Early severity predictors of snakebite envenomation in the southern region of Tunisia

• 作 者: Godpower Chinedu Michael
• 机 构: Department of Family Medicine,Aminu Kano Teaching Hospital,PMB 3452 Kano,Nigeria;Africa-Middle East
• 出 处: 急性病杂志（英文版）
• 发表日期: 2022年2期

I read with interest the paper by Chakroun-Walha et al.[1]; it is a retrospective review of the medical records of patients with a history consistent with snakebite in a region of Tunisia. It found that leucocytosis within the first 24 h of emergency department arrival and prior tourniquet application were the independent predictors of severe snakebite envenoming. Although it is a baseline study, I am delighted that authors are at the forefront in showcasing snakebite envenoming, a neglected tropical disease, in North Africa. However, I have few observations:rnFirst, I doubt the utility of leucocytosis in predicting severe envenoming in snakebite victims presenting at rural health centres of low and middle-income countries (who first receive most snakebite cases). This is because the resources for obtaining a complete blood count may be lacking. However, bedside 20 min whole blood clot test has been recommended to diagnose coagulopathy in this setting[2]; it does not require expensive equipment and training and ensures timely administration of anti-snake venom if indicated.