SNAKEBITE ANTIVENOM TREATMENT, CURRENT SITUATION, AND CHALLENGES IN BRAZIL AND OTHER HIGH-BURDEN COUNTRIES

Authors

  • Ana Paula da Conceição Fernandes de Amorim Author
  • Moana Ferreira dos Santos Author
  • Maria Cristina Schneider Author
  • Simone Aranha Nouér Author
  • Ricardo Pereira Igreja Author

DOI:

https://doi.org/10.56238/arev7n8-054

Keywords:

Antidote, Snakebite, Poisoning, Treatment

Abstract

Snakebites affect around three million people a year worldwide. The World Health Organization (WHO) considers them a neglected tropical disease that affects tropical and subtropical countries and poor and rural populations. The WHO's strategy to reduce morbidity and mortality includes ensuring safe and effective antivenom treatment for victims and accelerating antivenom production through public policies and international agreements. Countries in Asia and Africa have recorded the highest number of cases and deaths. Brazil has been producing its antivenom for years and distributes it free of charge in the public health system; however, production is a current concern. This study aims to highlight the challenges in accessing adequate treatment for snakebite accidents in Brazil and other high-incidence countries in Asia and Africa. We conducted a review of the literature and official websites related to the problem. The review suggests that most countries in these areas do not have easy access to antivenom, or it is not effective; several countries have antivenom as part of their public health system, such as India, Thailand and Brazil; however, challenges persist. There is an urgent need for global funding for research and production of snakebite antidotes.

Downloads

Download data is not yet available.

References

Chippaux JP, Massougbodji A, Habib AG. The WHO strategy for prevention and control of snakebite envenoming: A sub-Saharan Africa plan. Journal of Venomous Animals and Toxins Including Tropical Diseases [Internet]. 2019 [cited 2025 Feb 23];25. Available from: www.jvat.orghttp://dx. DOI: https://doi.org/10.1590/1678-9199-jvatitd-2019-0083

Gutiérrez JM. Snakebite envenoming from an Ecohealth perspective. Toxicon X [Internet]. 2020 [cited 2025 Feb 23];7. Available from: https://doi.org/10.1016/j.toxcx.2020.100043 DOI: https://doi.org/10.1016/j.toxcx.2020.100043

World Health Organization. World Health Assembly. Addressing the burden of snakebite envenoming. 2018 [cited 2025 Feb 24];17(January):24–6. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_R5-en.pdf

Patikorn C, Ismail AK, Abidin SAZ, Blanco FB, Blessmann J, Choumlivong K, et al. Situation of snakebite, antivenom market, and access to antivenoms in ASEAN countries. BMJ Glob Health [Internet]. 2022 [cited 2025 Feb 23];7(3):25. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8928241/pdf/bmjgh-2021-007639.pdf DOI: https://doi.org/10.1136/bmjgh-2021-007639

Erickson LT, Litschka-Koen T, Pons J, Bulfone TC, Bhendile G, Fuller S, et al. The ‘Snake song’: A pilot study of musical intervention in Eswatini. Rural Remote Health [Internet]. 2020 Jul 6 [cited 2025 Feb 23];20(3):1–14. Available from: https://www.rrh.org.au/journal/article/5494/

Schneider MC, Min KD, Hamrick PN, Montebello LR, Ranieri TM, Mardini L, et al. Overview of snakebite in Brazil: Possible drivers and a tool for risk mapping. PLoS Negl Trop Dis [Internet]. 2021 [cited 2025 Feb 23];15(1):1–18. Available from: https://doi.org/10.1371/journal.pntd.0009044 DOI: https://doi.org/10.1371/journal.pntd.0009044

Takayasu BS, Rodrigues SS, Madureira Trufen CE, Machado-Santelli GM, Onuki J. Effects on cell cycle progression and cytoskeleton organization of five Bothrops spp. Venoms in cell culture-based assays. Heliyon [Internet]. 2023 [cited 2025 Feb 23];9(7):2405–8440. Available from: https://doi.org/10.1016/j.heliyon.2023.e18317 DOI: https://doi.org/10.1016/j.heliyon.2023.e18317

Castro-Pinheiro C, Junior LCSP, Sanchez EF, da Silva ACR, Dwan CA, Karpiniec SS, et al. Effect of Seaweed-Derived Fucoidans from Undaria pinnatifida and Fucus vesiculosus on Coagulant, Proteolytic, and Phospholipase A2 Activities of Snake Bothrops jararaca, B. jararacussu, and B. neuwiedi Venom. Toxins (Basel) [Internet]. 2024 [cited 2025 Feb 23];16(4). Available from: https://doi.org/10.3390/toxins16040188 DOI: https://doi.org/10.3390/toxins16040188

Mise YF, Lira-da-Silva RM, Carvalho FM. Fatal snakebite envenoming and agricultural work in Brazil: A case–control study. American Journal of Tropical Medicine and Hygiene. 2019;100(1):150–4. DOI: https://doi.org/10.4269/ajtmh.18-0579

WHO. Snakebite: WHO targets 50% reduction in deaths and disabilities. [Internet]. Departamental news. 2019 [cited 2025 Mar 25]. p. 1. Available from: https://www.who.int/news/item/06-05-2019-snakebite-who-targets-50-reduction-in-deaths-and-disabilities

Minghui R, Malecela MN, Cooke E, Abela-Ridder B. WHO’s Snakebite Envenoming Strategy for prevention and control [Internet]. Vol. 7, The Lancet Global Health. Elsevier Ltd; 2019 [cited 2025 Feb 23]. p. e837–8. Available from: https://www.thelancet.com/action/showFullText?pii=S2214109X19302256 DOI: https://doi.org/10.1016/S2214-109X(19)30225-6

Longbottom J, Shearer FM, Devine M, Alcoba G, Chappuis F, Weiss DJ, et al. Vulnerability to snakebite envenoming: a global mapping of hotspots. The Lancet [Internet]. 2018 [cited 2025 Feb 23];392(10148):673–84. Available from: https://ecoengine.berkeley.edu/ DOI: https://doi.org/10.1016/S0140-6736(18)31224-8

WHO. Envenenamento por picada de cobra - Uma estratégia para prevenção e controle [Internet]. 2025 [cited 2025 Feb 23]. Available from: https://www.who.int/publications/i/item/9789241515641

de Oliveira RAD, Silva DRX, e Silva MG. Geographical accessibility to the supply of antiophidic sera in Brazil: Timely access possibilities. PLoS One [Internet]. 2022 [cited 2025 Feb 23];17(1 January). Available from: https://doi.org/10.1371/journal.pone.0260326 DOI: https://doi.org/10.1371/journal.pone.0260326

