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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 4  |  Issue : 3  |  Page : 55-56

Strengthening prevention and control activities for snakebite envenoming in endemic nations: World Health Organization


1 Vice-Principal Curriculum, Member of the Medical Education Unit and Medical Research Unit, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth-Deemed to be University, Ammapettai, Nellikuppam, Chengalpet Taluk, Kancheepuram, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth-Deemed to be University, Ammapettai, Nellikuppam, Chengalpet Taluk, Kancheepuram, Tamil Nadu, India

Date of Web Publication27-Sep-2019

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Associate Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet Taluk, Kancheepuram District, Tamil Nadu - 603 108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ed.ed_19_19

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How to cite this article:
Shrivastava SR, Shrivastava PS. Strengthening prevention and control activities for snakebite envenoming in endemic nations: World Health Organization. Environ Dis 2019;4:55-6

How to cite this URL:
Shrivastava SR, Shrivastava PS. Strengthening prevention and control activities for snakebite envenoming in endemic nations: World Health Organization. Environ Dis [serial online] 2019 [cited 2022 Dec 10];4:55-6. Available from: http://www.environmentmed.org/text.asp?2019/4/3/55/268148



Dear Editor,

Snakebite has been ignored as a public health concern in low- and middle-income nations within the tropical and subtropical region despite the alarming estimates, which often remains under-reported.[1],[2] In fact, the available global estimates indicate that each year, more than 5.3 million cases of snakebites are being reported, of which on an average 2.2 million are cases of envenomings.[2] Further, in terms of complications, in excess of 0.1 million deaths and millions of combined cases of irreversible renal failure, amputations, and other forms of permanent disabilities have been reported annually.[2]

Even though the magnitude of the problem is immense, and the condition affects the quality of life of the victims, the extent of the public health response has not been in proportion, and a number of challenges have been identified.[1],[2],[3] The most important challenge is the presence of a weak public health-care delivery system, especially in nations which are having the highest incidents of snakebites.[3] This is mainly because of the absence of norms and protocols of timely and quality hospital medical care, weak epidemiological surveillance system, shortage of trained personnel, and absence of the required antidotes in the hospital.[1],[3] This is often coupled with poor infrastructure, lack of resources, and no comprehensive surveillance to obtain the precise data about the problem.[1] Owing to the under-reporting and lack of complete data, it leads to our next important problem wherein we fail to explicitly identify the need of antivenoms.[1]

Moving on, it is important to understand that very few nations across the world have the capacity to produce antivenoms by adding the correct immunogens.[1],[3] Thus, most of the nations have to depend on the supply from these nations, but considering the fact of under-reporting, the public health authorities never get the actual estimate which is required for the procurement of antivenoms.[2],[3],[4] This eventually leads to less procurement or procurement of ineffective/incorrect antivenoms, and the problem is further magnified due to the poor inventory control and inefficient tactics for the distribution of the same.[3]

Keeping all the challenges in the context, it is high time to take strong measures to significantly improve the existing scenario.[3] In fact, the World Health Organization has come up with a comprehensive strategy to minimize the number of deaths and disability by 50% by the year 2030.[1],[4] The first and foremost strategy is to prevent snakebite envenoming and enhance the use of effective treatment through the engagement of the communities by means of awareness activities.[4] This has to be coupled with the training of health-care professionals and the availability of effective antivenoms in the primary health-care facilities, at a subsidized cost.[4],[5]

However, none of these strategies can be sustainable unless it is coupled with measures to strengthen the health systems, better reporting system, and fostering of partnership with different agencies.[2],[4] Moreover, a specific financial budget and monetary support have been made to ensure the success of the planned strategies.[5] In addition, there is a definite scope for enhancing research activities for the development of new therapies and medical interventions.[1],[3]

In conclusion, the need of the hour is to mobilize the resources and target the affected communities, strengthen the public health system, and ensure the availability of safe and effective mode of treatment for the victims through a concerted and coordinated response involving all stakeholders, including the private sector.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Snakebite Envenoming - Key Facts; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming. [Last accessed on 2019 May 9].  Back to cited text no. 1
    
2.
Williams DJ, Faiz MA, Abela-Ridder B, Ainsworth S, Bulfone TC, Nickerson AD, et al. Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming. PLoS Negl Trop Dis 2019;13:e0007059.  Back to cited text no. 2
    
3.
World Health Organization. Snakebite envenoming – A strategy for prevention and control. Executive Summary. Geneva: World Health Organization Press; 2019. p. 1-2.  Back to cited text no. 3
    
4.
Burki T. Resolution on snakebite envenoming adopted at the WHA. Lancet 2018;391:2311.  Back to cited text no. 4
    
5.
Hamza M, Idris MA, Maiyaki MB, Lamorde M, Chippaux JP, Warrell DA, et al. Cost-effectiveness of antivenoms for snakebite envenoming in 16 countries in west Africa. PLoS Negl Trop Dis 2016;10:e0004568.  Back to cited text no. 5
    




 

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