Strategies can halve snakebite fatalities
WATAMU, Kenya — On June 15, 2015, 4-year-old Chepchirchir Kiplagat’s life changed forever. Bitten by a snake as she slept, she permanently lost the use of the left side of her body.
Sleeping beside her on a mattress on the floor of their modest, mud-walled home, Chepchirchir’s 2-year-old sister Scholar was also bitten. But she did not survive.
Chepchirchir was hospitalized for two months and suffered permanent nerve damage.
Every year, snakes bite about 5.4 million people worldwide, of whom up to 2.7 million experience “envenoming” — when the animal transfers its poison through its fangs.
This number is likely a vast underestimation, given underreporting and patchy record-keeping, officials said.
An estimated 81,000-138,000 people die of snakebites annually, according to the World Health Organization, while about 400,000 survivors suffer permanent disabilities and other nasty aftereffects.
Snake venom can cause paralysis that stops breathing, bleeding disorders that can lead to fatal hemorrhage, irreversible kidney failure and tissue damage that can cause permanent disability and limb loss.
Most snakebite victims live in the world’s tropical and poorest regions, and children are worse affected due to their smaller body size.
The fate of victims like Chepchirchir and her little sister is avoidable, insisted Royjan Taylor, director of the Bio-Ken venomous snake center in Watamu on the Kenyan coast.
Even simple barriers such as mosquito nets around beds can repel the slithering reptiles, while easy access to trained medical staff and species-specific antivenoms can save thousands of lives.
Figures on antivenom availability today are hard to come by, but a report by Nick Brown of the Global Snakebite Initiative a few years ago estimated it could be as low as 2.5 percent of what is needed, with the majority of African countries having no effective or affordable antivenom at all.
And a recent study of more than 100 clinics in Kenya’s southern Kilifi county revealed that nearly 90 percent of staff had no training in snakebite treatment.
Kenya boasts some of the world’s deadliest snakes, key among them green and black mambas and spitting cobras.
And as in other poor, rural areas of Africa, Latin America and Asia, venomous snakes pose a public health risk that experts say has been neglected for far too long. Things may finally be changing. On February 21, a dedicated working group set up by the United Nations’ public health organ unveiled a strategy for halving snakebite deaths by 2030.
In its report, the group slams policymakers and drug developers for turning a blind eye to the issue.
“Like many diseases of poverty, snakebite envenoming has failed to attract requisite public health policy inclusion and investment …,” the authors state.
“This is largely due to the demographics of the affected populations and their lack of political voice.”
The working group’s plan envisions making 500,000 antivenom treatments available in sub-Saharan Africa every year by 2024, rising to 3 million per year globally by 2030.
WHO will work to boost production of the serum, improve regulatory control and reinvigorate the market by ensuring that safe and effective products are available, the report said.