@article{fdi:010073047,
  title = {{D}elayed double reading of whole blood clotting test ({WBCT}) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation},
  author = {{B}enjamin, {J}. {M}. and {C}hippaux, {J}ean-{P}hilippe and {S}ambo, {B}. {T}. and {M}assougbodji, {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he whole blood clotting test ({WBCT}) is a simple test of coagulation that is often used in the assessment, diagnosis, and therapeutic monitoring of snakebite patients in sub-{S}aharan {A}frica. {WBCT} requires only a clean glass tube and several milliliters of venous blood and is ideal for use in poorly equipped health centers throughout the rural areas where 95% of snakebites occur. {H}owever, questions surrounding the accuracy and reliability of the test remain unanswered due to variations in testing conditions and a lack of comparative research with which to validate them. {T}his is the first study to evaluate {WBCT} results at both 20-min ({WBCT}20) and 30-min ({WBCT}30) reading times in the same group of snakebite patients. {M}ethods: {I}n order to define the best reading time, the authors compared the results of serial {WBCT} evaluation at both 20 and 30 min after collection in 23 patients treated for snake envenomation in {B}embereke, northern {B}enin. {R}esults: {WBCT} results were identical at both reading times in patients without coagulopathy or when coagulation was restored permanently following a single dose of antivenom. {O}ut of 17 patients with coagulopathy, 14 showed discrepancies between {WBCT}20 and {WBCT}30 results in at least one pair of serial evaluations. {T}hese could be completely contradictory results (e.g. normal clot at {WBCT}20 and no clot at {WBCT}30) or a marked difference in the quality of the clot (e.g. no clotting activity at {WBCT}20 and an unstable partial clot at {WBCT}30). {WBCT} discrepancies were encountered most frequently in three situations: initial normalization of hemostasis following antivenom therapy, detection of a secondary resumption of coagulopathy, or final restoration of hemostasis after a secondary resumption had occurred. {C}onclusions: {T}his study suggests that the {WBCT} is robust and that a sequential reading should improve the diagnosis and monitoring of venom-induced coagulopathies. {I}t also indicates the possibility of discrepancies in the sensitivity of {WBCT}20 and {WBCT}30 for detecting the resolution or reoccurrence of coagulopathy and identifies how these findings, if confirmed, may be used to increase the efficacy and efficiency of antivenom treatment in the field.},
  keywords = {{A}frica ; {S}nakebite ; {E}chis ; {E}nvenomation ; {W}hole blood clotting test ; {WBCT} ; {V}enom-induced consumption coagulopathy ; {C}arpet viper ; {S}aw-scaled viper ; {BENIN} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{J}ournal of {V}enomous {A}nimals and {T}oxins {I}ncluding {T}ropical {D}iseases},
  volume = {24},
  numero = {},
  pages = {art. 14 [12 p.]},
  ISSN = {1678-9199},
  year = {2018},
  DOI = {10.1186/s40409-018-0151-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073047},
}