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.

<h4>Background</h4>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...

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Autores principales:	Stefanie K Menzies, Aniekan O Thomas, Frank-Leonel Tianyi, Saidu B Abubakar, Abdulsalami Nasidi, Nandul Durfa, Rohit Patel, Anna Trelfa, David G Lalloo, Abdulrazaq G Habib, Robert A Harrison
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4b4121fa6d47467a88623d784e6387a6
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spelling	oai:doaj.org-article:4b4121fa6d47467a88623d784e6387a62021-12-02T20:23:40ZLivestock 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.1935-27271935-273510.1371/journal.pntd.0009518https://doaj.org/article/4b4121fa6d47467a88623d784e6387a62021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009518https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 herders had a higher incidence of early adverse reactions compared to patients who were neither Fulani nor herders (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).<h4>Interpretation</h4>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.Stefanie K MenziesAniekan O ThomasFrank-Leonel TianyiSaidu B AbubakarAbdulsalami NasidiNandul DurfaRohit PatelAnna TrelfaDavid G LallooAbdulrazaq G HabibRobert A HarrisonPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 8, p e0009518 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Stefanie K Menzies Aniekan O Thomas Frank-Leonel Tianyi Saidu B Abubakar Abdulsalami Nasidi Nandul Durfa Rohit Patel Anna Trelfa David G Lalloo Abdulrazaq G Habib Robert A Harrison 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.
description	<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 herders had a higher incidence of early adverse reactions compared to patients who were neither Fulani nor herders (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).<h4>Interpretation</h4>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.
format	article
author	Stefanie K Menzies Aniekan O Thomas Frank-Leonel Tianyi Saidu B Abubakar Abdulsalami Nasidi Nandul Durfa Rohit Patel Anna Trelfa David G Lalloo Abdulrazaq G Habib Robert A Harrison
author_facet	Stefanie K Menzies Aniekan O Thomas Frank-Leonel Tianyi Saidu B Abubakar Abdulsalami Nasidi Nandul Durfa Rohit Patel Anna Trelfa David G Lalloo Abdulrazaq G Habib Robert A Harrison
author_sort	Stefanie K Menzies
title	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.
title_short	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.
title_full	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.
title_fullStr	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.
title_full_unstemmed	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.
title_sort	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.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4b4121fa6d47467a88623d784e6387a6
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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.

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