Snake Bite in South Asia A Review 英文参考文献.docVIP

Review SnakeBiteinSouthAsia:AReview EmilieAlirol1*,SanjibKumarSharma2,HimmatraoSalubaBawaskar3,UlrichKuch4,Franc?oisChappuis1 1Division of International and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland, 2B. P. Koirala Institute of Health Sciences, Dharan, Nepal, 3BawaskarHospitalandResearchCentre,Raigad,India,4BiodiversityandClimateResearchCentre,FrankfurtamMain,Germany countries.Additionalarticleswereobtainedbycitationtrackingof reviewandoriginalarticles.Thereviewalsodrewonconference proceedingsandoriginalresearchconductedbytheauthors. Abstract:Snakebiteisoneofthemostneglectedpublic health issues in poor rural communities living in the tropics. Because of serious misreporting, the true world- wideburdenofsnakebiteisnotknown.SouthAsiaisthe world’s most heavily affected region, due to its high population density, widespread agricultural activities, numerousvenomoussnakespeciesandlackoffunctional snake bite control programs. Despite increasing knowl- edgeofsnakevenoms’compositionandmodeofaction, Epidemiology An accurate measure of the global burden of snakebite envenoming remains elusive despite several attempts to estimate it and, apart from a few countries, reliable figures on incidence, morbidity,andmortalityarescarce[2–4].SouthAsiaisbyfarthe good understanding of clinical features of envenoming mostaffectedregion[2,4].Indiahasthehighestnumberofdeaths and sufficient production of antivenom by Indian duetosnakebitesintheworldwith35,000–50,000peopledying manufacturers, snake bite management remains unsatis- per yearaccording toWorld Health Organization (WHO) direst factory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not estimates [2,4]. In Pakistan, 40,000 bites are reported annually, which result in up to 8,200 fatalities [4,5]. In Nepal, more than coveralloftheimportantvenomoussnakesoftheregion. Care-givers need better t