Effect of Envenomation on Serum Hepatic Biomarkers in Snake (Echis Ocellatus) Bitten Individuals in Zamko Comprehensive Health Centre of the Jos University Teaching Hospital, North Central Nigeria

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Abdulazis longwap
Innocent Emmanuel
Ayuba Affi
Lucius Imoh
Mashor Mbwas
Titus Dajel
Ibrahim Bawa
Adamu Sani
Fredrick Akpagher
Alfred Odo
Christian Isichei
Yakubu Ajang
Simeon Adebisi
Fatima Salihu

Keywords

Envenomation, Snakebite, Hepatocellular, Biomarkers

Abstract

Background: Snake bite is a neglected public health issue in many tropical and subtropical countries of the world. About 5.4 million snakebites occur each year, resulting in 1.8 to 2.7 million cases of envenomation yearly. Hepatic markers have been reported to rise 3-6 hours after injection of venom in experimental animals. This study aims to biochemically assess ALT, AST, and GGT levels as biomarkers of Echis ocellatus envenomation in victims of snake bite presenting at JUTH Comprehensive Health Centre Zamko 6 hours post-bite and compare with values in those bitten by non-venomous snakes.


Methodology: The study was a comparative cross-sectional study where serum levels of AST, ALT, and GGT were compared between the study group and the control group.


Results: Of the 150 respondents, 75 from each study group, 90(60.0%) were Male while 60(40.0%) were Female, with a Male to Female ratio of 1.5:1. The most predominant age group was 20-29 years 57(38.0%), the mean age was 39 years. The most predominant occupation was farming 82(54.7%). The majority 82(54.7%) had a secondary level of education. 91(60.7%) were married. A large majority of 123(82.0) had Christianity as their religion. We found a significant increase in the levels of AST (47.45IU/L) and GGT (61.62 IU/L) in the study group compared to AST (25.88IU/L), GGT (29.61IU/L) in the control group at p<0.05, while the level of ALT was similar in both groups at p>0.05.


Conclusion: This implies that serum levels of AST and GGT can be used to diagnose envenomation in snakebite patients.

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References

1. WHO. Snakebite envenoming. Available at https://www.who.int/health-topics/snakebite#:~:text=After%20a%20bite%20by%20a,do%20not%20cause%20immediate%20death.[Accessed June 2023]

2. Ekwere E, Ede S, McNeil R, Aguiyi J. Prevalence of snakebites in Taraba and Plateau States of Nigeria. Journal of Pharmacy & Bioresources. 2011;7(1):26–36.

3. Madaki J, Obilom R, Mandong B. Clinical Presentation and Outcome of Snake-Bite Patients at Zamko Comprehensive Health Centre, Langtang, Plateau State. Highland Med Res J. 2004;2(2):61–7.

4. Aguiyi JC, Igweh AC, Egesie UG, Leocini R. Studies on possible protection against snake venom using Mucuna pruriens protein immunization. Fitoterapia. 1999;70(1):21–4.

5. Al Asmari AK, Khan HA, Banah FA, Al Buraidi AA, Manthiri RA. Serum biomarkers for acute hepatotoxicity of echispyramidum snake venom in rats. Int J Clin Exp Med. 2015;8(1):1376–80.

6. Jeyarajah R. Russell's viper bite in Sri Lanka. A study of 22 cases. Am J Trop Med Hyg. 1984 May;33(3):506-10.

7. Williams HF, Vaiyapuri R, Gajjeraman P, Hutchinson G, Gibbins JM, Bicknell AB, et al. Challenges in diagnosing and treating snakebites in a rural population of Tamil Nadu, India: The views of clinicians. Toxicon. 2017; 130:44–6.

8. Thabane L. Sample Size Determination in Clinical Trials HRM-733 Class Notes. In 2004. p. 31.

9. Jarrar BM. Histological alterations and biochemical changes in the liver of sheep following Echiscoloratus envenomation. Saudi J Biol Sci. 2011;18(2):169–74.

10. Ogundipe L. Sample size determination in clinical research: 2. Hospital Medicine. 2000;61(11):797–8.

11. Ralph R, Faiz MA, Sharma SK, Ribeiro I, Chappuis F. Managing snakebite. BMJ. 2022 Jan 7;376: e057926.doi: 10.1136/bmj-2020-057926.

12. Francis MF, Vianney SJM, Heitz-Tokpa K, Kreppel K. Risks of snakebite and challenges to seeking and providing treatment for agro-pastoral communities in Tanzania. PLoS One. 2023 Feb 1;18(2 February).

13. Nimzing T, Arigbede YA, Muhammad I. Examination of Snakebite Prevalence and Factors Predispose to Bite in Langtang North, Plateau State, Nigeria. Fudma Journal of Sciences. 2022 Jul 2;6(3):130–7.

14. Ekwere E, Ede S, McNeil R, Aguiyi J. Prevalence of snakebites in Taraba and Plateau States of Nigeria. Journal of Pharmacy & Bioresources. 2011 Jul 8;7(1).

15. Francis MF, Vianney SJM, Heitz-Tokpa K, Kreppel K. Risks of snakebite and challenges to seeking and providing treatment for agro-pastoral communities in Tanzania. PLoS One 2023 Feb 10;18(2):e0280836. doi: 10.1371/journal.pone.0280836.

16. Madaki JKA, Obilum RB, Mandong BM. Pattern of first-aid measures used by snakebite patients and clinical outcomes at Zamko Comprehensive Health Centre, Langtang, Plateau State. Nig Med Pract 2005;48(1):10– 13.

17. Leisewitz AL, Blaylock RS, Kettner F, Goodhead A, Goddard A, Schoeman JP. The diagnosis and management of snakebite in dogs--a southern African perspective. J S Afr Vet Assoc 2004;75(1):7-13.

18. Barraviera B. Liver Dysfunction in Patients Bitten by Bothrops and Crotalus Snakes in Botucatu (State Of São Paulo) Brazil: Experimental Hepatic Study in Wistar Rats Inoculated with Crotalus Durissus Terrificus (Laurenti, 1768) Venom. Journal of Venomous Animals and Toxins 1995;1(1):39–39.

19. Asmari AKA, Khan HA, Banah FA, Buraidi AA, Manthiri RA. Serum biomarkers for acute hepatotoxicity of echispyramidum snake venom in rats. Int J Clin Exp Med. 2015;8(1):1376–80.

20. Jarrar BM. Histological alterations and biochemical changes in the liver of sheep following Echiscoloratus envenomation. Saudi J Biol Sci 2011;18(2):169–74.

21. Martin A. Crook. Clinical Biochemistry & Metabolic Medicine. 8th ed. 2012. 272–276 p.

22. Wakasugi M, Kawagishi T, Hatano T, Shibuya T, Kuwano H, Matsui K. Case report: Treatment of a severe Puff adder snakebite without antivenom administration. American Journal of Tropical Medicine and Hygiene 2021;105(2):525–7.

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