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Menzies, Stefanie 
ORCID: https://orcid.org/0000-0002-9273-9296, Thomas, Aniekan, Tianyi, Frank, Abubakar, Saidu B., Nasidi, Abdulsalami, Durfa, Nandul, Patel, Rohit, Trelfa, Anna, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Habib, Abdulrazaq G. and Harrison, Robert
(2021)
'Livestock herding and Fulani ethnicity are a combined risk factor for development of early adverse reactions to antivenom treatment: Findings from a cross-sectional study in Nigeria'. PLoS Neglected Tropical Diseases, Vol 15, Issue 8, e0009518.
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Abstract
Background
Adverse reactions to antivenom considerably complicate the clinical management of snakebite envenomed patients because it necessitates a temporary suspension of life-saving antivenom, increases costs and can compromise patient outcomes. This study sought to explore the association between cattle-herding occupation and ethnic group and the occurrence of early adverse reactions to antivenom.
Methods
This cross-sectional study was conducted between the 25th April and 11th July 2011 at the Kaltungo General Hospital in north east Nigeria. The exposure variable of cattle-herding occupation showed a strong correlation with the ethnic group variable, thus these were combined into a new variable with three categories (Fulani and herder, either Fulani or herder, and neither Fulani nor herder). The outcome variable was the occurrence of early adverse reactions, defined as any new symptoms occurring within 6 hours of antivenom administration. Odds Ratios were estimated using multivariable logistic regression models controlling for potential confounders.
Results
Among 231 envenomed snakebite victims, the overall incidence of early adverse reactions was 11.9% (95% confidence intervals: 8.0–16.9%). Patients who were Fulani and herdershad a higher incidence of early adverse reactions compared to patients who were neither
Fulani nor herder (20% vs 5.7%). After adjusting for age and gender, victims who were Fulani and herders were 5.9 times more likely to have an early adverse reaction, compared to victims who were neither Fulani nor herders (95% CI: 1.88–18.59; p = 0.002).
Interpretation
To the best of our knowledge, this is the first study to provide evidence of higher odds of early adverse reactions among patients from a particular occupation and/or ethnic group. We recommend that snake envenomed patients of Fulani origin be especially closely monitored for adverse reactions, that hospitals receiving these patients be appropriately resourced to manage both envenoming and adverse reactions and that premedication with adrenaline should be considered. Our findings provide an argument for speculation on the
influence of immunological or lifestyle-related differences on the occurrence of early adverse reactions to antivenom.
| Item Type: | Article | ||||
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| Subjects: | QW Microbiology and Immunology > Antigens and Antibodies. Toxins and Antitoxins > QW 630 Toxins. Antitoxins WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Animal Poisons > WD 410 Reptiles |
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| Faculty: Department: | Biological Sciences > Department of Tropical Disease Biology | ||||
| Digital Object Identifer (DOI): | https://doi.org/10.1371/journal.pntd.0009518 | ||||
| Depositing User: | Cathy Waldron | ||||
| Date Deposited: | 23 Aug 2021 12:16 | ||||
| Last Modified: | 25 Jul 2023 10:49 | ||||
| URI: | https://archive.lstmed.ac.uk/id/eprint/18736 |
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