Kanankege K, Turner M, Moos B, Ruiz de Castaneda R, Nikiema Nidjergou YN, Seidu Korkor A, et al. Interim report on snakebite incidence and case fatality rates in sub-Saharan Africa. Weekly Epidemiological Record [Internet]. 2023;98(18):185–94. Available from: https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,uid&db=cin20&AN=163547434&site=ehost-live&authtype=ip,uid

Jenkins TP, Laustsen AH. Cost of Manufacturing for Recombinant Snakebite Antivenoms. Front Bioeng Biotechnol [Internet]. 2020 [cited 2025 Feb 23];8. Available from: www.frontiersin.org DOI: https://doi.org/10.3389/fbioe.2020.00703

Bhaumik S, Beri D, Tyagi J, Clarke M, Sharma SK, Williamson PR, et al. Outcomes in intervention research on snakebite envenomation: A systematic review. F1000Res [Internet]. 2022 [cited 2025 Feb 23];11. Available from: https://doi.org/10.12688/f1000research.122116.1 DOI: https://doi.org/10.12688/f1000research.122116.1

Habibid AG, Musa BM, Iliyasuid G, Hamza M, Kuznik A, Chippauxid JP. Challenges and prospects of snake antivenom supply in Sub-Saharan Africa. PLoS Negl Trop Dis [Internet]. 2020 Aug 1 [cited 2025 Feb 23];14(8):1–10. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008374 DOI: https://doi.org/10.1371/journal.pntd.0008374

Gajbhiye RK, Chaaithanya IK, Munshi H, Prusty RK, Mahapatra A, Palo SK, et al. National snakebite project on capacity building of health system on prevention and management of snakebite envenoming, including its complications in selected districts of Maharashtra and Odisha in India: A study protocol. PLoS One [Internet]. 2023 [cited 2025 Feb 23];18(2 February). Available from: https://doi.org/10.1371/journal.pone.0281809 DOI: https://doi.org/10.1371/journal.pone.0281809

Bhaumik S, Zwi AB, Norton R, Jagnoor J. How and why snakebite became a global health priority: A policy analysis. BMJ Glob Health. 2023;8(8):11923. DOI: https://doi.org/10.1136/bmjgh-2023-011923

WHO. Snakebite [Internet]. 2025 [cited 2025 Feb 23]. Available from: https://www.who.int/health-topics/snakebite#tab=tab_1

Farias AS de, Gomes Filho MR, da Costa Arévalo M, Cristino JS, Farias FR, Sachett A, et al. Snakebite envenomations and access to treatment in communities of two indigenous areas of the Western Brazilian Amazon: A cross-sectional study. PLoS Negl Trop Dis [Internet]. 2023 [cited 2025 Feb 23];17(7 July). Available from: https://doi.org/10.1371/journal.pntd.0011485 DOI: https://doi.org/10.1371/journal.pntd.0011485

Schneider MC, Vuckovic M, Montebello L, Sarpy C, Huang Q, Galan DI, et al. Snakebites in rural areas of Brazil by race: indigenous people are the most exposed group. Int J Environ Res Public Health [Internet]. 2021 [cited 2025 Feb 23];18(17). Available from: https://doi.org/10.3390/ijerph18179365 DOI: https://doi.org/10.3390/ijerph18179365

Albulescu LO, Xie C, Ainsworth S, Alsolaiss J, Crittenden E, Dawson CA, et al. A therapeutic combination of two small-molecule toxin inhibitors provides broad preclinical efficacy against viper snakebite. Nat Commun [Internet]. 2020 [cited 2025 Feb 23];11(1). Available from: https://doi.org/10.1038/s41467-020-19981-6 DOI: https://doi.org/10.1038/s41467-020-19981-6

da Silva WRGB, de Siqueira Santos L, Lira D, de Oliveira Luna KP, Fook SML, Alves RRN. Who are the most affected by Bothrops snakebite envenoming in Brazil? A Clinical-epidemiological profile study among the regions of the country. PLoS Negl Trop Dis [Internet]. 2023 Oct 1 [cited 2025 Feb 23];17(10 October):e0011708. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011708 DOI: https://doi.org/10.1371/journal.pntd.0011708

Harrison RA, Casewell NR, Ainsworth SA, Lalloo DG. The time is now: A call for action to translate recent momentum on tackling tropical snakebite into sustained benefit for victims [Internet]. Vol. 113, Transactions of the Royal Society of Tropical Medicine and Hygiene. 2019 [cited 2025 Feb 23]. p. 834–7. Available from: https://www.msf.org/global-health- DOI: https://doi.org/10.1093/trstmh/try134

Pejak DT, Adam VN, Srzić I. VENOMOUS SNAKEBITES IN CROATIA, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT. Acta Clin Croat. 2022;61:59 66.

Qamruddin RM, Safferi RS, Ismail ZM, Salleh MS, Hamid MNHA, Ng VERF, et al. Frequency, geographical distribution, and outcomes of pit viper bites in Malaysia were consulted with Remote Envenomation Consultancy Services (RECS) from 2017 to 2020. PLoS Negl Trop Dis [Internet]. 2023 [cited 2025 Feb 23];17(8 August). Available from: https://doi.org/10.1371/journal.pntd.0011569 DOI: https://doi.org/10.1371/journal.pntd.0011569

Bhaumik S, Norton R, Jagnoor J. Structural capacity and continuum of snakebite care in the primary health care system in India: a cross-sectional assessment. BMC Primary Care [Internet]. 2023 [cited 2025 Feb 23];24(1). Available from: http://creativecommons.org/licenses/by/4.0/.TheCreativeCommonsPublicDomainDedicationwaiver DOI: https://doi.org/10.1186/s12875-023-02109-2

Carvalho ÉDS, Souza ARDN, Melo DFC, De Farias AS, Macedo BBDO, Sartim MA, et al. Photobiomodulation Therapy to Treat Snakebites Caused by Bothrops atrox: A Randomized Clinical Trial. JAMA Intern Med [Internet]. 2024 Jan 1 [cited 2025 Feb 23];184(1):70–80. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2812544 DOI: https://doi.org/10.1001/jamainternmed.2023.6538

Menzies SK, Litschka-Koen T, Edge RJ, Alsolaiss J, Crittenden E, Hall SR, et al. Two snakebite antivenoms have the potential to reduce Eswatini’s dependency upon a single, increasingly unavailable product: Results of preclinical efficacy testing. PLoS Negl Trop Dis [Internet]. 2022 [cited 2025 Feb 23];16(9). Available from: https://doi.org/10.1371/journal.pntd.0010496 DOI: https://doi.org/10.1371/journal.pntd.0010496

