An analysis of paediatric snakebites in north-eastern South Africa
J J P Buitendag1, S Variawa2, D Wood3
1Department of Surgery, Tygerberg Hospital, Stellenbosch University, South Africa.
Insights
Paediatric snakebites are often cytotoxic, requiring antivenom or surgery. While adverse reactions to antivenom are common, they are manageable. A national snakebite registry is needed to improve prevention and treatment strategies.
Area of Science:
- Medical Research
- Paediatric Health
- Toxicology
Background:
- Snakebites pose a significant health risk, particularly in low- and middle-income countries.
- Limited national data hinders effective funding, treatment, and prevention strategies for snakebites.
- Children are disproportionately vulnerable to snakebite envenomation, with scarce data available for this demographic.
Purpose of the Study:
- To analyze the clinical characteristics and management of paediatric snakebites.
- To identify the types of envenomation and interventions required in children.
- To highlight the need for improved snakebite data collection and prevention.
Main Methods:
- Retrospective study of paediatric patients (≤13 years) admitted with snakebite from 2008-2013.
- Data collection included demographics, presentation time, symptoms, lab results, and patient management.
- Analysis focused on envenomation type, antivenom use, surgical interventions, and outcomes.
Main Results:
- 274 paediatric patients were included; median age was 8 years, with 70% aged 6-13.
- Most patients (71%) presented with cytotoxic manifestations; 56% required surgical procedures.
- Antivenom was administered to 53 patients (19.3%), with 25% experiencing adverse reactions. No mortalities were recorded.
Conclusions:
- Cytotoxic snakebites are predominant in the paediatric population studied.
- A significant proportion of children require antivenom and surgical intervention.
- Effective prevention programs and a national snakebite registry are crucial to address this public health issue.
Background:
Snakebites are an underappreciated health concern in middle- and lower-income countries. The lack of national data vastly impacts funding for this health crisis, as well as strategies for treatment and prevention. Children are particularly vulnerable to snakebite and data in this group is limited.
Methods:
This study included paediatric patients, aged 13 years old or younger, admitted to Ngwelezana Tertiary Hospital, Department of Surgery with a snakebite or snakebite related complication, from 1 September 2008 to 31 December 2013. Data captured included demographics, time of presentation, syndromic symptoms, blood results and patient management.
Results:
A total of 274 patients were included in this study. The median age at presentation was 8 years, with approximately 70% of the patients aged between 6 and 13 years, with a male predominance (56%). The median time of presentation after sustaining a snakebite was 7 hours (interquartile range 4-13 hours). The majority of patients (71%) presented with cytotoxic manifestations. A total of 53 patients received antivenom of whom 25% suffered adverse reactions. Fifty-six patients underwent one or more procedures on their affected limbs. Three patients required admission to the intensive care unit; all were part of the cytotoxic group and received antivenom. There were no recorded mortalities.
Conclusion:
The majority of snakebites are cytotoxic in nature. One-fifth of the paediatric population require antivenom and one-fifth require a surgical procedure post envenomation. Adverse effects post antivenom use are common but manageable. Prevention programmes are needed to help reduce this burden of disease and a nationwide snakebite registry is long overdue.
