Clinicopathological study of snakebite injury resulting from Zebra spitting Cobra (naja nigricincta nigricincta) and Puff adder (bitis arietans)
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Date
2022
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Publisher
University of Namibia
Abstract
Snakebite injury is a significant public health hazard worldwide, with an estimated 1.8 – 2.7 million people bitten annually by venomous snakes, resulting in about 81 000 – 137 8800 deaths. It is frequently overlooked and understudied, and it primarily affects rural and remote areas. Snakebites have been reported to be common in Namibia. The most commonly striking species being the zebra spitting cobra (Naja nigricincta nigricincta) and the puff adder (Bitis areitans) which are also regarded to be among the most venomous. There is a lack of information on snakebite pathology with few health care facilities equipped to treat snakebites. This study described for the first time, clinical course of patients bitten by Naja nigricincta nigricincta (N. n. nigricincta) and Bitis areitans (B. a. arietans) in Namibia. Furthermore, the current study evaluated systemic symptoms of organ damage as well as patient’s recovery from snakebite injuries. This was a mixed method, observational study including 20 patients with snakebite injury who presented to and were treated at Namibia's two major referral hospitals, Katutura Intermediate State Hospital and Windhoek Central Hospital. Clinical and laboratory data were gathered from patient hospital records and personal observation. GraphPad Prism (version 8.0.2) software was utilized for the analysis. Out of 20 cases of snakebites, the majority of about 65 % (13) were males, with minors between the age of 0 – 15 years accounting for 65 % (13) of the snakebite cases. N. n. nigricincta was responsible for 60 % (12) of the snakebite injuries and 40 % (8) by B. a. arietans. Most patients (80 %) admitted to the hospital showed cytotoxic bites, with two cases of dry bites from B. a. arietans. Neurotoxicity was observed in 40 % (8) patients bitten by N. n. nigricincta and 10 % (2) bitten by B. a. arietans. Snake antivenom was only administered to 15 % (3) patients with snakebite injuries. The bite of a N. n. nigricincta was associated with anaemia, haemolysis, rhabdomyolysis, kidney damage, and liver damage. Whereas bites form B. a. arietans had no systemic damage, beside mild neurotoxicity in the patients. Three patients of the snakebite cases required amputation, with no fatalities, and six required physiotherapy intervention to restore, maintain, and improve most of the participants' mobility and functions. In conclusion, the study demonstrated that in general snakebite injuries is common in Namibia. To reduce chances of complications it is essential that community members present early to health facilities. For the first time, this study documented clinical pathology induced by N. n. nigricincta and B. a. arietans in Namibia.
Description
A thesis submitted in fulfilment of the requirements for the Degree of Master of Science (Pathology)
Keywords
N. n. nigricincta, B. a. arietans, Cytotoxic, Neurotoxic, Antivenom, Rhabdomyolysis