Global Snake Bite Initiative

The GSI Committee are currently in the process of developing a workplan of projects to be undertaken in 2010 and beyond. We welcome suggestions, collaboration and support, and are also very willing to consider requests for specific assistance. Please contact us via one of the email addresses on our CONTACT US page.

DEVELOPING RATIONAL GUIDELINES FOR SNAKE BITE FIRST AID

Emergency physician and GSI Committee Member, Dr Simon Jensen is currently collating information on the present global situation regarding first aid recommendations for snake bite. Many of the first aid interventions that are used in both developing and developed world settings lack a strong evidence base, and while some are simply ineffective, others cause patients considerable pain and discomfort, and may even be life-threatening themselves.

As one of our first projects, Dr Jensen and colleagues are reviewing the available evidence for and against various techniques, and preparing a discussion paper for review and comment, that will include evidence-based recommendations on appropriate, safe first aid strategies to be considered after snake bite in different regions, and for different types of venomous snakes. This discussion paper will be presented to the membership of the IST, and the final ratified version will be published and made freely available, along with posters, instruction cards and other instructional materials via this website.


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TREATMENT FOR THE LOCAL EFFECTS OF SNAKE BITE

Many snakes contain toxins in their venoms which can cause very severe local effects at the bite site, and in the bitten limb of a snake bite patient. These effects range from pain, swelling and oedema, through to severe bruising, destruction of skin, muscle and other tissues, contractures and gangrene. Many thousands of people lose their hands, feet, arms and legs every year as a result of the bites of venomous snakes (a WHO Child Injury Report puts the figure at 400,000 amputations per year).

The GSI Committee member, Dr Simon Jensen is currently undertaking a review of the local effects of snake bite, and their treatment, and with colleagues from around the world is looking at developing guidelines for the medical treatment and nursing care of snake bite patients with local injury. They are preparing a discussion paper for review and comment, that will include evidence-based recommendations on appropriate, situationally-relevant treatment of local injury following bites by different species of venomous snakes. This discussion paper will be presented to the membership of the IST, and the final ratified version will be published and made freely available, along with posters, standard treatment protocols, other instructional materials via this website.


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MEASURING THE SOCIO-ECONOMIC IMPACT OF SNAKE BITES

Virtually nothing is known of the true socio-economic impact that snake bite has on individuals, families and their broader communities. This presents an important challenge because without having an understanding of the costs of snake bite (both immediate and extended), it is very difficult to both develop an effective strategy for dealing with the issue, and to convince others that there are clear benefits to be obtained by any particular approach to the problem.

Professor Paul Scuffham, a health economist at Griffith University in Queensland, Australia is collaborating with Dr Nick Brown from the Institute of Biotechnology at the University of Cambridge in the United Kingdom to examine the socio-economic costs of snake bite, and of different treatment strategies and other interventions. Their research is likely to prove invaluable in the development of long-term strategies for addressing snake bite problems in some of the world's poorest nations.


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IMPROVING GLOBAL SNAKE BITE DATA

Recent research by Kasturiaratne et al (2008), published
in PLoS Medicine, has redefined global estimates of snakebite epidemiology.

However, this is, to some extent, a “work in progress”. One of the authors, Prof. Janaka de Silva from the University of Kelaniya in Sri Lanka has kindly made available some of the data tables on which the study
conclusions were based, with a “challenge” to IST
members (and others) to provide more definitive
data for each listed country.

These tables have been listed on a separate page structure on the IST Website. All interested members are urged to peruse this information and contact Prof. de Silva if they have additional data that might be used to update the tables.

Building from this the GSI are developing standard protocols for both hospital-based and community-based epidemiological investigations of snake bite burden, along with a range of tools for data collation, analysis and interpretation. Once available these resources will be added to this website so that anyone wanting to investigate snake bite in their country, can freely download the protocols and data tools. A panel of GSI experts with experience in the field will be available to act as mentors to local investigators. The aim of the project is to promote the use of standard data collection, analysis and interpretation methods so that over time, a body of homogenous data can be assembled and used to guide decision-making and policy development agendas, as well as providing accurate resource need estimates.

Come back regularly for more updates...