title: [Evaluation of a new polyvalent antivenom against snakebite envenomation (Inoserp® Panafricain) in two different epidemiological settings: Northern Benin and Maritime Guinea].
abstract: OBJECTIVE
  The authors evaluated the safety and efficacy of Inoserp(®) Pan Africa, a new polyvalent antivenom composed of highly purified and lyophilized fragments of F(ab')2 immunoglobulins, recently registered in Benin and Guinea.
  
  
  METHODS
  We treated 100 patients in northern Benin (Atacora) and 109 in Maritime Guinea (Kindia) with confirmed envenomation. Treatment consisted of intravenous administration of 1 vial for uncomplicated envenomation, and 2 vials for hemorrhagic or neurotoxic envenomation. The dose was repeated when bleeding or signs of neurotoxicity persisted or appeared.
  
  
  RESULTS
  In Atacora, on arrival at the hospital, 90% of patients had incoagulable blood, and 50% were bleeding. The resolution of these bleeding disorders was obtained in less than 3 hours for 50% of the patients and in less than 24 hours for 98%. Four patients died. In Kindia, 96 patients (88%) presented viper bites with pain + edema and 13 (12 %) others showed elapid (ptosis, dyspnea) envenomation. One patient bitten by a member of the Elapidae family, died despite early treatment. In Benin, protocol deviations for 60% of patients led to significant underdosing of the antivenom; the proportion was much lower (2%) in Guinea. Signs of intolerance after Inoserp(®) Pan Africa administration were reported in 8% of patients. All these symptoms were mild and disappeared rapidly after an antihistamine or corticosteroid treatment.
  
  
  CONCLUSIONS
  Treatment using intravenous Inoserp(®) Pan Africa appeared to be well tolerated and effective against snakebite envenomation in both epidemiological settings.
authors.affiliation: UMR 216, Institut de recherche pour le développement, Santé de la mère et de l'enfant, 08 BP 841, Cotonou, Bénin, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75006 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chippaux
authors.affiliation: Institut Pasteur de Guinée, Kindia, Guinea.
authors.forename: M C
authors.initials: MC
authors.lastname: Baldé
authors.affiliation: Centre d'étude et de recherche sur le paludisme associé à la grossesse et à l'enfance, faculté des sciences de la santé, Cotonou, Bénin.
authors.forename: É
authors.initials: É
authors.lastname: Sessinou
authors.affiliation: Institut Pasteur de Guinée, Kindia, Guinea.
authors.forename: M
authors.initials: M
authors.lastname: Yéro Boiro
authors.affiliation: Unité d'enseignement et de recherche de parasitologie, de mycologie et d'écologie, faculté des sciences de la santé, Cotonou, Bénin.
authors.forename: A
authors.initials: A
authors.lastname: Massougbodji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D001541:Benin; D002648:Child; D005260:Female; D016701:Guinea; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012909:Snake Bites / Q000188:drug therapy*; D012910:Snake Venoms / Q000276:immunology*; D055815:Young Adult
chemical_list: D000997:Antivenins; D007140:Immunoglobulin Fab Fragments; D007155:Immunologic Factors; D012910:Snake Venoms
keywords: Africa; Benin; Guinea; antivenom; envenomation; snakes