Time for an alternative perspective: The eternal problem of supply and quality of anti snake venom in the developing world - "It's the economy, stupid"

Wilderness and Environmental Medicine

Volumn 19, Issue 3, 2008, Pages 186-194

  Simpson, Ian D ^a,b,c  

^a Pakistan Medical Research Council   (Pakistan)

^b West Bengal Government Snakebite Taskforce   (India)

^c Kooran House   (India)

Author keywords

Antivenom; Antivenom costs; Developing world; Policy maker; Snake envenomation; Snakebite

Indexed keywords

IMMUNOGLOBULIN G; SNAKE VENOM ANTISERUM;

COST EFFECTIVENESS ANALYSIS; DECISION MAKING; DEVELOPING COUNTRY; DRUG COST; DRUG INDUSTRY; DRUG MANUFACTURE; DRUG QUALITY; DRUG SAFETY; HEALTH ECONOMICS; HUMAN; REVIEW; SUSTAINED RELEASE PREPARATION; UNSPECIFIED SIDE EFFECT;

EID: 55849140569     PISSN: 10806032     EISSN: None     Source Type: Journal    
DOI: 10.1580/08-WEME-CON-194.1     Document Type: Article

References (45)

1. Warrell DA. Tropical health: venomous bites and stings in the tropical world. Med J Aust. 1993;159:773-779.
2. Warrell DA. Clinical toxicology of snakebite in Asia. In: White J, Meier J, eds. Handbook of Clinical Toxicology of Animal Venoms and Poisons. Boca Raton, FL: CRC Press; 1995:493-593.
3. Muguti G, Maramba A, Washaya CT. Snake bites in Zimbabwe: a clinical study with emphasis on the need for antivenom. Cent Afr J Med. 1994;40:83-88.
4. Wilde H, Thipkong P, Sitprija V, Chaiyabutr N. Heterologous antisera and antivenins are essential biologicals: perspectives on a worldwide crisis. Ann Intern Med. 1996;125:233-236.
5. Warrell DA. WHO/SEARO guidelines for the clinical management of snakebite in the Southeast Asian region. SE Asian J Trop Med Public Health. 1999;1:1-85.
6. Cheng AC, Winkel KD. Snakebite and antivenoms in Asia-Pacific: wokabaut wantaim raka hebou ("Walking Together"). Med J Aust. 2001;175:648-651.
7. White J, Warrell DA, Eddleston M, Currie BJ, Whyte IM, Isbister GK. Clinical toxinology - where are we now? J Toxicol Clin Toxicol. 2003;41:263-276.
8. Chippaux JP. Snake Venoms and Envenomations. Florida, FL: Krieger Publishing Company; 2006.
9. Gutierrez JM, Theakston RDG, Warrell DA. Confronting the neglected problem of snakebite envenoming: the need for a global partnership. PLoS Med. 2006;6:e150.DOI:10:1371/journal.pmed.0030150.
10. Warrell DA. Bites by venomous snakes outside the Americas. In: Auerbach PS, ed. Wilderness Medicine. St. Louis, MO: Mosby; 2007:1086-1123.
11. Stock RP, Massougbodji A, Alagon A, Chippaux JP. Bringing antivenoms to Sub-Saharan Africa. Nature. 2007;25:173-177.
12. Krifl MN, El Ayeb M, Dellagi K. The improvement and standardization of antivenom production in developing countries: comparing antivenom quality, therapeutical efficiency and cost. J Venom Anim Toxins. 1999;5:128-141.
13. Gutierrez JM, Lomonte B, Leon G, Rucavado A, Chaves F, Angulo Y. Trends in snakebite envenomation therapy: scientific, technological and public health considerations. Curr Pharma Des. 2007;13:2935-2950.
14. Laing GD, Lee L, Smith DC, Landon J, Theakston RDG. Experimental assessment of new, low cost antivenom for treatment of carpet viper (Echis ocellatus) envenoming. Toxicon. 1995;33:307-313.
15. Chippaux JP, Lang J, Amadi-Eddine S, Fagot P, Le Mener V. Short report: treatment of snake envenomations by a new polyvalent antivenom composed of highly purified F(ab)2: results of a clinical trial in Northern Cameroon. Am J Med Hyg. 1999;61:1017-1018.
16. Laing GD, Renjifo JM, Ruiz F, et al. A new pan African polyspecific antivenom developed in response to the antivenom crisis in Africa. Toxicon. 2003;42:35-41.
17. Gutiérrez JM, Rojas E, Quesada L, et al. Pan-African polyspecific antivenom produced by caprylic acid purification of horse IgG: an alternative to the antivenom crisis in Africa. Trans R Soc Trop Med Hyg. 2005;99:468-475.
18. Menou V, White A, Savitz A, Mehrpouya A. Global pharmaceutical sector report. Available at: http://www.ecologyexpress.com/guide/document/ innovest_industry_sample.pdf. Accessed January 14, 2008.
19. Government of Sindh. Anti Snake Venom Laboratory: (Pre Feasibility Report). Karachi: Health Department, Government of Sindh; 2005.
20. Fry BG, Winkel KD, Wickramaratna JC, Hodgson WC, Wuster W. Effectiveness of snake antivenom: species and regional venom variation and its clinical impact. J Toxicol. 2003;22:23-34.
