Screen Shot 2019-05-26 at 07.35.50.pngCITATION: WHO’s Snakebite Envenoming Strategy for prevention and control
Ren Minghui, Mwelecele Ntuli Malecela, Emer Cooke, Bernadette Abela-Ridder
Lancet Global Health
Open Access Published:May 22, 2019 DOI:https://doi.org/10.1016/S2214-109X(19)30225-6

To some, the prospect of getting bitten by a venomous snake might seem extremely remote, but most of the world’s population — 5·8 billion people — is at risk of encountering a venomous snake. Every day, 7400 people are bitten by snakes, and 81 000–138 000 die as a result every year. Currently, around 400 000 people who have been bitten have permanent physical or psychological disabilities including blindness, amputation, and post-traumatic stress disorder.

In acknowledgment of this important risk to health, WHO listed snakebite envenoming as a neglected tropical disease, which was followed by a 2018 World Health Assembly resolution, and began developing a global strategy to halve the number of snakebite-induced deaths and disabilities by 2030. WHO will launch the ambitious new strategy at this year’s World Health Assembly. A key aspect of this strategy will be to engage and empower communities in preventing venomous snakebites and increasing training to provide better treatment.

There are more than 250 species of venomous snake around the world that are considered to be medically important by WHO, and the people most at risk are those living in rural areas, including agricultural workers and herders. As many as 45% of snakebite victims are women and children. People are bitten working in fields, as they fetch drinking water, while sleeping in houses at night, when going to school, or even just walking to an outdoor toilet. Community education is therefore crucial, because many snakebites are not reported or ***people seek care too late*** [my emphasis – NPW].

Success will also depend on accelerating the development of antivenoms…

Snakebite envenoming is an acute emergency that requires health systems that can function at a level of responsiveness that ensures time-critical service delivery. Thus, integrating an approach to prevention, treatment, and management of snakebite envenoming, in which the community is fully engaged, into national health policy and health systems will be crucial. Tackling the underlying social, cultural, and economic barriers to health care that many victims of snakebite experience will lead to earlier treatment and more effective outcomes…

Comment (NPW): I have added emphasis to the words ***people seek care too late***. We know anecdotally that some deaths are due to inappropriate seeking of care from traditionalhealers, which results in delays in seeking care from a health facility. As the Comment points out, community education is essential. Information on what to do in the event of snakebite could readily be provided as part of a simple first aid app, perhaps as part of the Red Cross First Aid app? The same is true for other common medical emergencies where inappropriate decisions (such as seeking traditional medicine) can be fatal.

Best wishes, Neil

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