[Hospital care of snakebites in Africa]

Snakebites constitute a public health problem in Africa, with some 600,000 envenomations and 20,000 estimated deaths per year. Hospital care of cases guided by written protocols which take into account the epidemiological and physiopathological data, as well as the hospital situation, starts in the emergency room and is based on the diagnosis of envenomation, either by vipers or elapids. If this diagnosis is confirmed, intensive treatment must ensue. It includes a non-specific component, particularly the treatment of hypovolemia, consumptive coagulopathy tissue necrosis and respiratory failure and a specific component, immunotherapy the only ethiological treatment. The latter consists in giving an iv injection of polyvalent purified immunoglobulin fragments against the venom. This attention is included in a general public health policy which takes into account the organization and financing of the treatment.