Dossou AJ, Fandohan AB, Omara T, Chippaux JP. Comprehensive Review of Epidemiology and Treatment of Snakebite Envenomation in West Africa: Case of Benin. J Trop Med [Internet]. 2024 [cited 2025 Feb 23]; 2024:10 pages. Available from: https://doi.org/10.1155/2024/8357312 DOI: https://doi.org/10.1155/2024/8357312

Tednes M, Slesinger TL. Evaluation and Treatment of Snake Envenomations [Internet]. StatPearls. StatPearls Publishing; 2021 [cited 2025 Feb 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553151/

MS M da S. Brasil totalizou mais de 32 mil acidentes envolvendo serpentes em 2023 [Internet]. 2024 [cited 2025 Mar 25]. Available from: https://www.gov.br/saude/pt-br/assuntos/noticias/2024/setembro/brasil-totalizou-mais-de-32-mil-acidentes-envolvendo-serpentes-em-2023

Coutinho JVSC, Fraga Guimarães T, Borges Valente B, Gomes Martins de Moura Tomich L. Epidemiology of secondary infection after snakebites in center-west Brazil. PLoS Negl Trop Dis [Internet]. 2023 [cited 2025 Feb 23];17(3):e0011167. Available from: https://doi.org/10.1371/journal.pntd.0011167 DOI: https://doi.org/10.1371/journal.pntd.0011167

Afroz A, Siddiquea BN, Shetty AN, Jackson TNW, Watt AD. Assessing knowledge and awareness regarding snakebite and management of snakebite envenoming in healthcare workers and the general population: A systematic review and meta-analysis [Internet]. Vol. 17, PLoS Neglected Tropical Diseases. 2023 [cited 2025 Feb 23]. Available from: https://doi.org/10.1371/journal.pntd.0011048 DOI: https://doi.org/10.1371/journal.pntd.0011048

Castro KLP de, Lopes-De-Souza L, de Oliveira D, Machado-De-ávila RA, Paiva ALB, de Freitas CF, et al. A combined strategy to improve the development of a coral antivenom against Micrurus spp. Front Immunol [Internet]. 2019 [cited 2025 Feb 23];10(OCT):2422. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6816313/pdf/fimmu-10-02422.pdf DOI: https://doi.org/10.3389/fimmu.2019.02422

Ribeiro TBB, Santos FH dos, Pacheco D da S, Silva ACCM, Gonçalves EA. Acidentes com serpentes peçonhentas em Anápolis: uma análise de dados de 2012 a 2019. RESU–Revista Educação em Saúde [Internet]. 2019 [cited 2025 Feb 23];7(supplemento 2). Available from: https://periodicos.unievangelica.edu.br/index.php/educacaoemsaude/article/view/4054/2752

Roriz KRPS, Zaqueo KD, Setubal SS, Katsuragawa TH, da Silva RR, Fernandes CFC, et al. Epidemiological study of snakebite cases in Brazilian western Amazonia. Rev Soc Bras Med Trop [Internet]. 2018 [cited 2025 Feb 23];51(3):338–46. Available from: https://www.scielo.br/j/rsbmt/a/HwKFK7WHwGZqLzrrNgs39Bg/?format=pdf&lang=en DOI: https://doi.org/10.1590/0037-8682-0489-2017

Hakizimana D, Macdonald LE, Kampire HT, Bonaventure M, Tadesse M, Murara E, et al. Snakebite incidence and healthcare-seeking behaviors in Eastern Province, Rwanda: A cross-sectional study. PLoS Negl Trop Dis [Internet]. 2024 [cited 2025 Feb 23];18(8). Available from: https://doi.org/10.1371/journal.pntd.0012378 DOI: https://doi.org/10.1371/journal.pntd.0012378

Soopairin S, Patikorn C, Taychakhoonavudh S. Antivenom preclinical efficacy testing against Asian snakes and their availability in Asia: A systematic review. PLoS One [Internet]. 2023 [cited 2025 Feb 23];18(7 July). Available from: https://doi.org/10.1371/journal.pone.0288723 DOI: https://doi.org/10.1371/journal.pone.0288723

Isbister GK. Antivenom availability, delays, and use in Australia. Toxicon X [Internet]. 2023 Mar 1 [cited 2025 Feb 23];17:100145. Available from: https://www.sciencedirect.com/science/article/pii/S2590171022000558?via%3Dihub DOI: https://doi.org/10.1016/j.toxcx.2022.100145

Iddi S, Justin J, Hamasaki K, Konje ET, Kongola GW. Assessment of snakebite management practices at Meserani Juu in Monduli District, Northern Tanzania. PLoS One [Internet]. 2022 Dec 1 [cited 2025 Feb 23];17(12 December): e0278940. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0278940 DOI: https://doi.org/10.1371/journal.pone.0278940

Russell JJ, Schoenbrunner A, Janis JE. Snake Bite Management: A Scoping Review of the Literature [Internet]. Vol. 9, Plastic and Reconstructive Surgery - Global Open. 2021 [cited 2025 Feb 23]. p. E3506. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8084039/pdf/gox-9-e3506.pdf DOI: https://doi.org/10.1097/GOX.0000000000003506

Kaur N, Iyer A, Sunagar K. Evolution Bites — Timeworn Inefficacious Snakebite Therapy in the Era of Recombinant Vaccines. Indian Pediatr [Internet]. 2021 [cited 2025 Feb 23];58(3):219–23. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7610842/pdf/EMS124174.pdf DOI: https://doi.org/10.1007/s13312-021-2158-x

Silva WD da, De Andrade SA, Megale ÂAA, De Souza DA, Sant’Anna OA, Magnoli FC, et al. Antibodies as Snakebite Antivenoms: Past and future [Internet]. Vol. 14, Toxins. 2022 [cited 2025 Feb 23]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9503307/pdf/toxins-14-00606.pdf

Oliveira N da R, Silva TM, Sousa AC da R, Ferreira KK da S. EPIDEMIOLOGIA DE ACIDENTES OFÍDICOS NO BRASIL (2000-2018) [Internet]. 2022 [cited 2025 Feb 23]. Available from: https://editorarealize.com.br/editora/anais/conapesc/2022/TRABALHO_COMPLETO_EV177_MD1_ID1089_TB433_10082022145016.pdf

Habib AG, Brown NI. O problema da picada de cobra e a crise do antiveneno numa perspectiva económica da saúde. Tóxico [Internet]. 2018; 150:115–23. Available from: https://www.sciencedirect.com/science/article/abs/pii/S004101011830196X?via%3Dihub

