Snakebites and the Effect of Serum Anti Bisa Ular (SABU) Antivenom at Dr. Hasan Sadikin General Hospital Bandung, Indonesia: an Overview Period 2015–2019

Sharon Noor Alya, Enny Rohmawaty, Achadiyani Achadiyani, Muhammad Hasan Bashari, Hardisiswo Soedjana

Abstract


Background: Snakebite is considered a global health issue, especially in the Southeast Asian region. However, data regarding snakebite cases in Indonesia are still very limited. This study aimed to explore the venomous snakebite cases and the serum anti bisa ular (SABU) antivenom effect in treating venomous snakebite caused by other than the snake species indicated in currently available SABU antivenom formulas.

Methods: The analytical descriptive method with a cross-sectional study design was conducted in 2021 using a total sampling from the medical records of 63 patients diagnosed with snakebite at Dr. Hasan Sadikin General Hospital Bandung from 2015 to 2019. Characteristics of patients, clinical manifestation, and correlation between snakes species and outcomes after treatment with or without administration of SABU antivenom were collected.

Results: Out of 63 patients, males (79%) were predominant with an average age of 39 years. Fifty-six patients arrived at the Emergency Room less than 24 hours after the occurrence (89%). Most cases were categorized as grade 2 (41.%) where the upper extremities were commonly bitten the body area (64%). Edema (83%) was the most common manifestation. There was no correlation between snake antivenom administered to a specific snake species and the stated outcome (p=0.053), meaning that SABU antivenom might be an effective alternative to treat more types of snakebites.

Conclusions: Snakebites are most common in males, attack the upper extremities, categorized as grade 2 with edema. Administration of SABU antivenom provides the similar outcome compared to the group caused by the Javan spitting cobra, Banded krait, and Malayan pit viper.


Keywords


SABU; snake antivenom; snakebite

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References


Nikapitiya B, Maduwage K. Pharmacodynamics and pharmacokinetics of snake antivenom. Sri Lanka J Med. 2018;27(1):54–65.

Meyers SE, Tadi P. Snake toxicity [Updated 2021 Jan 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. [cited 2021 May 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557565/

Warrell DA. Venomous bites, stings, and poisoning: an update. Infect Dis Clin North Am. 2019;33(1):17–38.

Bawaskar HS, Bawaskar PH. Snakebite envenoming. Lancet. 2019;393(10167):131.

World Health Organization Regional Office for South-East Asia. Guidelines for the management of snake-bites. 2nd Ed. New Delhi: World Health Organization, Regional Office for South-East Asia; 2016.

Silva A, Marikar F, Murugananthan A, Agampodi S. Awareness and perceptions on prevention, first aid and treatment of snakebites among Sri Lankan farmers: a knowledge practice mismatch? J Occup Med Toxicol. 2014;9:20.

Sharma SK, Chappuis F, Jha N, Bovier PA, Loutan L, Koirala S. Impact of snake bites and determinants of fatal outcomes in southeastern Nepal. Am J Trop Med Hyg. 2004;71(2):234–8.

Adiwinata R, Nelwan EJ. Snakebite in Indonesia. Acta Med Indones. 2015;47(4):358–65.

Uetz P, Freed P, Aguilar R, Hošek J, editor. The reptile database [Internet]. 2021. [cited 2022 March 6]. Available from: http://www.reptile-database.org.

Kurniawan N, Fathoni M, Fatchiyah F, Aulani A, Septiadi L, Smith EN. Composition, distribution, and habitat type of snakes in Java, with discussion on the impact of human-snake interactions during 2013–2019. Herpetology Notes. 2021;14:691–711.

Roberts N, Johnson E, Zeng S, Hamilton E, Abdoli A, Alahdab F, et al. Mortality from snakebite envenomation: an analysis from the Global Burden of Disease Study 2019. Research Square. 2021. [cited 2022 March 6]. Available from: https://www.researchsquare.com/article/rs-1021472/v1.

Ahmed SM, Ahmed M, Nadeem A, Mahajan J, Choudhary A, Pal J. Emergency treatment of a snake bite: Pearls from literature. J Emerg Trauma Shock. 2008;1(2):97–105.

Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5(11):e218.

Rojnuckarin P, Suteparak S, Sibunruang S. Diagnosis and management of venomous snakebites in Southeast Asia. Asian Biomed. 2012;6(6):795–805.

Kumar MR, Veeraprasad M, Babu PR, Kumar SS, Subrahmanyam B, Rammohan P, et al. A retrospective review of snake bite victims admitted in a tertiary level teaching institute. Ann Afr Med. 2014;13(2):76–80.

Tan CH, Palasuberniam P, Blanco FB, Tan KY. Immunoreactivity and neutralization capacity of Philippine cobra antivenom against Naja philippinensis and Naja samarensis venoms. Trans R Soc Trop Med Hyg. 2021;115(1):78–84.

Tan CH, Liew JL, Tan KY, Tan NH. Assessing SABU (serum anti bisa ular), the sole Indonesian antivenom: a proteomic analysis and neutralization efficacy study. Sci Rep. 2016;6:37299.

Chippaux J-P. Snakebite envenomation turns again into a neglected tropical disease! J Venom Anim Toxins Incl Trop Dis. 2017;23:38.

Bagcchi S. Experts call for snakebite to be re-established as a neglected tropical disease. BMJ. 2015;351:h5313.

Peterson N. Venomous snake bites. In: Bruyette DS, Bexfield N, Chretin JD, Kube S, Owen TJ, Peterson N, et al, editors. Clinical small animal internal medicine. Hoboken: John Wiley & Sons; 2020. p. 459–65.

Afni ACN, Sani FN. Pertolongan pertama dan penilaian keparahan envenomasi pada pasien gigitan ular. J Kesehat Kusuma Husada. 2020;11(1):91–8.




DOI: https://doi.org/10.15850/amj.v9n1.2392

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