Snake bites in Nigeria: A study of the prevalence and treatment in Benin City

Purpose: Although snake bites occur frequently in Benin City, the prevalence has not been documented. This study was therefore done to determine the prevalence, morbidity, mortality, and the orthodox treatment of victims. Methods: The study was retrospective and data on victims of snake bite covering a period of twenty years were obtained from the records as contained in the individual patients\' case files available at the University of Benin Teaching Hospital and Central Hospital, Benin City. Results: Males were twice more often bitten than females, and teenagers and youths in their early twenties constituted the peak age range of victims. Most victims (59.5%) were bitten in the bush or farm. The limbs were the commonest sites of bite with the feet (73.5%) and arms (20.9%) more frequently bitten; both the upper and lower right limbs were also more frequently bitten than the corresponding left limbs. All patients who showed symptoms of envenomation (68.3%) received polyvalent antivenom, 67.4% received antibiotics while over 90% of patients received antitetanus prophylaxis. Some of the patients (61.5 %) were treated with analgesics, while 17.2% and 82.3% received diazepam and intravenous fluids, respectively. Although there was a high degree of morbidity as shown by the long stay of many patients in the hospital (mean duration of stay by patients in hospital is 5.7±5.1 days; rang

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Research Article - Snake bites in Nigeria: A study of the prevalence and treatment in Benin City

Purpose: Although snake bites occur frequently in Benin City, the prevalence has not been documented. This study was therefore done to determine the prevalence, morbidity, mortality, and the orthodox treatment of victims. Methods: The study was retrospective and data on victims of snake bite covering a period of twenty years were obtained from the records as contained in the individual patients' case files available at the University of Benin Teaching Hospital and Central Hospital, Benin City. Results: Males were twice more often bitten than females, and teenagers and youths in their earlytwenties constituted the peak age range of victims. Most victims (59.5%) were bitten in the bush or farm. The limbs were the commonest sites of bite with the feet (73.5%) and arms (20.9%) more frequently bitten; both the upper and lower right limbs were also more frequently bitten than the corresponding left limbs. All patients who showed symptoms of envenomation (68.3%) received polyvalent antivenom, 67.4% received antibiotics while over 90% of patients received antitetanus prophylaxis. Some of the patients (61.5 %) were treated with analgesics, while 17.2% and 82.3% received diazepam and intravenous fluids, respectively. Although there wasa high degree of morbidity as shown by the long stay of many patients in the hospital (mean duration of stay by patients in hospital is 5.7±5.1 days; range <1-23 days), mortality was not recorded. Conclusion: It is concluded that there is a high prevalence of snake bites with high morbidity especially among the very active youthful segment of the Benin City population