CAPES. Portal periódicos CAPES [Internet]. 2025 [cited 2025 Feb 23]. Available from: https://www.periodicos.capes.gov.br/

CAPES. Manual de acesso [Internet]. Periódicos Capes. 2019. Available from: https://www.periodicos.capes.gov.br/images/documents/Portal_Periódicos_CAPES_Guia_2019_4_oficial.pdf

Fiocruz. Portal Fundação Oswaldo Cruz (Fiocruz) [Internet]. 2025 [cited 2025 Mar 25]. Available from: https://portal.fiocruz.br/

IVB IVB. Instituto Vital Brazil - IVB [Internet]. 2025 [cited 2025 Mar 25]. Available from: https://www.rj.gov.br/vitalbrazil/

Butantan. Instituto Butantan [Internet]. 2025 [cited 2025 Feb 23]. Available from: https://butantan.gov.br/

FUNED. Fundação Ezequiel Dias [Internet]. 2025 [cited 2025 Mar 26]. Available from: https://www.funed.mg.gov.br/

CPPI. Secretaria da Saúde -Paraná. 2025 [cited 2025 Mar 26]. Centro de Produção e Pesquisa de Imunobiológicos. Available from: https://www.saude.pr.gov.br/Pagina/CPPI-Centro-de-Producao-e-Pesquisa-de-Imunobiologicos

ICP. Instituto Clodomiro Picado [Internet]. 2025 [cited 2025 Mar 26]. Available from: https://icp.ucr.ac.cr/en

SAVP. South African Vaccine Producers [Internet]. 2025 [cited 2025 Mar 26]. Available from: http://www.savp.co.za/

African Snakebite Institute. African Snakebite Institute [Internet]. 2025 [cited 2025 Mar 26]. Available from: https://www.africansnakebiteinstitute.com/

Amorim AP da CF de, Santos MF dos, Amorim JF de. ACIDENTES COM ANIMAIS PEÇONHENTOS E A IMPORTÂNCIA DAS MEDIDAS PROTETIVAS: UM ESTUDO NO MUNICÍPIO DE TRÊS RIOS DE 2014 A 2023. REVISTA FOCO [Internet]. 2025 Feb 11 [cited 2025 Feb 23];18(2):e7586. Available from: https://ojs.focopublicacoes.com.br/foco/article/view/7586 DOI: https://doi.org/10.54751/revistafoco.v18n2-059

Amorim AP da CF de, Santos MF dos. OFIDISMO: DOENÇA TROPICAL NEGLIGENCIADA DE GRANDE IMPACTO NA SAÚDE MUNDIAL. In: Giselle Medeiros da Costa One, (Org.), editors. SAÚDE: Os desafios da pesquisa na atualidade [Internet]. João Pessoa - PB; 2021 [cited 2025 Feb 23]. p. 421–43. Available from: https://cinasama.com.br/wp-content/uploads/2021/09/LIVRO-SAÚDE-I-2021.pdf

Atreya A, Kanchan T. Human–Snake Encounters and Folk Remedies in Nepal [Internet]. Vol. 29, Wilderness and Environmental Medicine. 2018 [cited 2025 Feb 23]. p. 138–40. Available from: https://journals.sagepub.com/doi/pdf/10.1016/j.wem.2017.08.006 DOI: https://doi.org/10.1016/j.wem.2017.08.006

Bhaumik S, Beri D, Jagnoor J. The impact of climate change on the burden of snakebite: Evidence synthesis and implications for primary healthcare. J Family Med Prim Care [Internet]. 2022 Oct [cited 2025 Feb 24];11(10):6147–58. Available from: https://pubmed.ncbi.nlm.nih.gov/36618235/ DOI: https://doi.org/10.4103/jfmpc.jfmpc_677_22

Seifert SA, Armitage JO, Sanchez EE. Snake Envenomation. N Engl J Med. 2022;386(1):68–78. DOI: https://doi.org/10.1056/NEJMra2105228

Costa MKB da, Fonseca CS da, Navoni JA, Freire EMX. Snakebite accidents in Rio Grande do Norte state, Brazil: Epidemiology, health management and influence of the environmental scenario. Tropical Medicine and International Health [Internet]. 2019 Apr 1 [cited 2025 Feb 23];24(4):432–41. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13207 DOI: https://doi.org/10.1111/tmi.13207

Silva LMG, Gouveia VA, Campos GRS, Dale CS, Da Palma RK, De Oliveira APL, et al. Photobiomodulation mitigates Bothrops jararacussu venom-induced damage in myoblast cells by enhancing myogenic factors and reducing cytokine production. PLoS Negl Trop Dis [Internet]. 2024 May 1 [cited 2025 Feb 23];18(5): e0012227. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012227 DOI: https://doi.org/10.1371/journal.pntd.0012227

Gutiérrez JM. Global availability of antivenoms: The relevance of public manufacturing laboratories [Internet]. Vol. 11, Toxins. 2019 [cited 2025 Mar 26]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6356591/pdf/toxins-11-00005.pdf

Chakma J, Menon J, Dhaliwal R. White paper on venomous snakebite in India [Internet]. Vol. 152, Indian Journal of Medical Research. 2020 [cited 2025 Mar 26]. p. 568–74. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6863067/pdf/rpsp-43-e92.pdf DOI: https://doi.org/10.4103/ijmr.IJMR_3377_20

Bhaumik S, Norton R, Jagnoor J. Burden and risk factors for snakebite in India: protocol for a systematic review. F1000Res [Internet]. 2020 [cited 2025 Feb 23]; 9:25. Available from: https://doi.org/10.12688/f1000research.21924.1 DOI: https://doi.org/10.12688/f1000research.21924.1

Francis MF, Vianney SJM, Heitz-Tokpa K, Kreppel K. Risks of snakebite and challenges to seeking and providing treatment for agro-pastoral communities in Tanzania. PLoS One [Internet]. 2023 [cited 2025 Feb 23];18(2 February). Available from: https://doi.org/10.1371/journal.pone.0280836 DOI: https://doi.org/10.1371/journal.pone.0280836

Farooq H, Bero C, Guilengue Y, Elias C, Massingue Y, Mucopote I, et al. Snakebite incidence in rural sub-Saharan Africa might be severely underestimated. Toxicon. 2022 Nov 1; 219:106932. DOI: https://doi.org/10.1016/j.toxicon.2022.106932

MS M da S. Guia de Vigilância em Saúde [Internet]. 2022 [cited 2025 Mar 26]. p. 1019–24. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_saude_5ed_rev_atual.pdf

