partir de las proporciones 1:5 y 1:10, respectivamente. Conclusiones: Los extractos analizados inhibieron los venenos de Bothrops alternatus y Bothrops moojeni debido a la presencia de moléculas con posibles propiedades antiofídicas(AU)

Objective: Evaluate the inhibition of venoms from the snakes Bothrops alternatus and Bothrops moojeni by plant extracts from Jatropha curcas, Myrsine guianensis and Zanthoxylum monogynum in terms of coagulant, phospholipase and hemorrhagic activities. Methods: The plant extracts were obtained by lyophilization of leaves of Jatropha curca, Myrsine guianensis and Zanthoxylum monogynum. In vitro inhibition tests were performed with a positive control group (10 μg of crude venom), experimental groups receiving a mixture of the venom with each of the extracts at concentrations of 5 to 500 μg, and a negative control group (500 μg of extract). In vivo tests were performed with Balb/c mice (n = 4). The mice in the positive control group were injected only the venom (25 μg), the experimental groups received a mixture of the venom with each of the extracts at concentrations of 25 to 500 μg, and the negative control group received only extract (500 μg). Results: Jatropha curcas and Myrsine guianensis significantly inhibited phospholipase activity at a 1:0.5 (venom:extract) proportion. Coagulant and hemorrhagic activities were markedly inhibited at 1:1 and 1:5 proportions with Myrsine guianensis and Jatropha curcas, respectively. Phospholipase and coagulant activities were inhibited with Zanthoxylum monogynum at 1:5 and 1:10 proportions, respectively. Conclusions: The extracts analyzed inhibited the venoms from Bothrops alternatus and Bothrops moojeni due to the presence of molecules with possible antiophidic properties(AU)

The WHO strategy for prevention and control of snakebite envenoming: a sub-Saharan Africa plan

Snakebite is a critical public health issue in tropical countries, particularly in Africa, where 20% of snakebites globally occur. In 2017, the WHO added snakebite envenoming to the category A of neglected tropical diseases. In 2019, thanks to broad institutional and international NGO support, including strong mobilization of African experts and governments, WHO launched a strategy for prevention and control of snakebite envenoming with more ambitious goals. In sub-Saharan Africa, accessibility of antivenoms and symptomatic, adjuvant or replacement therapy is a priority. Several antivenoms are available but their evaluation has not been properly carried out and they remain expensive. To date, there are no manufacturers of antivenom in sub-Saharan Africa (except in South Africa), which requires their importation from other continents. The lack of experience in antivenom choice and its use by health authorities, health personnel and population largely explains the shortage in sub-Saharan Africa. The deficiency of epidemiological data does not allow the implementation of appropriate and efficient care. It is crucial to strengthen the health system which does not have the necessary means for emergency management in general and envenoming in particular. Providing peripheral health centers with antivenoms would decrease complications and deaths. The motivation of communities at risk, identified through the epidemiological data, would be to reduce the delay in consultation that is detrimental to the efficiency of treatment. Partnerships need to be coordinated to optimize resources from international institutions, particularly African ones, and share the burden of treatment costs among all stakeholders. We propose here a project of progressive implementation of antivenom manufacturing in sub-Saharan Africa. The various steps, from the supply of...

Snakebites notified to the poison control center of Morocco between 2009 and 2013

Snakebites cause considerable death and injury throughout the globe, particularly in tropical regions, and pose an important yet neglected threat to public health. In 2008, the Centre Anti Poison et de Parmacovigilance du Maroc (CAPM) started to set up a specific strategy for the control of snakebites that was formalized in 2012. The aim of the present study is to describe and update the epidemiological characteristics of snakebites notified to CAPM between 2009 and 2013. Methods This retrospective five-year study included all cases of snakebites notified to CAPM by mail or phone. Results During the study period, 873 snakebite cases were reported to CAPM, an average incidence of 2.65 cases per 100,000 inhabitants with 218 cases each year. The highest incidence was found in Tangier-Tetouan region with 357 cases (40.9 %) followed by Souss Massa Draa region with 128 cases (14.6 %). The average age of patients was 26.8 ± 17.2 years. The male to female sex ratio was 1.67:1 and 77 % of cases occurred in rural areas. The bites occurred mainly in spring (44 %) followed by summer (42 %). Snake species was identified in 54 cases (6.2 %): colubrids represented 31 % (n = 18) and vipers 67 % (n = 36), mainly Daboia mauritanica, Bitis arietans and Cerastes cerastes. In 311 cases (35.6 %), the patients showed viper syndrome. Thrombocytopenia was observed in 23.5 % of viper syndrome cases, whereas, compartment syndrome was observed in 7.6 % patients. FAV-Afrique® was administered in 41 patients (5 %). In patients treated with antivenom, 38 patients recovered and three died. Twenty-seven deaths were reported (3.9 %). Conclusion Despite specific efforts to better understand the epidemiology of snakebites in Morocco (incidence, severity, snake species involved), it remains underestimated. Therefore, further work is still necessary to ensure accessibility of appropriate antivenom against venomous species and to improve the management of envenomation in Morocco.

