PDF | Abstract Different fractions (I-V) of the methanolic leaf extracts of Fractions III neutralized lethal toxicity induced by Echis ocellatus. Antisnake Venom Activity of Hibiscus aethiopicus L. against Echis ocellatus and Naja n. nigricollis. Article (PDF Available) in Journal of. See discussions, stats, and author profiles for this publication at: https://www. Failure of a new antivenom to treat Echis.

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Antisnake Venom Activity of Hibiscus aethiopicus L. against Echis ocellatus and . The venom of E. ocellatus was kindly Despite their smaller size, F(ab2)2 and. Echis) snake venoms on human plasma and the narrow taxonomic ranges of antivenom .. Equine whole IgG; specific Echis ocellatus, Bitis arietans apps. WHO. four species of saw-scaled vipers (Echis ocellatus, Echis coloratus, (>50% of all toxins) of the four Echis species correlates with our previous.

Clin Toxicol Phila ;— Victims of snakebite: a five year study at Shongwe Hospital, Kangwane, — South African Medical Journal. First clinical experiences with anew ovine Fab Echis ocellatus snake bite antivenom in Nigeria: randomized comparative trial with Institute Pasteur Serum Ipser African antivenom. American Journal of Tropical Medicine and Hygiene.

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Intrauterine fetal death caused by pit viper venom poisoning in early pregnancy. Gynecologic and Obstetric Investigation.

The effect of maternal envenomation by Naja haje Egyptian cobra snake on the developing central nervous system. Singapore Medical Journal.

Management of snake and spider bite in pregnancy. Obstetrical and Gynecological Survey. Incidence and mortality of snakebite in savanna Nigeria.

Envenoming due to snake bite during pregnancy. Death from a snake bite: associated with the supine hypotensive syndrome of pregnancy. Medical Journal of Australia. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years.

New England Journal of Medicine. The importance of bites by the saw-scaled or carpet viper Echis carinatus. Epidemiological studies in Nigeria and a review of the world literature. Garnvwa5, R.

Theakston5, L. Salako4, and D. All women survived but foetal loss in a victim with delayed presentation and a case of mild hypersensitivity reaction were recorded.

Excellent outcomes can be achieved in rural and semi-nomadic populations without specialized care and immediate access and provision of effective antivenoms is paramount in curtailing snakebite maternal morbidity, mortality and foetal loss.

The saw-scaled or carpet viper Echis ocellatus has proved to be the most important cause of snakebite mortality and morbidity in the region. The main clinical features of E. In many tropical countries men and women are equally exposed to the environmental and occupational hazards of snakebite.

In a large series of hospital admissions due to snakebite reported from South Africa, pregnant women accounted for 0. Hospital records are misleading and the true incidence of snakebite is unknown, but it Habib et al. Page 2 may play a significant role in maternal morbidity, mortality and foetal loss in those societies.

Journal of Toxins

Patients and results In , victims of snakebite with 26 deaths were seen at Kaltungo General Hospital. Snakes that bite the patients were identified when killed and brought to hospital or by incoagulable blood using the simple min whole blood clotting test [WBCT20] which is diagnostic of carpet viper in this part of Nigeria Meyer et al.

Eleven patients were pregnant, of whom 10 were bitten by E. Eight of the 10 victims were nomadic or semi-nomadic Fulani maids Table 1. An illustrative case is that of a 17 year old Tangale Waja student who was 6 months pregnant at presentation. She was bitten on the left foot by a carpet viper 6 days prior to hospitalization while walking to the toilet. No tourniquet was applied but incisions were made at the bite site.

Treatment of envenomation after Echis ocellatus bites in burkina faso

She was treated by a traditional herbalist for 6 days and had vomited several times after ingesting concoctions. She had a 3-day history of gum bleeding, epistaxis and maleana; foetal heart sounds were not heard at presentation.

Three millilitre of fresh whole blood placed in a clean test tube failed to clot within 20 min and she was treated with slow intravenous 20 ml of EchiTab IgG E.


She achieved restoration of WBCT20 1 day after admission and was transfused with a pint of fresh whole blood, after which she immediately and spontaneously delivered a stillbirth. Intravenous ampiclox and metronidazole were commenced together with oral ferrous sulphate and folic acid. Subsequently, daily WBCT20 did clot, the swelling subsided and the patient was discharged 6 days later after marked improvement with a 2-week follow up request. Discussions This case series suggests that snakebite, in particular carpet viper bite, is a significant cause of maternal morbidity and foetal loss among underprivileged rural dwellers in the West African savanna.

Foetal loss resulted from delayed presentation in a patient but there are several possible mechanisms for foetal loss after snakebite: they include the direct effects of NIH-PA Author Manuscript venom on the foetus, foetal hypoxia due to maternal shock, venom-induced uterine contractions and placental bleeding due to coagulopathy.

None of our patients had vaginal bleeding, although intra-uterine foetal death without bleeding [confirmed using transvaginal ultrasonography] has been reported Nasu et al.

Snake venom is a mixture of complex biochemical compounds including potentially tocolytic substances that may induce uterine contractions but their exact role in premature labour and maternal morbidity is unknown. Since the East and North-East African Echis vipers are also a public health concern, our objective was to determine, at the pre-clinical level, whether the efficacy of EchiTAbG against E.

Ideally, our pre-clinical assays would have been conducted on venoms from all the African Echis species but we could not justify the ethical and financial costs of such a large number of mice. Therefore, based upon the most comprehensive taxonomic study of the genus Echis [16] , we selected a single species from each of the four distinct species complexes; i E.

Our earlier work on the venom gland transcriptomes of these representative Echis species revealed considerable intra-generic differences in the number of isoforms comprising the main Echis toxin groups snake venom metalloproteinases, phospholipases A2, serine proteases, C-type lectins [15].

However, each pathogenic toxin family was represented in all the Echis species [15] — a result suggesting the possibility that EchiTAbG would have cross-Echis species efficacy.

Consequently, and in line with WHO recommendations [17] , we performed here a series of immunological assays examining the immunological venom cross reactivity of ovine IgG raised against each representative Echis species. The results of these assays, which were designed to measure IgG titre, specificity and relative avidity to venoms in reduced and native states, indicated a very considerable degree of immunological cross-reactivity of each species-specific IgG antisera to each Echis venom.

This indicates that while these immunological tests provide informative and comprehensive immunological profiles of an antivenom, they can not yet replace pre-clinical in vivo testing to indicate the efficacy of an antivenom. We believe this is vitally important to the sustained delivery of these new antivenoms, developed to resolve a crisis in antivenom supply to Nigeria, because their production is now vulnerable to the same fiscal insecurities that caused the antivenom crisis a decade ago.

A greater market, through geographical expansion, should permit the application of economies of scale that hopefully will, sequentially, reduce costs to the downloading ministries of health, increase demand and improve the delivery of these urgently needed life-saving therapies.

The authors would also like to take this opportunity to express our gratitude to other members of the EchiTAb Study Group, including Professors Warrell and Theakston, the clinicians Drs AS Ballah and YP Ofemile treating snakebite victims in Kaltungo and Zamko hospitals, whose sustained efforts have combined to dramatically improve the treatment of Nigerian snakebite victims.There are encouraging reports of more effec- tive antivenoms for Africa Laing et al.

Mar- keting claims for new antivenoms may be unreliable. However, many of the reported studies lack detailed scientific investigation, which is needed in the development of medicinal agents from plants [28, 30].

South African Medical Journal. Intra-Peritoneal Route Acute Toxicity.

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