Knudsen C, Jürgensen JA, Føns S, Haack AM, Friis RUW, Dam SH, et al. Snakebite Envenoming Diagnosis and Diagnostics [Internet]. Vol. 12, Frontiers in Immunology. 2021 [cited 2025 Feb 23]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8113877/pdf/fimmu-12-661457.pdf DOI: https://doi.org/10.3389/fimmu.2021.661457

Jenkins TP, Ahmadi S, Bittenbinder MA, Stewart TK, Akgun DE, Hale M, et al. Terrestrial venomous animals, the envenomings they cause, and treatment perspectives in the Middle East and North Africa [Internet]. Vol. 15, PLoS Neglected Tropical Diseases. 2021 [cited 2025 Feb 23]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8638997/pdf/pntd.0009880.pdf DOI: https://doi.org/10.1371/journal.pntd.0009880

Ediriweera DS, De Silva T, Kasturiratne A, De Silva HJ, Diggle P. Geographically regulated designs of incidence surveys can match the precision of classical survey designs whilst requiring smaller sample sizes: The case of snakebite envenoming in Sri Lanka. BMJ Glob Health [Internet]. 2022 [cited 2025 Feb 23];7(10):9500. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9557310/pdf/bmjgh-2022-009500.pdf DOI: https://doi.org/10.1136/bmjgh-2022-009500

Gutiérrez JM, Maduwage K, Iliyasu G, Habib A. Snakebite envenoming in different national contexts: Costa Rica, Sri Lanka, and Nigeria. Toxicon X [Internet]. 2021 [cited 2025 Feb 23];9–10. Available from: https://doi.org/10.1016/j.toxcx.2021.100066 DOI: https://doi.org/10.1016/j.toxcx.2021.100066

Have NJ Ten, Ooms GI, Waldmann B, Reed T. Barriers and enablers of community engagement practices for the prevention of snakebite envenoming in South Asia: A qualitative exploratory study. Toxicon X [Internet]. 2023 [cited 2025 Mar 31];17:100144. Available from: https://doi.org/10.1016/j.toxcx.2022.100144. DOI: https://doi.org/10.1016/j.toxcx.2022.100144

Chuang PC, Chang KW, Cheng SY, Pan HY, Huang KC, Huang YT, et al. Benefits of early in-hospital antivenom administration to patients with Protobothrops mucrosquamatus envenomation. American Journal of Tropical Medicine and Hygiene. 2021;104(1):323–8. DOI: https://doi.org/10.4269/ajtmh.20-0659

Resiere D, Kallel H, Florentin J, Houcke S, Mehdaoui H, Gutiérrez JM, et al. Bothrops (Fer-de-lance) snakebites in the French departments of the Americas (Martinique and Guyana): Clinical and experimental studies and treatment by immunotherapy [Internet]. Vol. 17, PLoS Neglected Tropical Diseases. 2023 [cited 2025 Feb 23]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9974124/pdf/pntd.0011083.pdf DOI: https://doi.org/10.1371/journal.pntd.0011083

Alcântara JA, Bernarde PS, Sachett J, da Silva AM, Valente SF, Peixoto HM, et al. Stepping into a dangerous quagmire: Macroecological determinants of Bothrops envenomings, Brazilian Amazon. PLoS One [Internet]. 2018 [cited 2025 Feb 23];13(12). Available from: https://doi.org/10.1371/journal.pone.0208532 DOI: https://doi.org/10.1371/journal.pone.0208532

Lopes-de-Souza L, Costal-Oliveira F, Stransky S, Fonseca de Freitas C, Guerra-Duarte C, Braga VMM, et al. Development of a cell-based in vitro assay as a possible alternative for determining bothropic antivenom potency. Toxicon. 2019 Dec 1;170:68 76. DOI: https://doi.org/10.1016/j.toxicon.2019.09.010

Brasil M da S do. Datasus. 2021 [cited 2025 Feb 23]. DATASUS - Ministério da Saúde. Available from: https://datasus.saude.gov.br/

Amorim AP da CF de, Santos MF dos Nouer SA, Igreja RP. EDUCAÇÃO AMBIENTAL E EM SAÚDE COMO ESTRATÉGIAS DE PREVENÇÃO DOS ACIDENTES COM SERPENTES PEÇONHENTAS. RevBea - Revista Brasileira de Educação Ambiental. 2025;20(2):436–53 Available from: https://periodicos.unifesp.br/index.php/revbea/article/view/19987/13722 DOI: https://doi.org/10.34024/revbea.2025.v20.19987

Câmara OF, da Silva DD, de Holanda MN, Bernarde PS, da Silva AM, Monteiro WM, et al. Ophidian envenomings in a region of the western Brazilian Amazon. Journal of Human Growth and Development [Internet]. 2020 [cited 2025 Feb 23];30(1):120–8. Available from: https://pepsic.bvsalud.org/pdf/rbcdh/v30n1/15.pdf DOI: https://doi.org/10.7322/jhgd.v30.9958

Melo PA, Maqui ONC. ASPECTOS EPIDEMIOLÓGICOS DE ACIDENTES OFÍDICOS REGISTRADOS NO ESTADO DO ACRE, BRASIL, ENTRE 2013-2017: UM ESTUDO ECOLÓGICO. Hygeia - Revista Brasileira de Geografia Médica e da Saúde [Internet]. 2020 Sep 14 [cited 2025 Feb 23]; 16:174 87. Available from: https://seer.ufu.br/index.php/hygeia/article/view/53321 DOI: https://doi.org/10.14393/Hygeia16053321

de Oliveira LP, Moreira JGDV, Sachett J de AG, Monteiro WM, Meneguetti DU de O, Bernarde PS. Snakebites in Rio Branco and the surrounding region, Acre, Western Brazilian Amazon. Rev Soc Bras Med Trop [Internet]. 2020 [cited 2025 Feb 23]; 53:1 8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7523524/pdf/1678-9849-rsbmt-53-e20200214.pdf DOI: https://doi.org/10.1590/0037-8682-0214-2020

Strauch MA, Souza GJ, Pereira JN, Ramos T dos S, Cesar MO, Tomaz MA, et al. True or false coral snake: Is it worth the risk? A Micrurus corallinus case report. Journal of Venomous Animals and Toxins Including Tropical Diseases [Internet]. 2018 [cited 2025 Feb 23];24(1). Available from: https://doi.org/10.1186/s40409-018-0148-9 DOI: https://doi.org/10.1186/s40409-018-0148-9

