Snakebite in north-eastern South Africa: clinical characteristics and risks for severity

Objectives: To identify the toxicity profile of snakebites and to assess clinical severity. Methods: An analysis of all patients admitted to Ngwelezane Hospital’s Emergency Department with a diagnosis of snakebite over five years was done. All patients were admitted, assessed and standard haematolo...

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Main Authors: Darryl Wood, Benjamin Sartorius, Richard Hift
Format: Article
Language:English
Published: AOSIS 2016-03-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/5676
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author Darryl Wood
Benjamin Sartorius
Richard Hift
author_facet Darryl Wood
Benjamin Sartorius
Richard Hift
author_sort Darryl Wood
collection DOAJ
description Objectives: To identify the toxicity profile of snakebites and to assess clinical severity. Methods: An analysis of all patients admitted to Ngwelezane Hospital’s Emergency Department with a diagnosis of snakebite over five years was done. All patients were admitted, assessed and standard haematological and biochemical tests were done. Patients were observed for a minimum of 12 hours’ observation. Results: In total, 879 cases were analysed. Envenomation was identified in over two-thirds of admissions. Cytotoxic snakebites accounted for 98% of envenomations. Only four cases of haemotoxic bleeding and five cases of neurotoxicity were admitted. Abnormal laboratory indices correlated with severity: INR 1.5 (odds ratio 2.25, CI 1.12–4.53; p = 0.023), platelets 100x109/L (OR 2.35, CI 1.01– 5.49; p = 0.048), haemoglobin concentration 8.0 g/dL (OR 5.68, CI 2.15–15.00; p 0.001) and leucocyte count 10x109 (OR 3.15, CI 1.89– 5.26, p 0.001). Children and delays to admission correlated to and were predictors of severity. Conclusion: Two-thirds of patients who present to hospital with snakebite will have symptoms of envenomation, with the overwhelming majority having been bitten by cytotoxic species. Some factors correlate to severity and may be useful for anticipating the patient’s clinical course.
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spelling doaj-art-9eeea5446f734402b1fe73bd52909a7a2025-08-20T04:03:12ZengAOSISSouth African Family Practice2078-61902078-62042016-03-0158210.4102/safp.v58i2.56764286Snakebite in north-eastern South Africa: clinical characteristics and risks for severityDarryl Wood0Benjamin Sartorius1Richard Hift2Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; and Ngwelezane Hospital, KwaZulu-Natal, DurbanSchool of Public Health, University of KwaZulu-Natal, DurbanNelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, South AfricaObjectives: To identify the toxicity profile of snakebites and to assess clinical severity. Methods: An analysis of all patients admitted to Ngwelezane Hospital’s Emergency Department with a diagnosis of snakebite over five years was done. All patients were admitted, assessed and standard haematological and biochemical tests were done. Patients were observed for a minimum of 12 hours’ observation. Results: In total, 879 cases were analysed. Envenomation was identified in over two-thirds of admissions. Cytotoxic snakebites accounted for 98% of envenomations. Only four cases of haemotoxic bleeding and five cases of neurotoxicity were admitted. Abnormal laboratory indices correlated with severity: INR 1.5 (odds ratio 2.25, CI 1.12–4.53; p = 0.023), platelets 100x109/L (OR 2.35, CI 1.01– 5.49; p = 0.048), haemoglobin concentration 8.0 g/dL (OR 5.68, CI 2.15–15.00; p 0.001) and leucocyte count 10x109 (OR 3.15, CI 1.89– 5.26, p 0.001). Children and delays to admission correlated to and were predictors of severity. Conclusion: Two-thirds of patients who present to hospital with snakebite will have symptoms of envenomation, with the overwhelming majority having been bitten by cytotoxic species. Some factors correlate to severity and may be useful for anticipating the patient’s clinical course.https://safpj.co.za/index.php/safpj/article/view/5676snakebitecytotoxicneurotoxichaemotoxicenvenomationemergencykwazulu-natal
spellingShingle Darryl Wood
Benjamin Sartorius
Richard Hift
Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
South African Family Practice
snakebite
cytotoxic
neurotoxic
haemotoxic
envenomation
emergency
kwazulu-natal
title Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
title_full Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
title_fullStr Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
title_full_unstemmed Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
title_short Snakebite in north-eastern South Africa: clinical characteristics and risks for severity
title_sort snakebite in north eastern south africa clinical characteristics and risks for severity
topic snakebite
cytotoxic
neurotoxic
haemotoxic
envenomation
emergency
kwazulu-natal
url https://safpj.co.za/index.php/safpj/article/view/5676
work_keys_str_mv AT darrylwood snakebiteinnortheasternsouthafricaclinicalcharacteristicsandrisksforseverity
AT benjaminsartorius snakebiteinnortheasternsouthafricaclinicalcharacteristicsandrisksforseverity
AT richardhift snakebiteinnortheasternsouthafricaclinicalcharacteristicsandrisksforseverity