Snake bites are well-known medical emergencies
in many parts of the world, especially in rural areas.
The
incidence of snake bite mortality is particularly high in South-East Asia, home
to many different venomous snakes, and farmers, rural workers and children are
often the most at risk. In 2009, snake bites were included in WHO’s list of
neglected tropical diseases, recognising how snake bites represent a common
occupational hazard and result in thousands of deaths and chronic physical
handicap cases every year.
Much is
now known about the species of venomous snakes responsible for these bites and
the clinical effects of their venom in humans. In Myanmar, the most common
venomous snakes are the Russell’s viper (Daboia siamensis) – responsible for
almost 90% of bites in the country, the Monocellate cobra (Naja kaouthia) and
the Banded krait (Bungarus fasciatus), which are widespread throughout the
nation.
In 1999,
the Ministry of Health initiated a programme for the management and prevention
of snake bites, with technical support from WHO especially in terms of capacity
building. Fellowships are provided to both staff members of the MoH and of the
Myanmar Pharmaceutical Factory to conduct research in different institutions of
the South East Asia region and receive training on the production of anti-snake
venom and the clinical management of snake bites. In-country training is also
provided to health personnel, especially in high risk townships where the occurrence
of snake bites is most frequent.
The Anti
Snake-Venom Production Centre of the Ministry of Industry in Yangon is one of
the high-technology facilities that have benefitted from the collaboration with
external partners, in particular Australian, Brazilian (Instituto Butanta, Sao
Paulo, Brazil) and Thailand (Thai Red Cross) institutions” . The Production
centre is responsible for the nationwide production of anti-venom, and is now
able to cover for the country’s needs thanks to increased investments and the
implementation of new technologies.
Thanks to
improvements in all steps of the production process – from ensuring better
health and survival rates of horses and sheep, from which the anti-venom
anti-bodies are extracted, to using new purification methods to improve the
quality of the product – the Production Centre has been able to increase
production of specific anti-venom vials (anti-viper and anti-cobra the two most
common forms of snake bites) from around 30,000 in 2007-08 to 80,000 vials in
2015-16”.
The
production of anti-venom is essential to ensure that the consequences of
snake-bites can be mitigated: around 8 vials are needed to treat a single bite,
and there is a limited time span (only 3-4 hours after the bite) within which
the anti-venom can be fully effective. The time limitations for treatment call
for an increased dissemination of anti-venom across the country, in particular
in Rural and Sub-rural health centres, where most cases are likely to be
reported. In order to tackle the difficulties of storing the anti-venom vials
and prolonging their shelf life, the Ministry of Industry and the MPF Anti
Snake -Venom Production Centre has implemented a new technology for producing
anti-venom, which will allow the lyophilisation of the product to ensure its
durability and prolonging its effectiveness even in more difficult storage
conditions.
WHO
remains committed to supporting the Ministry of Health and the Ministry of
Industry in improving the production and dissemination of anti-venom across the
country, to ensure that this important public health threat for Myanmar can be
effectively managed and controlled.
No comments:
Post a Comment