Management of Snakebite and Research Management of Snakebite ...

Management of Snakebite and Research
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(5) Poster on important venomous snakes of Myanmar, 6,000 copies
(6) Flipchart on important venomous snakes of Myanmar, 4,000 copies
(7) Flipchart on “When a snake bites......” 4,000 copies
(8) Pamphlet on “The danger of poisonous snakes” 50,000 copies
(9) Making peritoneal dialysis available in township hospitals in endemic areas,
training health personnel in management skills. First aid. Application of modified
compre-ssion and immobili-zation tech-nique. Clinical assessment of the patient,
antivenom therapy and the management of renal failure including dialysis skills
and the opening of dialysis centre in divisional and township hospitals.
(10) Advocacy and coordination in obtaining material for the production of more
and better antivenom, leading to adequate distribution of antivenom
More Freeze-dried Antivenom
Coordinating the Myanmar Pharmaceutical Factory, Ministry of Industry 1, (where the
antivenom is produced) and the Ministry of Health which distributes the antivenom, to
the health facilities where the patients are treated.
The antivenom production is complex. It requires obtaining and keeping of healthy
horses big enough for adequate bleeding. There is batch to batch variation of the potency
of various fractions of antivenom. The liquid antivenom requires careful storage and
instructions. Freeze dry machines and generators are required for the more stable freeze
dry antivenom.
A proposal made by the project manager using methods from Australia for producing
antivenom IgY from chickens to run concurrently was turned down.
The greatly needed freeze dry machine was procured by UNDP and WHO and
installed in the Myanmar Pharmaceutical Factory since the year 2000 and is now being
used to produce some of the freeze dry antivenom. The strength of each vial of Russell’s
viper antivenom produced was converted from 20 mg neutralizing capacity to 10 mg
neutralizing capacity so that in comparing production the number of vials of 10 mg
neutralizing strength must be divided by two and the production over the past few years
has not increased significantly.
Although there is a gradual fall in the morbidity rate, mortality rate has not fallen (Fig. 1)
probably due to..... improper first aid measures and inappropriate management, late arrival,
inadequate and delayed administration of antivenom and loss of potency of antivenom.
Benefits
• Reduction in snakebite morbidity and mortality.
• Improved health care facilities and capabilities of health personnel for critically
ill patients resulting in improved health care infrastructure.