[Snake bites and antivenom availability in the urban community of Niamey, Niger].

In order to appreciate certain aspects of the epidemiology of snake bites and the availability of antivenom in Niamey (the capital of Niger), we performed a series of retrospective and prospective studies. The retrospective study involved 175 snake bite patients hospitalised from 1 January 1997 to 31 December 1999 in the internal medicine and surgery wards of the two national hospitals of Niamey. The average age of patients was 29 years, with 3 years and 80 years as limits. The average number of snake bites was 58 cases per year with an annual incidence of approximately 10 cases for 100,000 inhabitants. Males were mainly concerned with a sex-ratio of 2.4 (124 males versus 51 females). Snake bites involved mostly teenagers (29.1%). 84.6% of bites occurred in persons aged 15 to 60 years. Incidence was higher during the farming period: 65% of cases occurred between June and October. Lethality reached 6.9%. However, 25.7% of the patients left hospital without staff permission before the end of the treatment. Complications represented 4.6% of the cases and consisted in necrosis, gangrene and coagulopathy. The treatment protocol was inconsistent, such that both therapeutic algorithm and formation are necessary. The prospective survey involved 41 pharmacies or drug middlemen and hospital drug stocks, prospected from 1 January to 31 May 2000. Antivenom was available in 1 hospital and 1 pharmacy and stocks could be considered sufficient for 1 year. However, it appeared that the supply policy had not been clearly defined.