PDF(Pubmed)
Abstract：
Background: Snakebite is a global environmental and occupational hazard and a significant public health threat. In rural areas, snakebite cases often go unreported and undocumented due to the lack of access to well-structured healthcare facilities/infrastructure. In some cases, the need for antisnake venom (ASV) far outstrips supply, negatively affecting treatment outcomes. This study, therefore, assessed the epidemiological characteristics of snakebite cases, their management, and how antivenoms are utilised at the selected hospital in the Jasikan District Hospital. Methods: A 6-year retrospective study using secondary data from antivenom return forms (pharmacy records), clinical records (patient folders), the District Health Information Management System-2 (DHIMS-2) database, and consulting room registers was carried out in selected hospitals in the Jasikan District, Oti, Ghana. Results: The predominant symptom of snakebite was localised pain (71.4%). The snakebite commonly occurred at home (19%) and on farms (18%). Of the 98 snakebite cases, ASV was administered to 73 (74.5%) cases. Supportive treatment applied included prophylactic antitetanus immunoglobulin (ATS) (80.6%), prophylactic antibiotics (63%), corticosteroids (80.6%), and analgesics (63%). 95% (n = 94) of complete recoveries were recorded; three were discharged against medical advice, and one was mortality. The supply and use of antivenom were erratic throughout the months of high incidence, partly due to inconsistent availability at the Regional Medical Stores. The average ASV vials and hospital stay duration were 1.23 ± 0.86 vials and 2.67 ± 1.97 days, respectively. Although the peak of snakebites occurs in April, May, and June, the demand for antivenom in April and May exceeded supply. Conclusion: The outcome of most snakebite case management was appropriate, irrespective of inadequate ASV supply in certain months. The erratic antivenom supply should be aligned with seasonal and facility-use patterns to enhance regional snakebite management.
摘要：
背景：蛇咬伤是一种全球性的环境和职业危害，也是一种重大的公共卫生威胁。在农村地区,由于缺乏结构良好的医疗设施/基础设施，蛇咬伤病例往往没有报告和记录。在某些情况下,对抗蛇毒（ASV）的需求远远超过了供应，负面影响治疗结果。这项研究,因此,评估蛇咬伤病例的流行病学特征，他们的管理,以及在Jasikan地区医院的选定医院中如何使用抗蛇毒血清。方法：一项为期6年的回顾性研究，使用抗蛇毒血清返回表（药房记录）的次要数据，临床记录（患者文件夹），区卫生信息管理系统-2(DHIMS-2)数据库，并在Jasikan区的部分医院进行了诊室登记，奥蒂,加纳。结果：蛇咬伤的主要症状为局部疼痛（71.4％）。蛇咬伤通常发生在家中（19％）和农场（18％）。在98个蛇咬伤案例中，73例（74.5%）患者接受ASV治疗。支持性治疗包括预防性抗破伤风免疫球蛋白（ATS）（80.6%），预防性抗生素(63%)，皮质类固醇（80.6%），和镇痛药(63%)。记录了95％（n=94）的完全恢复；三人在医疗建议下出院，一个是死亡。在高发的几个月中，抗蛇毒血清的供应和使用不稳定，部分原因是区域医疗商店的可用性不一致。平均ASV瓶和住院时间分别为1.23±0.86瓶和2.67±1.97天，分别。尽管蛇咬伤的高峰出现在4月份，May,六月,4月和5月抗蛇毒血清的需求超过了供应。结论：大多数蛇咬伤病例管理的结果是适当的，无论在某些月份ASV供应不足。不稳定的抗蛇毒血清供应应与季节性和设施使用模式保持一致，以加强区域蛇咬伤管理。