Ética sobre el envenenamiento ofídico en el paisaje agrario de Guatemala / Ethics of snakebite envenoming in agrarian landscapes of Guatemala

El envenenamiento ofídico es una enfermedad accidental, no infecciosa o contagiosa, causada por los efectos de los venenos de serpientes de las familias Viperidae, Elapidae y Colubridae. Esta enfermedad representa un problema de salud pública a nivel mundial, afectando principalmente a los trabajadores agrícolas. A pesar de derivarse de una relación ecológica antagónica natural entre humanos y serpientes el accidente ofídico es moralmente juzgado como algo malo. En tal sentido, el examen de esta relación supone un componente ético. En el presente ensayo se discute cuál es el significado moral de las serpientes venenosas bajo las perspectivas antropocentrista y biocentrista. Se abordan los temas de riesgo ocupacional y vulnerabilidad del trabajador agrícola a la enfermedad, se elabora sobre las causas de la desatención de esta enfermedad y se reflexiona sobre cuál es la responsabilidad ética del estado, del empresario y del consumidor, en la existencia de ésta enfermedad. Finalmente se discute el papel de la epidemiología social, como una herramienta generadora de información útil para la comprensión de la realidad multidimensional del envenenamiento ofídico.

Snakebite envenoming is an accidental, non-infectious, non-contagious disease, caused by the effects of snake venoms. This disease is a relevant worldwide public health problem in tropical countries. Agricultural workers are highly exposed and therefore, commonly affected. The occurrence of snake envenoming involves some ethics concerns. In this assay, the moral significance of venomous snakes under anthropocentric and biocentric perspectives is discussed. Occupational risk and vulnerability of agricultural workers are also addressed. The ethical roles of government, agricultural enterprises and consumers in the occurrence of the disease are analyzed to try to explain why snakebite envenoming is a neglected disease. Finally, the role of the emerging social epidemiology as the contributor factor to gain involvement of stakeholders ‒which should be responsible for mitigation, prevention, treatment and control of snakebite envenoming‒ is discussed.

[Snakebite in Iran: diagnosis, treatment and prevention]

Due to different questions about how to handle snakebite and its mortality, snakebite management is an emergency and it is necessary to be discussed about. Snakes are divided to three categories including poisonous, semi-poisonous and non-poisonous. Poisonous snakes are divided to elapidae, viperidae, crotalidae and hydrophidae, each of them cause specific symptoms. Snakebite can cause local and systemic symptoms. Local symptoms include edema, tissue necrosis and bulla. Systemic symptoms include hemotoxicity, neurotoxicity, myotoxicity, nephrotoxicity and cardiotoxicity. In this article snakebite diagnosis, prevention and treatment like antivenom, antibiotic, tourniquet, suctioning, etc. has been discussed

Snakebites in southwestern Goiás State, Brazil

The present study evaluated snakebite cases recorded by the Southwest II Regional Health Bureau [Regional de Saúde Sudoeste II], Goiás State, Brazil. The following data were analyzed: accident period; patient's age and gender; bite site; envenomation severity; and time elapsed between the bite and medical treatment. We evaluated 211 cases recorded between January 2002 and December 2005, which resulted in an incidence coefficient of 32.4/100,000 inhabitants. Most accidents were due to the bite of snakes from the Bothrops genus (78.2 percent). The months between January and April had a larger number of accidents (93 percent-44.1 percent), although no significant differences were observed. Only one death occurred, resulting in a mortality rate of 0.5 percent. The lower limbs were the most frequently affected (66.3 percent). The majority of the victims were male (75.1 percent). The age group of most of the patients was from 21 to 30 years (20.8 percent). The accidents were classified as mild, moderate and severe, representing 44.9 percent, 47.6 percent and 7.5 percent of the cases, respectively. The time elapsed between the accident and medical treatment was less than 3h in most of the cases (80.7 percent), reflecting the high frequency of mild and moderate accidents (92.5 percent) as well as the large number of healed patients.