MS M da S. Guia De Animais Peçonhentos Do Brasil [Internet]. Ministério da Saúde - Secretaria de Vigilância em Saúde e Ambiente - Departamento de Doenças Transmissíveis; 2024. 164 p. Available from: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/a/animais-peconhentos/publicacoes/guia-animais-peconhentos-do-brasil.pdf/view

Funasa. Manual de diagnóstico e tratamento de acidentes por animais peçonhentos [Internet]. 2a. Saúde. BFN de, editor. Fundação Nacional de Saúde. Ministério da Saúde; 2001. 76 p. Available from: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/a/animais-peconhentos/aguas-vivas-e-caravelas/publicacoes/manual-de-diagnostico-e-tratamento-de-acidentes-por-animais-peconhentos.pdf/view

Yuan FL, Devan-Song A, Yue S, Bonebrake TC. Snakebite Management and One Health in Asia Using an Integrated Historical, Social, And Ecological Framework. American Journal of Tropical Medicine and Hygiene [Internet]. 2022 [cited 2025 Feb 23];106(2):384–8. Available from: http://snakebiteinitiative.in/snakerescue/. DOI: https://doi.org/10.4269/ajtmh.21-0848

Hammer FM, Feio RN, Siqueira-Batista R. Acidentes crotálicos no Brasil: atualidades e perspectivas. Revista Médica de Minas Gerais [Internet]. 2022 [cited 2025 Feb 23];32(1):1–13. Available from: https://www.rmmg.org/artigo/detalhes/3882 DOI: https://doi.org/10.5935/2238-3182.2022e32202

Casewell NR, Jackson TNW, Laustsen AH, Sunagar K. Causes and Consequences of Snake Venom Variation [Internet]. Vol. 41, Trends in Pharmacological Sciences. 2020 [cited 2025 Feb 23]. p. 570–81. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7116101/pdf/EMS94818.pdf DOI: https://doi.org/10.1016/j.tips.2020.05.006

Abdullahi A, Yusuf N, Debella A, Eyeberu A, Deressa A, Bekele H, et al. Seasonal variation, treatment outcome, and its associated factors among the snakebite patients in the Somali region, Ethiopia. Front Public Health [Internet]. 2022 [cited 2025 Feb 23];10. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9583943/pdf/fpubh-10-901414.pdf DOI: https://doi.org/10.3389/fpubh.2022.901414

Afroz A, Siddiquea BN, Chowdhury HA, Jackson TN, Watt AD. Snakebite envenoming: A systematic review and meta-analysis of global morbidity and mortality. PLoS Negl Trop Dis [Internet]. 2024 [cited 2025 Feb 23];18(4). Available from: https://doi.org/10.1371/journal.pntd.0012080 DOI: https://doi.org/10.1371/journal.pntd.0012080

Brito M, de Almeida ACC, Cavalcante F, Mise YF. Completeness of notifications of accidents involving venomous animals in the Information System for Notifiable Diseases: a descriptive study, Brazil, 2007-2019. Epidemiologia e Servicos de Saude [Internet]. 2023 [cited 2025 Feb 23];32(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10013100/pdf/2237-9622-ress-32-01-e2022666.pdf DOI: https://doi.org/10.1590/s2237-96222023000100002

Bhaumik S, Kallakuri S, Kaur A, Devarapalli S, Daniel M. Mental health conditions after snakebite: A scoping review [Internet]. Vol. 5, BMJ Global Health. 2020 [cited 2025 Feb 23]. p. 4131. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7705584/pdf/bmjgh-2020-004131.pdf DOI: https://doi.org/10.1136/bmjgh-2020-004131

Igawe PB, Muhammad JO, Nwokoro UU, Abubakar JD, Isah SI, Aketemo U, et al. Snakebite outbreak and associated risk factors in Donga, Taraba State, Nigeria, June 2016. Pan African Medical Journal [Internet]. 2020 [cited 2025 Feb 23];37(82):1–8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7680248/pdf/PAMJ-37-82.pdf

Bhaumik S, Habib AG, Santra V. Strategic priorities for accelerating action to reduce the burden of snakebite [Internet]. Vol. 4, PLOS Global Public Health. 2024 [cited 2025 Feb 23]. Available from: https://doi.org/10.1371/journal.pgph.0002866 DOI: https://doi.org/10.1371/journal.pgph.0002866

Waiddyanatha S, Silva A, Siribaddana S, Isbister GK. Long-term effects of snake envenoming. Toxins (Basel) [Internet]. 2019 [cited 2025 Feb 23];11(4). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6521273/pdf/toxins-11-00193.pdf DOI: https://doi.org/10.3390/toxins11040193

Araújo SCM, Andrade EB de. Aspectos epidemiológicos dos acidentes ofídicos ocorridos no estado do Piauí, Nordeste do Brasil, entre os anos de 2003 e 2017. Pesquisa e Ensino em Ciências Exatas e da Natureza [Internet]. 2019 [cited 2025 Feb 23];3(2):154. Available from: https://cfp.revistas.ufcg.edu.br/cfp/index.php/RPECEN/article/view/1265/504 DOI: https://doi.org/10.29215/pecen.v3i2.1265

Machado C. ACIDENTES OFÍDICOS NO BRASIL: DA ASSISTÊNCIA NO MUNICÍPIO DO RIO DE JANEIRO AO CONTROLE DA SAÚDE ANIMAL EM INSTITUTO PRODUTOR DE SORO ANTIOFÍDICO [Internet]. MINISTÉRIO DA SAÚDE, CRUZ FOCIO, editors. [Rio de Janeiro]: Fundação Oswaldo Cruz; 2018. Available from: https://www.arca.fiocruz.br/handle/icict/27452

Matos RR, Ignotti E. Incidence of venomous snakebite accidents by snake species in Brazilian biomes. Ciencia e Saude Coletiva [Internet]. 2020 [cited 2025 Feb 23];25(7):2837–46. Available from: https://orcid.org/0000-0002-0926-6783 DOI: https://doi.org/10.1590/1413-81232020257.31462018

Souza LA de, Silva AD, Chavaglia SRR, Dutra CM, Ferreira LA. Profile of snakebite victims reported in a public teaching hospital: A cross-sectional study. Revista da Escola de Enfermagem [Internet]. 2021 [cited 2025 Feb 23]; 55:1 7. Available from: https://doi.org/10.1590/S1980-220X2020007003721 DOI: https://doi.org/10.1590/s1980-220x2020007003721

Duque BR, Bruno SF, Ferreira V, Guedes TB, Machado C, Hamdan B. Venomous snakes of medical importance in the Brazilian state of Rio de Janeiro: habitat and taxonomy against ophidism. Brazilian journal of biology. 2023;83:e272811. DOI: https://doi.org/10.1590/1519-6984.272811

