In November 2000, the Federal Ministry of Health of Nigeria requested the WHO Regional Office for Africa to develop guidelines for the management of snakebite due to increasing cases of snakebite in many parts of that country as well as the difficulties in obtaining sufficient quantities of effective antivenom. In response to this request, the WHO Regional Office for Africa developed the first guidelines in 2004 with the assistance of Professor Charles Nhachi (Zimbabwe): Guidelines for the management of snakebite in the WHO African Region (AFRO/EDP/04.1). Following their release, comments on the guidelines were received from various experts and this set the scene for their revision. The revision process started with a technical review meeting with various experts in Nairobi, Kenya, in November 2005.
Snakebite is a neglected public health problem mainly affecting rural populations where medical resources are sparse. Health workers in both rural and urban settings are ill prepared to deal with snakebite cases and effective antivenom is often not available. Communities need to be educated about what to do and what not to do in case of snakebite, and prior to transferring a patient to professional medical care.
The exact extent and impact of the problem is still to be determined due to lack of reliable epidemiological data in most countries. Much research is still required into various aspects of snakes and snakebite management in Africa if case fatality rates are to be reduced. It is hoped that these guidelines will provide the target audiences, health-care providers and the general public with the necessary practical information for dealing with snakes and snakebite within and outside health-care facilities.
The World Health Organization wishes to build up a coalition of partners interested in putting
the problem of snakebite on the public health agenda, and in particular stimulating further
collaboration and research in the following areas:
Snakebite is a neglected public health problem. Rural populations are frequent victims as they go about their daily food production and animal rearing activities and as they reside in the comfort of their homes. Unfortunately, many of these snakebite cases go unreported and thus do not appear in official epidemiological statistics. Health workers often have little or no formal training in the management of snakebite, and appropriate antivenom is rarely available. The Guidelines for the prevention and clinical management of snakebite in Africa have been developed by the World Health Organization Regional Office for Africa with contributions from technical experts. They are meant to assist health workers to improve medical care for snakebite victims; they also serve as a source of information for the general public on issues related to snakes and snakebite.
The guidelines discuss snakes, snake venoms and snakebites and their consequences with emphasis on the medically important snakes i.e. those causing serious envenoming. The volume contains over a hundred snake photographs, clinical signs of envenoming and the consequences. The guidelines also feature various annexes and in particular the geographical distribution of African venomous snakes, as well as their classification, habitats and clinical toxinology. The document is divided into fifteen chapters. Chapters 1, 2 and 3 introduce the subject, outline the morphological characteristics of African venomous snakes, present the distribution of African venomous snakes and provide epidemiological data on snakebite. This Article is specifically devoted to prevention of snakebite. Discuss snake venoms as well as clinical features and profiles of envenoming by some snakes of
The guidelines are designed to provide useful information and guide the work of various levels of health workers in dealing with snakes and snakebite. Some sections provide useful and easily understood information for the general public on topics such as snake characteristics and distribution, prevention of snakebite, first aid in case of snakebite, easily observable venom effects in a snakebite victim, and what not to do in case of snakebite.