A retrospective study of poisoning due to snake venom in Zimbabwe

1. Hospital records at the six major referral hospitals in urban Zimbabwe were reviewed for the years 1980-1989 in order to determine the types of snake, incidence, morbidity and mortality associated with snake venom poisoning. 2. A total of 1087 cases of animal toxin poisoning were retrieved retrospectively, 91.5% (995) of which were due to snake venom poisoning. Of the 995 cases, 50.9% (506) were females and 49.1% (489) males. The majority of patients were aged from 21 to 30 years (22%), followed by the 6-15 (16%) and the 16-20 year age groups (11%), respectively. 3. The mean period of hospitalization of a snake venom-poisoned patient was found to be 2 d (the range was 1 d-9 weeks). The mean total cost of keeping (excluding treatment) a poisoned patient during that period was calculated at Zimbabwean dollars (Zw$) 450.00 (US$ 225.00) per day. The total number of hospitalization days was 344 and the cost of keeping the patients in hospital was therefore Zw$ 154,800 (i.e. US$ 77,400). 4. The first-line treatment most used was a combination of antibiotics (44.6%), alone or with an antivenom tropical snake polyvalent (ATT) (21.2%), and analgesics (19.9%). 5. Mortality was recorded at 1.8% (18 patients) and the few records of the types of snakes associated with envenomation in order of frequency were the cobra, adders (puff and night), mamba and boomslang. The prevention and prompt treatment of snake envenomation is of priority in the reduction of incidence of poisoning.