Treatment of Bothrops alternatus envenomation by Curcuma longa and Calendula officinalis extracts and ar-turmerone

Investigou-se a eficácia do extrato de plantas no tratamento local do envenenamento botrópico. Veneno de serpentes Bothrops alternatus (1,25µg) diluído em 100µl de solução salina estéril foi inoculado (via intradérmica) entre as escápulas de 30 coelhos. Os animais foram divididos em seis grupos (tratamentos): grupo I: tratamento subcutâneo com extrato de Curcuma longa; grupo II: tratamento tópico com extrato hidroalcoólico de Curcuma longa; grupo III: tratamento tópico com ar-turmerone em vaselina; grupo IV: tratamento tópico com extrato metanólico de Curcuma longa; grupo V: tratamento tópico com pomada de Calendula officinalis e grupo VI: aplicação tópica de solução salina a 0,9 por cento (Controle). Os tratamentos foram realizados 30 minutos, 2h, 4h, 24h e 72h após a inoculação do veneno. Foram avaliados intensidade de edema local (com paquímetro), halo hemorrágico (régua com gabaritos circulares) e presença de necrose. Sete dias após a inoculação do veneno botrópico (168h) foi coletado sangue do coração, com e sem EDTA, para realização de hemograma, dosagem plasmática de fibrinogênio e dosagens séricas de proteína total, uréia e creatinina. Após as coletas de sangue, todos os animais foram anestesiados, sacrificados com inalação pelo éter etílico e necropsiados. Fragmentos de pele foram retirados para avaliação histopatológica. Os resultados obtidos mostraram que o tratamento mais eficaz para inibição da evolução do edema, necrose e hemorragia local após envenenamento com Bothrops alternatus foi a aplicação tópica de ar-turmerone.

Manejo de las mordeduras de serpientes venenosas en pacientes atendidos en el servicio, de medicina interna en el Hospital Escuela Oscar Danilo Rosales, durante el período de enero 1997-noviembre 1999

En el presente estudio se encontro que el grupo de edad más afectado con mordeduras de serpientes correspondió de 12 a 20 años lo cual coincide con estudios internacionales, donde se reporta que las edades mas afectadas por accidente ofídico es la comprendida entre 10 y 19 años lo cual esta en correspondencia a la actividad laboral ya que la gran mayoría se dedica a la agricultura y pertenece al área rural y es campesino. Con respecto a los tipos de serpientes, la más frecuente que ocasionó accidentes ofídico fue serpiente cascabel con un 41.7 porciento, seguido de serpientes desconocidas en un 38.9 porcientos, sólo se presentó un caso de mordedura de coral. Podemos observar que en relación al tiempo transcurrido entre la mordedura de serpiente y la atención hospitalaria fue en promedio de 8 horas con una desviación estándar de 9.1 horas. Se presentaron los resultados clínicos de la familia de serpientes viperidae, en donde se observa que los datos de laboratorio hubo una prolongación en tiempo de protombina siendo en promedio de 15.4 +- 10.3 segundos. Un 44 porciento de los accidentes correspondió a persona que deambulaban y un 43.1 porciento durante el trabajo en el campo. El área anatómica más frecuente afectada correspondió a miembro inferior izquierdo en un 38.9 porciento. Del total de pacientes 89 porciento recibieron suero antiofídico polivante, 96 porciento tratamiento con penicilina cristalina, en un 14 porciento gentamicina y se utilizó un tercer antibiótico en un 8.3 porciento de los pacientes. Recibieron terapia analgésica con diclofenac sódico en un 8.3 porciento. Se indicó el uso de hidrocortisona en 18.1 porciento de los pacientes y en un 7 porciento de dichos pacientes no se aplicó toxoide cuando estaba indicada. El 62.5 porciento de los pacientes recibió hidroterapia y se aplicó inmunoglobulina antitetánica humana en un 82 porciento. Hubo complicaciones hemorrágicas y se reportó un caso de amputación

Epidemiological and clinical aspects of snakebite in Belo Horizonte, Southeast Brazil

