Snakebite knowledge among healthcare workers in Gabon: A health facility-based cross-sectional survey

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  Snakebite knowledge among healthcare workers in Gabon: A health facility-based cross-sectional survey Abstract Background Snakebite envenoming remains a neglected health issue in many countries, including Gabon, where the limited availability of snakebite-specific training, clinical guidelines, and essential resources at health facilities may lead to gaps in healthcare workers’ knowledge and confidence and the use of non-recommended treatment practices. This study aimed to assess healthcare workers’ knowledge of snakebite management in the Ogooué et des Lacs department of Moyen-Ogooué province in Gabon. Methods From June to August 2023, we conducted a cross-sectional survey targeting all healthcare workers in Ogooué et des Lacs who may be involved in snakebite management. We collected information on prior training, self-perceived knowledge of snakebite management, symptom recognition, clinical management practices, and snake identification. Knowledge was assessed using 10 true/fa...

Development and Efficacy of the Antivenom Specific to Severe Envenomations in Morocco and North Africa: Advancements in Scorpion Envenomation Management

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Development and Efficacy of the Antivenom Specific to Severe Envenomations in Morocco and North Africa: Advancements in Scorpion Envenomation Management

Abstract

Scorpion envenomation poses a global public health issue, with an estimated 1,500,000 cases worldwide annually resulting in 2600 deaths. North Africa, particularly Morocco, experiences severe envenomations, mainly attributed to Androctonus mauretanicus and Buthus occitanus in Morocco, and Buthus occitanus and Androctonus australis hector in Algeria and Tunisia, with case numbers often underestimated. Current treatment relies mainly on symptomatic approaches, except in Morocco, where management is limited to symptomatic treatment due to controversies regarding specific treatment. In Morocco, between 30,000 and 50,000 scorpion envenomation cases are reported annually, leading to hundreds of deaths, mainly among children. Controversies among clinicians persist regarding the appropriate course of action, often limiting treatments to symptomatic measures. The absence of a specific antivenom for the venoms of the most lethal scorpions further exacerbates the situation. This study aims to address this gap by developing a monovalent antivenom against the endemic and most dangerous scorpion, Androctonus mauretanicus. The antivenom was produced by immunizing albino rabbits with a mixture of Androctonus mauretanicus venom collected from high-risk areas in Morocco. Immunizations were performed by subcutaneous injections at multiple sites near the lymphatic system, following an immunization schedule. Production control of neutralizing antibody titers was conducted through immunodiffusion. Once a sufficient antibody titer was achieved, blood collection was performed, and the recovered plasma underwent affinity chromatography. The efficacy of purified IgG was evaluated by determining the ED50 in mice, complemented by histological and immunohistochemical studies on its ability to neutralize venom-induced tissue alterations and the neutralization of toxins bound to receptors in the studied organs. The monovalent antivenom demonstrated specificity against Androctonus mauretanicus venom and effective cross-protection against the venom of the scorpions Buthus occitanus and Androctonus australis hector, highly implicated in lethal envenomations in the Maghreb. This study shows that the developed monovalent antivenom exhibits notable efficacy against local scorpions and a surprising ability to neutralize the most lethal envenomations in North Africa. These results pave the way for a new, more specific, and promising therapeutic approach to countering severe scorpion envenomations, especially in Morocco, where specific treatment is lacking.

Darkaoui, Bouchra, Ines Hilal, Soukaina Khourcha, Ayoub Lafnoune, Salma Chakir, Ayoub Aarab, Abdellah Moustaghfir, Ouafaa Aniq Filali, and Naoual Oukkache. 2024. "Development and Efficacy of the Antivenom Specific to Severe Envenomations in Morocco and North Africa: Advancements in Scorpion Envenomation Management" Toxins 16, no. 5: 214. https://doi.org/10.3390/toxins16050214