Snakebite envenoming at MSF: A decade of clinical challenges and antivenom access issues

IF 3.6 Q2 TOXICOLOGY Toxicon: X Pub Date : 2023-03-01 DOI:10.1016/j.toxcx.2022.100146
Julien Potet , Saschveen Singh , Koert Ritmeijer , Kasaye Sisay , Gabriel Alcoba , Fabienne Jouberton , Yannick Wilson Henko Kinding , Alexandra Kruse , Aboubacar Bengaly , Malwal Sabino , Narcisse Patrice Komas , Matthew Coldiron
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引用次数: 2

Abstract

The medical humanitarian organization Médecins Sans Frontières (MSF) provides medical care in more than 70 countries and admits more than 7000 cases of snakebite in its facilities each year.

We describe our activities against snakebite in three African countries: Central African Republic, South Sudan and Ethiopia, in which different models of care have been developed. A standard protocol using two different antivenoms depending on the patient's syndrome has been introduced, and a simple blood coagulation test is performed to detect venom-induced coagulopathy. Other services, including surgery for necrotizing wounds, are offered in the facilities where MSF admits a large number of snakebite patients. All services, including provision of antivenom, are offered free-of-charge in MSF-supported facilities. Community-based activities focusing on preventive measures and prompt transport to hospital have been developed in a few MSF projects.

The provision of quality care and treatment, including effective antivenoms, without out-of-pocket payments by the patients, probably explains why MSF has admitted an increasing number of snakebite victims over the last years. This model requires significant resources and monitoring, including regular training of healthcare workers on treatment protocols and a considerable budget for antivenom procurement.

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无国界医生的蛇咬伤环境:十年的临床挑战和抗蛇毒血清获取问题
医疗人道主义组织无国界医生组织(MSF)在70多个国家提供医疗服务,每年在其设施中收治7000多例蛇咬伤病例。我们介绍了我们在中非共和国、南苏丹和埃塞俄比亚这三个非洲国家开展的反蛇咬活动,这些国家已经制定了不同的护理模式。根据患者的综合征,引入了使用两种不同抗蛇毒血清的标准方案,并进行了简单的凝血测试来检测毒液诱导的凝血病。其他服务,包括坏死性伤口的手术,也在无国界医生接纳大量蛇咬伤患者的设施中提供。所有服务,包括提供抗蛇毒血清,都在无国界医生支持的设施中免费提供。无国界医生组织的一些项目开展了以社区为基础的活动,重点是预防措施和及时送往医院。提供高质量的护理和治疗,包括有效的抗蛇毒血清,而患者无需自付费用,这可能解释了为什么无国界医生在过去几年里接纳了越来越多的蛇咬伤受害者。这种模式需要大量的资源和监测,包括对医护人员进行治疗方案的定期培训,以及采购抗蛇毒血清的可观预算。
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来源期刊
Toxicon: X
Toxicon: X Pharmacology, Toxicology and Pharmaceutics-Toxicology
CiteScore
6.50
自引率
0.00%
发文量
33
审稿时长
14 weeks
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