Round table and synthesis of the meeting

Our knowledge of the epidemiology of scorpion stings and snakebites remains fragmentary but sufficient, nevertheless, to be able to confirm that envenomations constitute a real public health problem throughout Africa. In order for the health authorities to be able to improve management of this problem, data collection must be enhanced. The objective should be to determine what kinds of intervention are necessary (quantity of antivenom serum and drugs, in particular) and where they should be applied. Specialists must come to a rapid consensus for a simple therapeutic protocol to be used in peripheral health centres where means are often scarce. Training for health personnel is also insufficient. Appropriate courses must be organised for medical doctors and nurses within both their basic and on-going training. These courses must necessarily involve health personnel from rural zones must affected by envenomations. The availability of antivenom serum--the only specific, efficacious drug--must be improved as soon as possible. If quantitative and geographic needs can be determined by epidemiological studies, then distribution must be developed by original means (grouping orders at national level, direct orders) and diversified financial support (purchase on the open market, local authority grants, community participation). The symposium attendees agreed to meet again within two years' time to evaluate progress in the area.