University of Adelaide researchers are leading an international project aimed at saving some of the thousands of people who die each year from venomous snakebites in the South-East Asian nation of Myanmar.
Snakebites are a major public health issue in Myanmar (Burma), mainly among rural poor people who work in agricultural areas, such as in rice paddies. Although actual figures are not currently known, an estimated 2000 people die each year following snakebite in Myanmar, many as a result of acute renal failure caused by the bite.
Australia's Department of Foreign Affairs and Trade (DFAT) has awarded the University of Adelaide $2.3 million for a three-year project to help improve the management of snakebite patients in Myanmar and – in partnership with leading Australian antivenom producer bioCSL – to improve the quality, quantity and availability of antivenom.
The research team will work with industry and government bodies to identify and implement changes that have the potential to save lives. Their work will involve population studies, to help better target the distribution of antivenom, as well as first aid education and building capacity in clinical care at a local level.
"With the combination of quality healthcare systems and research, and an outstanding antivenom industry, Australia is uniquely placed to play a global leadership role through this humanitarian work," says project leader Dr Chen Au Peh, Clinical Senior Lecturer in the University's School of Medicine and a Consultant Renal Physician with the Royal Adelaide Hospital.
"Snakebite is one of the world's most neglected tropical diseases. A severe bite from a Russell's viper – one of the most common deadly snakes in Myanmar – requires antivenom within the first 1-3 hours, otherwise the patient risks severe renal failure and death. Unfortunately for many snakebite victims, they are in remote regions with little access to antivenom, and often do not receive the care they need within the required time," Dr Peh says.
Team member Associate Professor Julian White, from the Toxinology Department at the Women's and Children's Hospital, and the University's School of Paediatrics and Reproductive Health, says: "Australia is well known for having some of the deadliest snakes in the world, but in reality we have only 600-1000 snakebites each year, and only a couple of deaths. Myanmar has at least 14,000 snakebites a year, which is a conservative estimate – the actual figure could be three times higher than that."
Team member Dr Afzal Mahmood, of the University’s School of Population Health, says the Myanmar government helps to subsidise the cost of antivenom treatment. "But there are additional costs for patients, such as transport and accommodation, and these can amount upwards of US$700. This can be more than a year's income. Even if the patient survives, the impact of snakebite on the farming poor is severe.
"The project will help address these costs, by ensuring higher quality antivenom is in the right places at the right time, and by improving clinical care, thereby reducing hospital stays," Dr Mahmood says.
The project, funded under DFAT's Government Partnerships for Development program, builds on years of close association between University of Adelaide health researchers and the Myanmar health sector.
Collaborators on the project include bioCSL, South Australian-based Venom Supplies, four Myanmar government Ministries (Industry, Health, Forestry and Livestock), and researchers from the University of Sydney, University of Oxford, CSIRO, and the Royal Adelaide Hospital and Women's and Children's Hospital.