Um estudo clinico-epidemiologico, comparando 310 pacientes hospitalizados por acidentes ofidicos (casos) e 310 pacientes hospitalizados por outras causas (controles), pareados por idade e sexo, durante um periodo de sete anos, foi conduzido em um hospital de emergencias em Belo Horizonte, MG. O diagnostico dos casos foi baseado no quadro clinico ou na identificacao do ofidio

Emponzoñamiento ofidico en pediátria años 1983-1993 H.P.E.C Valera / Snake poisoming in the pediatric years 1983-1993 H.P.E.C Valera

Con la finalidad de conocer las características clínicas, evaluar la eficacia del tratamiento del emponzoñamiento ofídico en la población pediátrica, se realizó un estudio retrospectivo en el cual se revisaron 69 casos de mordedura de serpiente, atendidos en la Emergencia Pediátrica del Hospital Central de Valera "Dr. Pedro Emilio Carrilo", desde enero de 1983 a diciembre de 1993. Las serpientes del género BOTHROPS fueron las responsables de los accidentes. Los hallazgos clínicos más frecuentes fueron: Edema, dolor, equimosis y hemorragias. Las mayores complicaciones se presentaron en 13 pacientes y de ésta la más frecuente fue la celulitis (61,5 por ciento). El emponzoñamiento ofídico se presentó en mayor proporción en el medio rural (88,4 por ciento) afectando especialmente al sexo masculino (55,1 por ciento). Los grupos etarios más afectados fueron los escolares (62,3 por ciento). Seguidos de los pre-escolares 37,7 por ciento. El 84 por ciento de las mordeduras ocurrió en los miembros inferiores, con predominio a nivel de pie (71 por ciento). La mortalidad representó el 0,69 por ciento. El 92,7 por ciento de los pacientes recibió tratamiento con suero antiofidio. El emponzoñamiento fue más frecuente en 1991 y la incidencia fue mayor en el mes de diciembre (17,4 por ciento)

Epidemiologia do acidente por serpentes peçonhentas: estudo de casos atendidos em 1988 / Epidemiology of poisonons snake-bites: a study of cases assisted in 1988

Avalia aspectos epidemiológicos de acidentes por serpentes peçonhentas no Estado de Säo Paulo, Brasil, com base em prontuários de 322 pacientes e em entrevistas feitas com 209 deles e/ou seus acompanhantes. Os acidentes ocorreram principalmente com pessoas de 10 a 20 anos de idade, do sexo masculino, nos meses de outubro a abril e no período diurno. As regiöes anatônicas mais freqüentemente picadas foram os pés, as mäos e as pernas. Bothrops, Crotalus e Micrurus foram responsáveis por, respectivamente, 95,0 por cento, 4,4 por cento e 0,6 por cento dos casos. Näo ocorreram óbitos, mas 2,2 por cento dos pacientes apresentaram seqüelas. Dentre os 209 entrevistados, a ocupacäo de lavrador foi a mais freqüentemente relacionada ao acidente que, em aproximadamente 60 por cento das vezes, ocorreu durante o trabalho. O total de 160 pacientes (76,6 por cento) submeteram-se a alguma forma de tratamento antes de chegarem a um serviço de saúde: foram mais comuns o uso de torniquete (50,2 por cento), a expressäo local na tentativa de retirar parte do veneno (33,5 por cento), a colocaçäo das mais diversas substâncias sobre o local da picada (36,8 por cento) e a ingestäo de outras (12,9 por cento); pouco mais de um quarto dos pacientes submeteram-se a alguma forma de tratamento médico antes de chegar ao HVB sendo mais comum a antissepsia (8,2 por cento), a administraçäo do antiveneno (6,2 por cento), de anti-histamínicos (5,7 por cento) e de analgésicos (5,3 por cento)

Investigaçao dos casos de acidentes ofídicos na populaçao pantaneira,no Passo do Lontra,MS agosto/1993 a julho /1994 / Investigation about snake bite cases in population of pantanal sul-mato-grossense,in Passo do Lontra-MS August/1993 to July/1994

A regiao Centro-Oeste apresenta os maiores índices de acidentes ofídicos no Brasil.Entretanto,pouco se sabe a esse respeito na regiao do Pantanal sul-mato-grossense.Esse estudo visou obter dados sobre esse assuntoutilizando-se de um inquerito epidemiologico.Os autores estudaram a frequência dos acidentes ofídicos nessa localidade,observando a prática de metodos de prevençao e tratamento para esse tipo de agravo.