BRASIL M da S. Acidentes por Animais Peçonhentos — Ministério da Saúde [Internet]. 2025 [cited 2025 Feb 23]. Available from: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/a/animais-peconhentos

Ralph R, Faiz MA, Sharma SK, Ribeiro I, Chappuis F. Managing snakebite. The BMJ [Internet]. 2022 [cited 2025 Feb 25];376. Available from: https://www.bmj.com/content/bmj/376/bmj-2020-057926.full.pdf DOI: https://doi.org/10.1136/bmj-2020-057926

Hardcastle TC, Kajee M, Lachenicht K, van der Walt N. Approach to the diagnosis and management of snakebite envenomation in South Africa in humans: Layperson aspects and the role of emergency medical services. South African Medical Journal [Internet]. 2023 [cited 2024 Sep 19];113(5):1190–4. Available from: https://samajournals.co.za/index.php/samj/article/view/666/461

Pandey DP, Ghimire A, Shrestha BR. Retrospective Documentation of a Confirmed White-Lipped Green Pit Viper (Trimeresurus albolabris Gray, 1842) Bite in the South-Central Hills of Nepal. JSES Open Access [Internet]. 2017 [cited 2025 Feb 25]; 1:139 40. Available from: https://journals.sagepub.com/doi/pdf/10.1016/j.wem.2018.11.001

Lang HJ, Amito J, Dönser MW, Giera R, Towey R. Intensive-care management of snakebite victims in rural sub-Saharan Africa: An experience from Uganda. Southern African Journal of Critical Care. 2020;36(1):39–45. DOI: https://doi.org/10.7196/SAJCC.2020.v36i1.404

Bawaskar HS, Bawaskar PH, Bawaskar PH. Primary health care for snakebite in India is inadequate [Internet]. Vol. 395, The Lancet. Lancet Publishing Group; 2020 [cited 2025 Feb 23]. p. 112. Available from: https://www.thelancet.com/action/showFullText?pii=S0140673619319099 DOI: https://doi.org/10.1016/S0140-6736(19)31909-9

Ceron K, Bernarde PS, Sestito GA, Zocche JJ. Snakebite of Santa Catarina state, Brazil. Oecologia Australis. 2019;23(1):56–65. DOI: https://doi.org/10.4257/oeco.2019.2301.05

Pintor AFV, Ray N, Longbottom J, Bravo-Vega CA, Yousefi M, Murray KA, et al. Addressing the global snakebite crisis with geospatial analyses – Recent advances and future direction. Toxicon X. 2021 Sep 1; 11:100076. DOI: https://doi.org/10.1016/j.toxcx.2021.100076

Mavoungou LB, Jackson K, Goma-Tchimbakala J. Snake species assemblages across habitat types in four departments of the Republic of Congo, with emphasis on medically-relevant venomous species. Heliyon [Internet]. 2024 [cited 2025 Feb 23];10(13). Available from: https://doi.org/10.1016/j.heliyon.2024.e33583 DOI: https://doi.org/10.1016/j.heliyon.2024.e33583

Isaacson JE, Ye JJ, Silva LL, Hernandes Rocha TA, de Andrade L, Scheidt JFHC, et al. Antivenom access impacts severity of Brazilian snakebite envenoming: A geographic information system analysis. PLoS Negl Trop Dis [Internet]. 2023 [cited 2025 Feb 23];17:1/19. Available from: https://www.sciencedirect.com/science/article/abs/pii/S004101011830196X?via%3Dihub DOI: https://doi.org/10.1371/journal.pntd.0011305

Williams DJ, Faiz MA, Abela-Ridder B, Ainsworth S, Bulfone TC, Nickerson AD, et al. Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming. PLoS Negl Trop Dis [Internet]. 2019 Feb 1 [cited 2025 Feb 23];13(2):1/12. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007059 DOI: https://doi.org/10.1371/journal.pntd.0007059

Gutiérrez JM, Zanette L, Vigilato MAN, Pompei JCA, Martins D, Fan HW. Appraisal of antivenom production in public laboratories in Latin America during the first semester of 2020: The impact of COVID-19. PLoS Negl Trop Dis [Internet]. 2021 [cited 2025 Feb 23];15(6). Available from: https://doi.org/10.1371/journal.pntd.0009469 DOI: https://doi.org/10.1371/journal.pntd.0009469

Dalhat MM, Potet J, Mohammed A, Chotun N, Tesfahunei HA, Habib AG. Availability, accessibility, and use of antivenom for snakebite envenomation in Africa with proposed strategies to overcome the limitations. Toxicon X [Internet]. 2023 [cited 2025 Feb 23];18. Available from: https://doi.org/10.1016/j.toxcx.2023.100152 DOI: https://doi.org/10.1016/j.toxcx.2023.100152

Faust A, Ray N. Consequences of geographical accessibility to post-exposure treatment for rabies and snakebite in Africa: a mini review. Vol. 4, Frontiers in Health Services. 2024. p. 1309692. DOI: https://doi.org/10.3389/frhs.2024.1309692

Bhaumik S, Jagadesh S, Lassi Z. Quality of WHO guidelines on snakebite: The neglect continues [Internet]. Vol. 3, BMJ Global Health. 2018 [cited 2025 Feb 23]. p. 783. Available from: http://www. DOI: https://doi.org/10.1136/bmjgh-2018-000783

Musah Y, Ameade EPK, Attuquayefio DK, Holbech LH. Epidemiology, ecology, and human perceptions of snakebites in a savanna community of northern Ghana. PLoS Negl Trop Dis [Internet]. 2019 [cited 2025 Feb 23];13(8). Available from: https://doi.org/10.1371/journal.pntd.0007221 DOI: https://doi.org/10.1371/journal.pntd.0007221

Gutiérrez JM, Albulescu LO, Clare RH, Casewell NR, Abd El-Aziz TM, Escalante T, et al. The search for natural and synthetic inhibitors that would complement antivenoms as therapeutics for snakebite envenoming [Internet]. Vol. 13, Toxins. 2021 [cited 2025 Feb 23]. Available from: https://doi.org/10.3390/toxins13070451 DOI: https://doi.org/10.3390/toxins13070451

Benhammou D, Chippaux JP, Ntone R, Madec Y, Amta P, Noel G, et al. Snakebites in Cameroon: Tolerance of a Snake Antivenom (InoserpTM PAN-AFRICA) in Africa in Real-Life Conditions. Toxins (Basel). 2024;16(4):165. DOI: https://doi.org/10.3390/toxins16040165

