title: Overlooked issues of snakebite management: time for strategic approach.
abstract: Snakebite is a medical emergency in many parts of the world, particularly in the temperate regions. According to 2007 World Health Organization (WHO) report, there are about 5 million snakebite incidences resulting in 2.5 million envenoming, and 125,000 deaths occur annually. Most affected are the healthy individuals like children and farming populations with resource poor settings and away from health care centers in low-income countries of Africa, Asia and Latin America. In view of this, the WHO has declared snakebite as an ignored health crisis and a tropical disease. Although the death rate has reduced markedly due to anti-venom regiment, several limitations of it offer scope for better understanding of various ignored issues. Currently, snakebite therapeutics facing plethora of scientific, technological and public health challenges, including secondary/long term complications that have not been given importance so far. Because of dearth of knowledge, venom researchers and medical practitioners from affected countries worldwide should join together to accomplish this scenario. In view of this, the present review provides a broader perspective on the possible production and application of highly effective therapeutic master anti-venom, designing master diagnostic kit and also to deal with the inefficacy of anti-venom therapy against local manifestations and secondary complications of snakebite. The review demands thorough understanding of venom pharmacology, inculcating new strategies to handle and to enhance the efficacy of snakebite management and urge the governing systems of affected countries to take steps to curtail accidental debilitation and death rate of healthy individuals due to snakebite.
authors.affiliation: DOS in Biochemistry, University of Mysore, Manasagangothri, Mysore- 570 006, India. kemparaj@rediffmail.com
authors.forename: K S
authors.initials: KS
authors.lastname: Girish
authors.forename: K
authors.initials: K
authors.lastname: Kemparaju
mesh_terms: D000328:Adult; D000349:Africa; D000997:Antivenins / Q000008:administration & dosage / Q000627:therapeutic use; D001208:Asia; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods*; D019468:Disease Management; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000037:antagonists & inhibitors / Q000378:metabolism; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage* / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007843:Latin America; D045726:Metalloproteases / Q000037:antagonists & inhibitors / Q000378:metabolism; D009336:Necrosis / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D058069:Neglected Diseases / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010946:Plants, Medicinal; D011634:Public Health; D012909:Snake Bites / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D012910:Snake Venoms / Q000009:adverse effects* / Q000201:enzymology
chemical_list: D000997:Antivenins; D007140:Immunoglobulin Fab Fragments; D012910:Snake Venoms; D006821:Hyaluronoglucosaminidase; D045726:Metalloproteases