01969nas a2200193   4500000000100000008004100001653003900042653002400081653002200105653001200127100001400139700001500153700001500168245008300183300001100266490000800277520147600285022001401761       2011                            d10aNeglected tropical diseases (NTDs)10aVenomous snake bite10aPre-hospital care10aNigeria1 aMichael G1 aThacher TD1 aShehu MI L00aThe effect of pre-hospital care for venomous snake bite on outcome in Nigeria.  a95-1010 v1053 a<p>We studied pre-hospital practices of 72 consecutive snake bite victims at a hospital in north-central Nigeria. The primary outcome assessed was death or disability at hospital discharge. Victims were predominantly male farmers, and in 54 cases (75%) the snake was identified as a carpet viper (Echis ocellatus), with the remainder unidentified. Most subjects (58, 81%) attempted at least one first aid measure after the bite, including tourniquet application (53, 74%), application (15, 21%) or ingestion (10, 14%) of traditional concoctions, bite site incision (8, 11%), black stone application (4, 5.6%), and suction (3, 4.2%). The majority (44, 61%) presented late (after 4 hours). Most (53, 74%) had full recovery at hospital discharge. Three deaths (4.2%) and thirteen (18%) disabilities (mainly tissue necrosis) occurred. The use of any first aid was associated with a longer hospital stay than no use (4.6 ± 2.0 days versus 3.6 ± 2.7 days, respectively, P = 0.02). The antivenom requirement was greater in subjects who had used a tourniquet (P = 0.03) and in those who presented late (P = 0.02). Topical application (Odds Ratio 15, 95% CI 1.4-708) or ingestion of traditional concoctions (OR 20, 95% CI 1.4-963) were associated with increased risk of death or disability. Ingestion and application of concoctions were associated with a longer time interval before presentation, a higher cost of hospitalization, and an increased risk of wound infection.</p>
  a1878-3503