Segura Á, Moscoso E, Umaña D, Vargas M, Sánchez A, Hernández A, et al. Design, development, and preclinical assessment of MENAVip-ICP, a new snake antivenom with potential coverage of species in the Middle East and North Africa regions. Toxicon X [Internet]. 2024 [cited 2025 Feb 23]; 24:100206. Available from: https://doi.org/10.1016/j.toxcx.2024.100206 DOI: https://doi.org/10.1016/j.toxcx.2024.100206

Mejri H, Mokrani R, Ksouri A, Seddik M, Awad N, Ayme G, et al. Neutralizing Nanobodies against Venoms from Naja haje Species Captured in North Africa. Toxins (Basel). 2024;16(9):393. DOI: https://doi.org/10.3390/toxins16090393

Potet J, Singh S, Ritmeijer K, Sisay K, Alcoba G, Jouberton F, et al. Snakebite envenoming at MSF: A decade of clinical challenges and antivenom access issues. Toxicon X [Internet]. 2023 [cited 2025 Feb 23];17. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9813776/pdf/main.pdf DOI: https://doi.org/10.1016/j.toxcx.2022.100146

Gajbhiye RK, Munshi H, Bawaskar HS. National programme for prevention & control of snakebite in India: Key challenges & recommendations Snakebite [Internet]. Vol. 157, Indian Journal of Medical Research. Wolters Kluwer – Medknow for Director-General, Indian Council of Medical Research; 2023. p. 271–5. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10438420/pdf/IJMR-157-271.pdf DOI: https://doi.org/10.4103/ijmr.ijmr_2424_22

Blessmann J, Kreuels B. Urgent administration of antivenom following proven krait bites in Southeast Asia irrespective of neurotoxic symptoms. PLoS Negl Trop Dis [Internet]. 2024 [cited 2025 Feb 23];18(4). Available from: https://doi.org/10.1371/journal.pntd.0012079 DOI: https://doi.org/10.1371/journal.pntd.0012079

Zimmerman A, Monteiro W, Nickenig Vissoci JR, Smith ER, Rocha T, Sachett J, et al. Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis. The Lancet Regional Health - Americas [Internet]. 2024 [cited 2025 Feb 23];29. Available from: www.thelancet.com DOI: https://doi.org/10.1016/j.lana.2023.100651

Knudsen C, Belfakir SB, Degnegaard P, Jürgensen JA, Haack AM, Friis RUW, et al. Multiplex lateral flow assay development for snake venom detection in biological matrices. Sci Rep [Internet]. 2024 [cited 2025 Feb 23];14(1):2567. Available from: https://doi.org/10.1038/s41598-024-51971-2 DOI: https://doi.org/10.1038/s41598-024-51971-2

Santana CR, Oliveira MG. Evaluation of the use of antivenom sera in the emergency service of a regional public hospital in Vitória da Conquista (BA), Brazil. Ciencia e Saude Coletiva [Internet]. 2020 [cited 2025 Feb 25];25(3):869–78. Available from: https://orcid.org/0000-0002-4460-2412 DOI: https://doi.org/10.1590/1413-81232020253.16362018

Bernarde PS, Wen FH, Monteiro WM. The risk of exotic venomous snakes to public health in Brazil [Internet]. Vol. 54, Revista da Sociedade Brasileira de Medicina Tropical. 2021 [cited 2025 Feb 23]. Available from: www.scielo.br/rsbmtIwww.rsbmt.org.br DOI: https://doi.org/10.1590/0037-8682-0585-2020

de Farias AS, Do Nascimento EF, Gomes Filho MR, Felix AC, Arévalo M da C, Adrião AAX, et al. Building an explanatory model for snakebite envenoming care in the Brazilian Amazon from the indigenous caregivers’ perspective. PLoS Negl Trop Dis [Internet]. 2023 [cited 2025 Feb 23];17(3):e0011172. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011172 DOI: https://doi.org/10.1371/journal.pntd.0011172

Basnyat B, Shilpakar O. Snakebite envenoming: a hidden health crisis. Lancet Glob Health. 2022;10(3): e311–2. DOI: https://doi.org/10.1016/S2214-109X(22)00029-8

Khochare S, Jaglan A, Rashmi U, Dam P, Sunagar K. Harnessing the Cross-Neutralisation Potential of Existing Antivenoms for Mitigating the Outcomes of Snakebite in Sub-Saharan Africa. Int J Mol Sci [Internet]. 2024 [cited 2025 Feb 23];25(8). Available from: https://doi.org/10.3390/ijms25084213 DOI: https://doi.org/10.3390/ijms25084213

Roberts NLS, Johnson EK, Zeng SM, Hamilton EB, Abdoli A, Alahdab F, et al. Global mortality of snakebite envenoming between 1990 and 2019. Nat Commun [Internet]. 2022 [cited 2025 Mar 26];13(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9596405/pdf/41467_2022_Article_33627.pdf DOI: https://doi.org/10.1038/s41467-022-33627-9

Michael GC, Bala AA, Mohammed M. Snakebite knowledge assessment and training of healthcare professionals in Asia, Africa, and the Middle East: A review. Toxicon X [Internet]. 2022 [cited 2025 Mar 27];16:100142. Available from: https://doi.org/10.1016/j.toxcx.2022.100142 DOI: https://doi.org/10.1016/j.toxcx.2022.100142

Fan HW, Vigilato MAN, Pompei JCA, Gutiérrez JM, (RELAPA) en representación de la R de LPP de A de AL. Situación de los laboratorios públicos productores de antivenenos en América Latina. Revista Panamericana de Salud Pública [Internet]. 2019 [cited 2025 Mar 26];43. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6863067/pdf/rpsp-43-e92.pdf DOI: https://doi.org/10.26633/RPSP.2019.92

Gutiérrez JM. Avaliação pré-clínica da eficácia neutralizante de antivenenos de cobras na América Latina e no Caribe : uma revisão. 2025; 146:1–8.

Published

2025-08-07

Issue

Section

Articles

How to Cite

DE AMORIM, Ana Paula da Conceição Fernandes; DOS SANTOS, Moana Ferreira; SCHNEIDER, Maria Cristina; NOUÉR, Simone Aranha; IGREJA, Ricardo Pereira. SNAKEBITE ANTIVENOM TREATMENT, CURRENT SITUATION, AND CHALLENGES IN BRAZIL AND OTHER HIGH-BURDEN COUNTRIES. ARACÊ , [S. l.], v. 7, n. 8, p. e7122, 2025. DOI: 10.56238/arev7n8-054. Disponível em: https://periodicos.newsciencepubl.com/arace/article/view/7122. Acesso em: 5 dec. 2025.