Photo-onycholysis associated with the use of doxycycline

Abstract

<h3>Objectives</h3> Envenoming resulting from snake bites is a serious public health problem in many regions of the world. The aim of this study is to describe the difficulties in the management of envenomation in the prefecture of San in Mali. <h3>Methods</h3> A retrospective study of snake bites cases, recorded in the Health Reference Center of San (Ségou region) in 2001–2003, was conducted. <h3>Results</h3> During the period of study, 88 victims were received and treated at the Health Reference Center of San. Of these, 42% were farmers and 6,8% shepherds. Adults 15 years and over were most commonly concerned because of their socio-professional activities (cattle breeding, gathering [3DOTS]). The majority (50,6% of reported cases) were occurred during fieldwork, 24,7% during nature walks and 9,4% during picking<i>.</i> Snakes belong to the Viperidae family (<i>Bitis arietans</i>, <i>Echis ocellatus</i>) and the Elapidae family (<i>Naja nigricolis</i>). In 50,6% of cases, the bite was on the lower limb<i>,</i> 48,2% on the upper limb and 1,2% on the trunk. According to data available, 28,4% of envenomated patients have benefited from antivenom administered intravenously. The average length of stay in hospital was 3 days, with a range of 12 hours to 11 days. Among the 29 cases for whom the evolution is known, 7 of them died. For other cases, the outcome was favourable with or without sequelae. <h3>Conclusions</h3> Concerted action is needed to ensure adequate supplies of effective antivenom to develop systems that deliver high quality health care.