Evaluation of Snakebite Cases in Assiut Governorate, Egypt (Prospective Study)

November 21, 2024 updated by: Rania Alkady Mohamed, Assiut University
  1. Study the sociodemographic profile of snakebite victims in Assiut Governorate.
  2. Portray the clinical profile of snakebite victims admitted to Assiut University , El Eman General Hospital and Assiut General Hospital.
  3. Assess the predictors of severity and outcome of cases.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Snake's envenomation is a serious socio-medical problem, which causes considerable mortality and morbidity, with approximately 125,000 deaths worldwide annually. There were 4.5 to 5.4 million bites every year, and of those figures, 40-50% had some clinical disability as a result. Furthermore, the death from such an issue could go somewhere between 80,000 and 130,000 individuals each year. In the Middle East and North Africa, there are over 70,000 snakebites bites each year.

There are many species of snakes, approximately 3,700 species of snakes worldwide only about 15% are venomous belong to the four large families including Viperidae, Colubridae, Elapidae and Atractaspidinae. Two of these toxic species are widespread in Egypt; the family Viperidae and the family Elapidae Egyptian copra Naja Haje.

Snake venoms are complex mixtures consisting of enzymatic components e.g., proteolytic enzymes e.g., serine protease and metalloproteases (SVMPs), non-enzymatic components e.g., cysteine-rich secretory proteins (CRISP), amines, lipids, nucleotides, and carbohydrates. Venoms also contain inorganic cations that are presumed to function as cofactors and include sodium, calcium, potassium, magnesium, and zinc.

Snake venoms are usually classified as hemotoxic or neurotoxic. Snakes of the Viperidae family have venom containing proteins that can disrupt the coagulation cascade, the hemostatic system and tissue integrity. In contrast, neurotoxic venoms, which are typical of the Elapidae snakes, contain several toxins that primarily affect the peripheral nervous system, in particular the neuromuscular junction.

Depending on the species of snakes, manifestations can be localized symptoms of mild pain, progressive edema, ecchymosis, and tissue necrosis and generalized ones as spontaneous bleeding e.g., bleeding per gums, epistaxis, hematuria, vaginal bleeding, hematemesis, hematochezia, hemoptysis, hemolytic anemia and hemolytic jaundice with hemototoxic snake venom. In severe cases patients may develop acute renal, myocardial infarction, disseminated intravascular coagulation, or even death. Ptosis, diplopia, dysphagia, trunk and limbs weakness, and respiratory paralysis which can lead to respiratory failure and apnea with neurotoxic snake venom.

Study Type

Observational

Enrollment (Estimated)

49

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Cases will be collected from emergency departments, inpatient units of Assiut University Hospitals, El Eman General Hospital and Assiut General Hospital. All cases will be evaluated by detailed history, examination, investigations and through sheet which consist of:

  1. Detailed information regarding demographic and epidemiological parameters such as age, sex, residence, occupation, site, time and place of bite in addition to type of snake if identification was obtained.

  2. Clinical manifestations:

    • Local manifestations

    • Systemic manifestations

      • Hematological e.g., spontaneous bleeding like epistaxis, hematemesis, melena, and hematuria.
      • Neurological e.g., ptosis, dysphonia, dysphagia, and descending paralysis.
      • Cardiovascular e.g., dizziness, palpitation, faintness, hypotension, cardiac arrhythmias, and shock.
      • Respiratory e.g., tachypnea and shortness of breathing
    • The severity of envenomation will be assessed using the scoring and grading systems

Description

Inclusion Criteria:

  • Patients admitted with a reliable history of snakebite.
  • Presence of fang marks and/or signs of local and systemic envenomation.

Exclusion Criteria:

  • Fake or uncertain snakebites.
  • Patients with history of hematological disorders, liver diseases, renal diseases and anticoagulation therapy in the past week.
  • Patients who are not willing to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants with recovery
Time Frame: through study completion, an average of 1 year".
  1. Number of Participants with complete recovery.
  2. Number of Participants with recovery with disability and complications as amputation and renal failure, etc.
through study completion, an average of 1 year".
Number of Participants with Death
Time Frame: through study completion, an average of 1 year".
Any complication due to snake bite end with death as respiratory arrest, disseminated intravascular coagulation and renal failure.
through study completion, an average of 1 year".

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Study Director: Hala Mohammed Fathy, Professor, Assiut University
  • Study Director: Nora Zeidan Abdellah, Assistant lecture, Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 30, 2024

Primary Completion (Estimated)

December 30, 2025

Study Completion (Estimated)

January 30, 2026

Study Registration Dates

First Submitted

November 17, 2024

First Submitted That Met QC Criteria

November 21, 2024

First Posted (Estimated)

November 25, 2024

Study Record Updates

Last Update Posted (Estimated)

November 25, 2024

Last Update Submitted That Met QC Criteria

November 21, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Snakebites in Assiut Governate

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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