Snake bites rising in Nigeria

The Nigerian government has been paying, in recent time, more attention to the agricultural and mining sectors, in an attempt to diversify the economy.

But  government is ignoring a major area associated with the two industries: the menace and rising prevalence of snake bites. The victims of the reptiles are the people who will actualise government goal: the  farmers, cattle grazers, hunters, miners, rat-hunting youths and other active members of the society on the fields.

The  World Health Organisation says an estimated five million people are bitten by snakes each year globally, resulting into 100,000 deaths.

The picture is not different in Nigeria.

Statistics of snake bites obtained from some medical centres across the country indeed show a steady rise, with the Kaltungo General Hospital, Gombe, for instance recording an average of 16 to 20 cases everyday.

Records from the hospital showed that between 2005 and 2010,  a total of 12,398 snake bites were reported, with 55 deaths recorded. Many of the victims were from Gombe, Bauchi, Taraba and Adamawa States.

The situation is worse at the Zamko Comprehensive Centre, Langtang, a rural outreach health unit established by the Jos University Teaching Hospital (JUTH).

According to Nyam Azi, a medical doctor, who is on rural posting to Zamko, the cases of snake bites get higher during harvests as most farmers go without boots.

In November 2016, for instance, we recorded 280 cases. The situation keeps getting worse,” he said.

Azi  said that the number of victims could be higher because some of the victims consult traditional medicine men.

Most victims who visit the herbalists, he said,  could not afford  the anti-snake venom that costs an average of N27,000 a vial.
“Some usually require two, three or more vials, but since they cannot afford the cost, they seek alternative treatments. That is always dangerous because it could worsen their situation and lead to complications and even death, but they appear helpless,” he said.

He said that vials provided by government were not enough to meet the demand.

“Sometimes, 100 vials are sent to us, but we can exhaust that quantity in less than five days during the hot season,” he said.

Mr Tim Golu, a member of the House of Representatives representing Pankshin/Kanam/Kanke Federal constituency, who spoke on the rising cases of snakebites in his constituency, recently decried the high cost of the antivenom drug and urged government to supply more to help the rural dwellers.

But Dr. Nandul Durfa, Managing Director, EchiTAB Study Ltd, distributors of EchiTAB Anti-Snake Venom (ASV) in Africa, has said that bringing down the cost of ASV is only possible if the Federal Government establish an ASV producing factory.

Durfa told newsmen in Jos recently that a local factory would make the product cheap and available, and reduce mortality from  snake bites.

“We sell a dose at N30,000 to clients who, in turn, sell to the patients at their own rates,” he said.

He listed some of the major clients in Nigeria to include the Federal Ministry of Health, state governments, JUTH, Dalhatu Arab Hospital, Lafia, Federal Medical Centre, Yola, Bingham University Teaching Hospital, Jos, private medical outfits and individuals.

`If the ASV is produced in Nigeria, a dose could go for as low as N5,000,” the pioneer Chief Medical Director of the University of Abuja Teaching Hospital, said.

Durfa said that the ASV was produced in United Kingdom and had remained expensive because of the processes involved in manufacturing and importing it.

“Normally, we take the live snakes to Liverpool School of Tropical Medicine where they are killed and their venom extracted and sent to the manufacturing sites in Wales and Costa Rica. The drugs are produced there and brought to Nigeria.

“Aside the transport, the weather is different; we must ensure that the snakes are kept in a regulated temperature similar to what they are used to in Nigeria, so that they will not die.

“If we produce at home, we shall also ward off  the heavy amounts paid in foreign exchange to technicians in the UK, because salaries are lower here,” he said.

Durfa explained that local production of ASV would be “very easy” in Nigeria because the consultants had expressed their readiness to transfer the technology to the country.

“The consultants are willing to transfer the technology and also train local personnel to handle the processes. Nigeria must take full advantage of this kindness,” he added.

He said former President Olusegun Obasanjo approved the manufacturing of the ASV in 2006, but regretted that nothing came out it.

“Obasanjo approved a production cost of N2 billion and suggested that the money be sourced from the Millennium Development Goals (MDGs) fund; sadly, no money was made available for the project.”

Durfa explained that EchiTAB ASV, whose name is sourced from Echis ocellatus – the biological name for carpet viper – with TAB referring to Therapeutic Anti-Bodies, had three variants including EchiTAB G for carpet vipers responsible for 97 per cent cases of snake bites in Nigeria, and EchiTAB Plus for carpet viper, Puff Adder and Black Cobra venom.

>He traced the ASV’s production to 1991, when Prof. Ransome Kuti, then health minister, sought the assistance of two UK Professors – David Warrel of Oxford University and David Theakston of Liverpool School of Tropical Medicine.

‘`There was an acute shortage of ASV then, and the minister contacted the duo.

“The production processes went through various levels of screening and 11 clinical purification trials before the drugs were certified and registered by NAFDAC.

“The clinical trials were carried out in Kaltungo General Hospital, Gombe State, Zamko Comprehensive Health Centre, Langtang and Jos University Teaching Hospital,” he revealed.

He advised government to pay special attention to local production of the drug because snake bites affect mostly the productive group, and regretted that many had continued to die from a menace that could be effectively tackled.

“With government making agriculture a priority, there is always a link between farmers and snakes in the fields. Government must take steps to reduce the number of people being killed by this menace,” he said.

Durfa expressed deep concern over victims’ tendency to rush to native doctors who he described as “the greatest enemies of snake bite victims”.

“They (native doctors) keep the victims for a very long time just to get money. By the time such victims arrive the hospital, a lot of damage would have been done.

“We have often met with some of the native doctors; some of them see EchiTAB as an enemy, but we are creating more awareness so that no snake bite victim will die when he should live,” he said.

The ASV distributor said that EchiTAB was prepared for a Public-Private-Partnership with government as it had gone far in the handling of the product and would not be ready to completely surrender it.

“We are always ready to partner with government to produce the ASV and other medically relevant biological products. That cooperation will save a lot of lives,” he said.

But Dr. Adamu Atiku, a specialist in human medicine, says that the first step to establishing a factory for the local production of ASV must start with the Federal Government declaring snake bites as a national emergency in view of its prevalence.

“When government does that, it will give give special attention to the menace and adopt measures to curb it. One of such measures will naturally include the local production of ASV and the National Assembly will be compelled to see the need for a special vote for that project.”

With World Health Organisation records indicating an estimated five million people bitten by snakes each year, and an average of 100,000 deaths, it is indeed time for Nigeria to establish a factory for ASV.