21. Chippaux JP, Goyffon M. Round table and synthesis of the meeting. Bull Soc Pathol Exot. 2002;95:217-219.
22. Morais V, Massaldi H. Economic evaluation of snake antivenom production in the public system. J Venom Anim Toxins incl Trop Dis. 2006;12:497-511.
23. Simpson ID, Norris RL. Snake antivenom product guidelines in India: the devil is in the details. Wilderness Environ Med. 2007;18:163-168.
24. Phillips RE, Theakston RD, Warrell DA. Paralysis, rhabdomyolysis and haemolysis caused by bites of Russell's viper (Vipera russelli pulchella) in Sri Lanka: failure of Indian (Haffkine) antivenom. Q J Med. 1988;8:691-715.
25. Ariaratnam CA, Sjostrom L, Raziek Z, et al. An open randomised comparative trial of two antivenoms for the treatment of envenoming by Sri Lankan Russell's viper (Daboia russelii russelii). Trans R Soc Trop Med Hyg. 2001;95:74-80.
26. Warrell DA. Animal toxins. In: Cook GC, Zumla A, eds. Manson's Tropical Diseases. London, UK: WB Saunders; 2003:581-618.
27. Warrell DA. Injuries, envenoming, poisoning, and allergic reactions caused by animals. In: Warrell DA, Cox TM, Firth JD, eds. Oxford Textbook of Medicine. Oxford: Oxford University Press, Oxford, U.K.; 2003:923-947.
28. Kochar DK, Tanwar PD, Norris RL, et al. Rediscovery of severe saw scaled viper (Echis sochureki) envenoming in the Thar Desert region of Rajasthan, India. Wilderness Environ Med. 2007;18:75-85.
29. World Health Organization. Progress in the characterization of venoms and standardization of antivenoms. WHO Offset Publ. 1981;58:1-44.
30. Malasit P, Warrell DA, Chanthavanich R et al. Prediction, prevention and mechanism of early (anaphylactic) antivenom reactions in victims of snake bites. BMJ. 1986;292:17-20.
31. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327:380-384.
32. Simons FE, Gu X, Simons KJ. Epinephrine absorption in adults: intramuscular versus subcutaneous injection. J Allergy Clin Immunol. 2001;108:871-873.
33. McLean-Tooke APC, Bethune CA, Fay AC, Spickett GP. Adrenaline in the treatment of anaphylaxis: what is the evidence? BMJ. 2003;327:1332-1335.
34. Simpson ID. Snakebite management in India, the first few hours: a guide for primary care physicians. J Indian Med Assoc. 2007;105:324-335.
35. De Silva HJ, Fonseka MMD, Gunatilake SB, Kularatne SAM, Sellahewa KH. Anti-venom for snakebite in Sri Lanka. CMJ. 2002;2:43-45.
36. Cheng AC, Currie BJ. Venomous snakebites worldwide with a focus on the Australia-Pacific region: current management and controversies. J Intensive Care Med. 2004;19:259-269.
37. Visser LE, Kyei-Faried S, Belcher DW, Geelhoed DW, van Leeuwen JS, van Roosmalen J. Failure of a new antivenom to treat Echis ocellatus snake bite in rural Ghana: the importance of quality surveillance. Trans R Soc Trop Med Hyg. 2008; [Epub ahead of print].
38. Simpson ID. The 'worldwide shortage' of anti snake venom: is the only right answer 'produce more' or is it also 'use it smarter'? Wilderness Environ Med. 2008;19:99-107.
39. Rojas G, Jiménez JM, Gutiérrez JM. Caprylic acid fractionation of hyperimmune horse plasma: description of a simple procedure for antivenom production. Toxicon. 1994;2:351-363.
40. Otero-Patiño R, Cardoso JL, Higashi HG, et al. A randomized, blinded, comparative trial of one pepsin-digested and two whole IgG antivenoms for Bothrops snake bites in Uraba, Colombia. Am J Trop Med Hyg. 1998;58:183-189.
41. Otero R, Gutiérrez JM, Rojas G, et al. A randomized blinded clinical trial of two antivenoms, prepared by caprylic acid or ammonium sulphate fractionation of IgG, in Bothrops and Porthidium snake bites in Colombia: correlation between safety and biochemical characteristics of antivenoms. Toxicon. 1999;37:895-908.
42. Otero R, León G, Gutiérrez JM, et al. Efficacy and safety of two whole IgG polyvalent antivenoms, refined by caprylic acid fractionation with or without beta-propiolactone, in the treatment of Bothrops asper bites in Colombia. Trans R Soc Trop Med Hyg. 2006;100:1173-1182.
43. Dart RC, McNally J. Efficacy, safety, and use of snake antivenoms in the United States. Ann Emerg Med. 2001;37:181-188.
44. Ruha AM, Curry SC, Beuhler M, et al. Initial postmarketing experience with Crotalidae polyvalent immune Fab for treatment of rattlesnake envenomation. Ann Emerg Med. 2002;39:609-615.
45. World Health Organization. Rabies and Envenomings: A Neglected Public Health Issue. Geneva, Switzerland: World Health Organization; 2007.