%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Chippaux, Jean-Philippe
%A Amta, P.
%A Madec, Y.
%A Ntone, R.
%A Noël, G.
%A Clauteaux, P.
%A Boum, Y., II
%A Nkwescheu, A. S.
%A Taieb, F.
%T Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon
%D 2025
%L fdi:010094797
%G ENG
%J PLoS Neglected Tropical Diseases
%@ 1935-2735
%K CAMEROUN ; AFRIQUE SUBSAHARIENNE
%M ISI:001538431900009
%N 7
%P e0013195 [18 ]
%R 10.1371/journal.pntd.0013195
%U https://www.documentation.ird.fr/hor/fdi:010094797
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-09/010094797.pdf
%V 19
%W Horizon (IRD)
%X Background Species of the genus Echis, particularly those of the 'ocellatus' group, are responsible for the majority of snakebite envenomations and deaths in the savannas of sub-Saharan Africa. In a clinical study conducted in Cameroon, we treated a series of patients bitten by formally identified E. romani. The clinical outcomes are described and discussed.Methodology/Principal findings Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.Methodology/Principal findings Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.Conclusion/Significance This study confirms the frequency and severity of hemorrhagic complications in E. romani envenomation. Lethality remains high despite antivenom treatment. Cytotoxic syndromes, present in 95% of victims, rarely progress to extensive necrosis.
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